Fibrinolysis

Unable to Obtain Dimer Result on Xarelto

From Heather DeVries, Indiana University Health. Hi George! We use the DDHS kit from IL on our TOP series instruments. There is a cancer patient at one of our facilities who has not been able to get a dimer result while on Xarelto. From the error codes, it looks like it would be human anti-mouse […]

Anticoagulant Therapy

D-dimer AMR and CRR

From Heather DeVries, Indiana University: Greetings George! The labs within our system have been discussing our reportable range for D-dimers. Our vendor’s stated limit is beyond what calculates from our AMR and maximum dilution. We are debating changing our reportable range to what we calculate, and stop using the vendor’s limit so that we truly […]

D-dimer Interference

With reference to our September 8, 2016 discussion entitled Still More on Xarelto and D-dimer, attached is information on another individual with whom I have been corresponding for several months whose D-dimer remains moderately to markedly elevated but whose lab results have demonstrated there is no human anti-mouse antibody or rheumatoid factor present. This person, […]

Still More on Xarelto and D-dimer

Here is further follow-up on our April 13 discussion entitled Xarelto and D-dimer (click or tap). In summary, a patient who was on Xarelto had markedly elevated D-dimer results reported by the laboratory where the patient was being treated, but normal D-dimer results when tested at two other laboratories using alternate technologies. George has since […]

More on Xarelto and D-dimer

Dr. Jeanine Walenga, Clinical Coagulation Laboratory Director at Loyola University Medical Center added a helpful comment to our April 13, 2016 discussion about Xarelto and D-dimer. Click here to see the discussion and her comment.

Anticoagulant Therapy

D-dimer Questionnaire

Remember that D-dimer questionnaire link that we asked you to post on Fritsma Factor in early November of 2014?: https://docs.google.com/forms/d/1IVMqgIsZRN_rqbv2PdhPoerRB6UERXdEuCi0Czr-7m0/viewform?usp=send_form. Well, we had a look at the responses and greater than 90% have come from Europe/Australia. Seems that North Americans don’t do D-dimers! We are keeping the link open indefinitely. It would be good to […]

More on Unexplained Elevated D-dimer

Here is an update to Tony Tang’s D-dimer post from Fritsma Factor technical advisor Donna Castellone, QA Manager, Specialty Testing and Supervisor, Special Coagulation and Hematology at New York Presbyterian-Columbia. Donna writes, my input on TEG is limited, however I agree with what you said. Tony can also look at factor V and protein C to […]

Unexplained Elevated D-dimer

From Tony Tang: Dear George, recently we met a 1 year old child with serious hepatitis, the results of coagulation tests were as follows: PT: 26s, APTT: 56s, FIB: 1.07 g/L, TT: 23s, D-dimer: greater than 80 ug/mL FEU, FDP: greater than 360 ug/mL, AT-III: 54%, factor VIII: 212%, PLT count: 102 X 109/L (and […]

More on Age-Adjusted D-dimer Limits

I’d like to draw your attention to the numerous and insightful responses to Sylvia Stacy‘s question about applying age-adjusted D-dimer limits to venous thromboembolic disease diagnosis, especially Dr. Giuseppe Lippi’s entry with a link to his brief questionnaire, which he intends to keep open through February, 2015. Let’s give Dr. Lippi as many responses as possible.

Age-adjusted D-dimer Limit?

Hi George, I am wondering if anyone is using the age-related D-dimer cutoff for the emergency room based on the ADJUST-PE study? We use Innovance D-dimer reagents from Siemens on the BCS XP analyzer. Our ER physicians are very impatient for us to allow them to use this age-adjusted cut-off, but we have reservations due […]

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George Fritsma is a medical laboratory scientist, educator, and author. George is a member of the International Society on Thrombosis and Hemostasis, the International Society for Laboratory Hematology, and the American Society for Clinical Laboratory Science.

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