A Case of False Elevation of D-Dimer and Elimination Methods.
Journal
Clinical laboratory
ISSN: 1433-6510
Titre abrégé: Clin Lab
Pays: Germany
ID NLM: 9705611
Informations de publication
Date de publication:
01 Jun 2024
01 Jun 2024
Historique:
medline:
13
6
2024
pubmed:
13
6
2024
entrez:
13
6
2024
Statut:
ppublish
Résumé
There are many methods for the detection of D-dimer in clinical laboratories. Immunoturbidimetric assays are widely used because of its high sensitivity and specificity [1-3]. However, this method may be affected by the interference of rheumatoid factor (RF), heterophilic antibodies, and other unknown proteins, and its falsity will increase, thus affecting clinical diagnosis. This paper reports the cause analysis of a case of spurious D-dimer increase and four corresponding elimination methods: double dilution of the original specimen, detection of fibrin degradation product (FDP) level, addition of heterophilic blocking reagent, and comparison between different instruments. It was confirmed that there were special antibodies in the patient's body by four methods, which had non-specific reactions with D-dimer reagents, resulting in false increases of results. When the coagulation function results of patients show isolated increases in D-dimer, or the results are inconsistent with clinical symptoms, laboratory personnel should consider the possibility of interference factors, and conduct effective treatment to obtain correct test results, and thus reduce the occurrence of medical adverse events caused by inaccurate test results.
Sections du résumé
BACKGROUND
BACKGROUND
There are many methods for the detection of D-dimer in clinical laboratories. Immunoturbidimetric assays are widely used because of its high sensitivity and specificity [1-3]. However, this method may be affected by the interference of rheumatoid factor (RF), heterophilic antibodies, and other unknown proteins, and its falsity will increase, thus affecting clinical diagnosis.
METHODS
METHODS
This paper reports the cause analysis of a case of spurious D-dimer increase and four corresponding elimination methods: double dilution of the original specimen, detection of fibrin degradation product (FDP) level, addition of heterophilic blocking reagent, and comparison between different instruments.
RESULTS
RESULTS
It was confirmed that there were special antibodies in the patient's body by four methods, which had non-specific reactions with D-dimer reagents, resulting in false increases of results.
CONCLUSIONS
CONCLUSIONS
When the coagulation function results of patients show isolated increases in D-dimer, or the results are inconsistent with clinical symptoms, laboratory personnel should consider the possibility of interference factors, and conduct effective treatment to obtain correct test results, and thus reduce the occurrence of medical adverse events caused by inaccurate test results.
Identifiants
pubmed: 38868870
doi: 10.7754/Clin.Lab.2023.231229
doi:
Substances chimiques
Fibrin Fibrinogen Degradation Products
0
fibrin fragment D
0
Antibodies, Heterophile
0
Rheumatoid Factor
9009-79-4
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM