The main purpose of this Manual is to provide useful guidelines for the selection of pathology tests and to facilitate interpretation of results.
Contains a comprehensive listing of all genes from the Human Gene Nomenclature Committee (HGNC) database alongside laboratories and tests available in the country.
A manual for the process of macroscopic dissection in Anatomical Pathology laboratories.
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Keywords: DD, FDP, Fibrinogen degradation products
Citrate plasma.
D-Dimers are generated by the degradation of cross-linked fibrin during fibrinolysis. D-Dimer is detected using monoclonal antibodies specific for a specific epitope found on cross-linked D-Dimer molecules.
There are many commercial D-Dimer assays available, with different methodologies, different sensitivities, and different reporting units. The most commonly used automated D-Dimer assays utilise a latex particle agglutination method using bi-specific antibodies with binding sites for the latex particle and D-Dimer.
Results can be reported in D-Dimer Units (DDU) or Fibrinogen Equivalent Units (FEU), with FEU approximately 2-fold higher than DDU.
D-Dimer is an indirect measure of recent or ongoing fibrinolysis.The assay is used in the investigation of suspected disseminated intravascular coagulation (DIC), can be used in conjunction with clinical algorithm in the assessment of potential venous thromboembolism (VTE), and has been evaluated for determining duration of anticoagulation in patients with VTE as well as representing a potential prognostic marker for disease severity in SARS-CoV-2 infection.
D-Dimers are usually increased in DIC. Although D-Dimers are usually elevated in the setting of venous thromboembolism (VTE), D-dimers can also be increased in a variety of clinical situations including in patients with malignancy, pregnancy, recent surgery, liver disease, snake bite, or infection/inflammation and so have a low positive predictive value for VTE.
In a patient with a low pre-test probability of VTE, a normal result from a high-sensitivity D-Dimer assay has a high negative predictive value for DVT/PE when used as part of a defined clinical management algorithm.
Note: Results can be reported in D-Dimer Units (DDU) or Fibrinogen Equivalent Units (FEU), with FEU approximately 2-fold higher than DDU. It is important to be aware of the assay used and the reporting units, as well as being aware that normal values/cut-off values used in various algorithms are not transferable between methods.
Johnson ED, Schell JC, Rodgers GM. The D-dimer assay.Am J Hematol. 2019; 94: 833– 39.
Thachil J, Longstaff C, Favaloro EJ, Lippi G, Urano T, Kim PY; SSC Subcommittee on Fibrinolysis of the International Society on Thrombosis and Haemostasis. The need for accurate D-dimer reporting in COVID-19: Communication from the ISTH SSC on fibrinolysis. J Thromb Haemost. 2020; 18(9): 2408-11.
Linkins L-A, Takach Lapner S. Review of D-dimer testing: Good, Bad, and Ugly. Int J Lab Hem. 2017; 39(Suppl. 1): 98– 103
Pathology Tests Explained - D-dimer
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