Differential Diagnosis for Markedly Elevated D-Dimer in a 35-year-old Female without Symptoms of VTE
- Single Most Likely Diagnosis
- Recent surgery or trauma: A recent surgical procedure or trauma can cause an elevation in D-dimer levels due to the activation of the coagulation and fibrinolytic systems. This is a common and likely explanation for an elevated D-dimer in an asymptomatic patient.
- Other Likely Diagnoses
- Malignancy: Certain types of cancer, such as pancreatic or ovarian cancer, can cause an elevation in D-dimer levels due to the production of pro-coagulant factors.
- Infection or sepsis: Severe infections can cause an elevation in D-dimer levels due to the activation of the coagulation and inflammatory systems.
- Autoimmune disorders: Conditions such as lupus or rheumatoid arthritis can cause an elevation in D-dimer levels due to the production of autoantibodies that activate the coagulation system.
- Do Not Miss Diagnoses
- Pulmonary embolism (PE) with atypical presentation: Although the patient does not have symptoms of VTE, it is essential to consider the possibility of a PE, especially if the patient has risk factors such as obesity, immobility, or family history.
- Aortic dissection: An aortic dissection can cause an elevation in D-dimer levels due to the activation of the coagulation system. This is a life-threatening condition that requires prompt diagnosis and treatment.
- Rare Diagnoses
- Thyroid disorders: Certain thyroid conditions, such as hyperthyroidism, can cause an elevation in D-dimer levels due to the increased metabolic rate and activation of the coagulation system.
- Inflammatory bowel disease: Conditions such as Crohn's disease or ulcerative colitis can cause an elevation in D-dimer levels due to the chronic inflammation and activation of the coagulation system.