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Clinical Usefulness of D-dimer Test with Semiquantitative Latex Agglutination Method in Pulmonary Embolism  

Kim, Dong Kyun (Department of Internal Medicine, College of Medicine, Soonchunhyang University)
Chun, Kang Il (Department of Internal Medicine, College of Medicine, Soonchunhyang University)
Kim, Yang-Ki (Department of Internal Medicine, College of Medicine, Soonchunhyang University)
Lee, Young-Mok (Department of Internal Medicine, College of Medicine, Soonchunhyang University)
Kim, Ki Up (Department of Internal Medicine, College of Medicine, Soonchunhyang University)
Uh, Soo-taek (Department of Internal Medicine, College of Medicine, Soonchunhyang University)
Kim, Yong Hoon (Department of Internal Medicine, College of Medicine, Soonchunhyang University)
Park, Choon Sik (Department of Internal Medicine, College of Medicine, Soonchunhyang University)
Park, No Jin (Department of Laboratory Medicine, College of Medicine, Soonchunhyang University)
Choi, Tae Youn (Department of Laboratory Medicine, College of Medicine, Soonchunhyang University)
Publication Information
Tuberculosis and Respiratory Diseases / v.59, no.6, 2005 , pp. 651-655 More about this Journal
Abstract
Background : Diagnosing a pulmonary embolism is difficult because its presenting symptoms are nonspecific and there are limitations with all of the objective tests. The D-dimer is known to be a marker of the lysis of intravascular cross-linked fibrin as a result of the activation of the endogenous fibrinolytic pathways, and the D-dimer assay is these an objective method for diagnosing a pulmonary embolism. This study assessed the benefits of the D-dimer test for diagnosing a pulmonary embolism using semiquantitative latex agglutination. Methods : The latex agglutination results of 185 patients were retrospectively reviewed. The D-dimer test was performed at the time a pulmonary embolism was suspected. Ninety patients(group I) were diagnosis with PE through spiral chest CT or a chest CT angiogram, perfusion/ventilation scans, and/or pulmonary angiogram. Ninety-five patients (group II) were found not to have a pulmonary embolism through the above tests. Results : The male to female ratio and mean age in groups I and II was 37:55, and 57 years old to 50:45 and 52 years old, respectively. When the cut off value for a positive D-dimer assay was set to $500{\mu}g$, the sensitivity, positive predictive value, negative predictive value and specificity was 86.7%, 61.4%, 79.3%, and 48.4%, respectively. Conclusion : The semiquantitative latex agglutination method in the D-dimer test has a lower sensitivity and negative predictive value than the well known ELISA test particularly for small emboli. Therefore, this test is not a suitable screening test for excluding a pulmonary embolism.
Keywords
Pulmonary embolism; D-dimer; ELISA; Latex agglutination;
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