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D-dimer Testing in Pulmonary Embolism with a Focus on Potential Pitfalls: A Narrative Review
Loris Wauthier1, Julien Favresse1,2, Michaël Hardy3
1Department of Laboratory Medicine, Clinique St-Luc Bouge, 5004 Namur, Belgium.
Diagnostics (Basel, Switzerland)
|November 26, 2022
Summary
D-dimer testing aids in ruling out pulmonary embolism (PE) and deep vein thrombosis (DVT) but requires careful laboratory assessment to avoid diagnostic errors. Understanding assay specifics and pre-analytical, analytical, and post-analytical phases is crucial for accurate results.
Area of Science:
- Clinical Biochemistry
- Hematology
- Diagnostic Medicine
Background:
- D-dimer is a key biomarker for coagulation and fibrinolysis activation.
- It is routinely used alongside clinical assessment to exclude pulmonary embolism (PE) and deep vein thrombosis (DVT).
Purpose of the Study:
- To review D-dimer testing for PE diagnosis.
- To discuss factors impacting laboratory assessment quality.
Main Methods:
- Literature review on D-dimer's role in PE/DVT diagnosis.
- Analysis of pre-analytical, analytical, and post-analytical variables affecting D-dimer assays.
Main Results:
- D-dimer's utility is assay-dependent and requires adherence to local guidelines.
- Diagnostic errors can occur across all testing phases (pre-analytical, analytical, post-analytical).
Conclusions:
- Accurate D-dimer interpretation necessitates understanding assay limitations and potential error sources.
- Quality control throughout the testing process is vital for reliable D-dimer results in diagnosing PE and DVT.
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