From the Research
A d-dimer level of 327 in a 16-year-old female with a BMI of 31.6 is not clinically significant. This value falls within the normal range, which is typically below 500 ng/mL FEU (Fibrinogen Equivalent Units), though reference ranges may vary slightly between laboratories. Despite the patient's elevated BMI, which can sometimes be associated with increased baseline d-dimer levels, this result does not suggest an active clotting process. D-dimer is a fibrin degradation product formed when blood clots are broken down, and elevated levels can indicate conditions such as deep vein thrombosis, pulmonary embolism, or disseminated intravascular coagulation. However, d-dimer has high sensitivity but low specificity, meaning that while a normal result like this helps rule out thrombotic disorders, an elevated result would require further investigation. In this case, no additional testing would be needed based solely on this d-dimer result, though clinical symptoms and other risk factors should always be considered in the overall assessment, as suggested by studies such as 1 which found that elevated plasma D-dimer levels are associated with increased risk of incident VTE, but also noted that D-dimer levels can be influenced by factors like BMI and inflammation. Key points to consider include:
- The patient's age and BMI
- The d-dimer level in relation to the normal range
- The potential for elevated d-dimer levels due to conditions other than thrombosis, as discussed in 2
- The importance of considering clinical symptoms and other risk factors in the overall assessment, as emphasized in 3. Given the most recent and highest quality evidence, such as the study published in 2022 2, the d-dimer level of 327 in this patient is not indicative of a significant thrombotic event, and therefore, no immediate action based solely on this result is required.