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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 .
This enzyme is released by damaged muscle, and levels above 1000 U/L (5 times the upper limit of normal (ULN)) indicate rhabdomyolysis. [5] More than 5000 U/L indicates severe disease but depending on the extent of the rhabdomyolysis, concentrations up to 100 000 U /l are not unusual.
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 ...
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A low level, however, is more consistent with the consumptive process of DIC. A rapidly declining platelet count High levels of fibrin degradation products, including D-dimer , are found owing to the intense fibrinolytic activity stimulated by the presence of fibrin in the circulation.
Lab tests and clinical monitoring show low blood oxygen, widened pulse pressure, increased cardiac output (early), potentially diminished cardiac output (late), high levels of nitrogen compounds in the blood, elevated D-dimer, elevated transaminases, factor I deficiency and excessive bleeding, higher-than-normal level of bilirubin. [5] [8]
Superficial vein thrombosis (SVT) is a blood clot formed in a superficial vein, a vein near the surface of the body. Usually there is thrombophlebitis, which is an inflammatory reaction around a thrombosed vein, presenting as a painful induration (thickening of the skin) with redness.
In European Americans, 2% of the variation in D-dimer levels is due to polymorphisms in various fibrinolysis-related genes such as fibrinogen, PAI-1 and plasminogen. In African Americans the sample was too small to establish any linkage. Fibrinogen mutations, in particular, explained D-dimer levels >20% higher than controls.