Differential Diagnosis for Elevated D-Dimer with No Evidence of Pulmonary Embolism
Single Most Likely Diagnosis
- Recent surgery or trauma: Elevated D-dimer levels can be seen after recent surgery or trauma due to the activation of the coagulation and fibrinolytic systems. This is a common and expected finding in these situations.
Other Likely Diagnoses
- Deep vein thrombosis (DVT): Although the question specifies no evidence of pulmonary embolism, DVT can still cause elevated D-dimer levels. It's essential to rule out DVT, especially if there are symptoms such as leg swelling or pain.
- Infection or sepsis: Certain infections, such as sepsis, can lead to elevated D-dimer levels due to the activation of the coagulation system.
- Cancer: Some types of cancer, such as pancreatic or ovarian cancer, can cause elevated D-dimer levels due to the production of pro-coagulant factors.
- Chronic inflammatory diseases: Conditions like rheumatoid arthritis or lupus can cause elevated D-dimer levels due to chronic inflammation.
Do Not Miss Diagnoses
- Aortic dissection: Although rare, aortic dissection can cause elevated D-dimer levels and is a life-threatening condition that requires prompt diagnosis and treatment.
- Disseminated intravascular coagulation (DIC): DIC is a serious condition that can cause elevated D-dimer levels and requires prompt recognition and treatment.
Rare Diagnoses
- Thyroid disorders: Certain thyroid disorders, such as hyperthyroidism, can cause elevated D-dimer levels, although this is a rare finding.
- Heparin-induced thrombocytopenia: This rare condition can cause elevated D-dimer levels due to the formation of antibodies against heparin.
- Antiphospholipid syndrome: This rare autoimmune disorder can cause elevated D-dimer levels due to the production of antiphospholipid antibodies.