From the Research
Mononucleosis (mono) typically does not raise dimer levels. D-dimer is a blood test that measures a substance released when blood clots break down, and it's primarily elevated in conditions involving abnormal blood clotting such as deep vein thrombosis or pulmonary embolism 1. Infectious mononucleosis, caused by the Epstein-Barr virus, primarily affects the lymphatic system and causes symptoms like fatigue, sore throat, fever, and swollen lymph nodes 2. While mono can cause various blood abnormalities such as increased white blood cells (particularly lymphocytes) and mild liver function test elevations, it does not typically cause the blood clotting abnormalities that would lead to elevated D-dimer levels. Some studies have shown that D-dimer levels can be elevated in various conditions, including inflammation, thromboembolism, and disseminated intravascular coagulation 3, 4, but mono is not typically one of them. If a patient with mono shows elevated D-dimer levels, clinicians should consider other concurrent conditions that might explain this finding, as it would be unusual for mono alone to cause this laboratory abnormality. It's also worth noting that elevated D-dimer levels can be associated with inflammation and disease activity rather than risk of venous thromboembolism in certain conditions, such as granulomatosis with polyangiitis 5. However, based on the most recent and highest quality study, mono is not typically associated with elevated D-dimer levels 4.
Some key points to consider:
- D-dimer is a sensitive marker of intravascular thrombus and may be markedly elevated in disseminated intravascular coagulation, acute aortic dissection, and pulmonary embolus 3
- Elevations in D-dimer can occur in normal pregnancy, rising two- to fourfold by delivery, and also rises with age, limiting its use in those >80 years old 3
- D-dimer can be elevated in active malignancy and indicates increased thrombosis risk in active disease 3
- Elevated D-dimer following anticoagulation for a thrombotic event indicates increased risk of recurrent thrombosis 3