Hello George, recently we’ve met two or three cases from paediatrics with unexplained massively elevated D-dimer. In these cases, PT
were normal, levels of fibrinogen were decreased (about 1.0-1.5g/L), different D-dimer reagents (STAGO AND IL
) got consistent results, levels of rheumatoid factors were normal, clot and hemolysis of specimens could be excluded, however the second specimen from the same patient often got a normal D-dimer result on the next day. Did they got a transient hyperfibrinolysis? or we could attribute these to abnormal sampling for children? Thanks for your suggestion.
Hello, Tony, and thank you for your question. I can think of no clinical circumstance in which the D-dimer could fluctuate from massively elevated to normal within the same day, and based on the other lab results you report, may consider a sampling error or interference by some form of therapy. It would be interesting, however, to learn of the patients’ age and clinical condition for these cases. Do any of our participants have any experience of such wide D-dimer fluctuations?