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The diagnosis of hyperfibrinolysis is made indirectly with immunochemical methods which detect the elevation of biomarkers such as D-Dimer (cross-linked fibrin degradation products), fibrinogen split products (FSP), complexes of plasmin and alpha-2-antiplasmin (PAP).
D-dimer (or D dimer) is a dimer that is a fibrin degradation product (FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two D fragments of the fibrin protein joined by a cross-link , hence forming a protein dimer .
Fibrinogen level was initially thought to be useful in the diagnosis of DIC but because it is an acute phase reactant, it will be elevated due to the underlying inflammatory condition. Therefore, a normal (or even elevated) level can occur in over 57% of cases. A low level, however, is more consistent with the consumptive process of DIC.
D-dimer levels in the blood may be elevated as a result of fibrin breakdown. [ citation needed ] On duplex ultrasound, demonstration of echogenic material within the portal vein, complete or partial absence of colour flow in the portal vein, presence of collateral vessels around the portal vein or gall bladder that bypass the portal vein.
Principles of D-dimer testing. Fibrin degradation products (FDPs), also known as fibrin split products, are components of the blood produced by clot degeneration. [1] Clotting, also called coagulation, at the wound site produces a mass of fibrin threads called a net that remains in place until the cut is healed. As a cut heals, the clotting ...
Pregnancy-induced hypercoagulability is probably a physiologically adaptive mechanism to prevent post partum hemorrhage. [1] Pregnancy changes the plasma levels of many clotting factors, such as fibrinogen, which can rise up to three times its normal value. [2] Thrombin levels increase. [3] Protein S, an anticoagulant, decreases.
Those who finish warfarin treatment after idiopathic VTE with an elevated D-dimer level show an increased risk of recurrent VTE (about 9% vs about 4% for normal results), and this result might be used in clinical decision making. [133] Thrombophilia test results rarely play a role in the length of treatment. [80]
In pregnancy, D-dimer is likely to be elevated and loses its use a diagnostic tool. No different normal range is used, because by increasing the cutoff you'd lose its sensitivity. In pregnancy clinical assessment and V/Q scanning is used. JFW | T@lk 19:06, 26 November 2006 (UTC)