From the Guidelines
Disseminated Intravascular Coagulation (DIC) Markers
The most sensitive marker for Disseminated Intravascular Coagulation (DIC) is the D-dimer, a fibrin degradation product that is elevated in the setting of fibrinolysis 1.
- A D-dimer level greater than 0.5 μg/mL is considered abnormal and indicative of DIC.
- The sensitivity of D-dimer for DIC is approximately 90-95%, making it a valuable diagnostic tool in clinical practice 1.
Comparison with Other Markers
In contrast, other markers such as:
- Fibrin degradation products
- Thrombin time
- Thromboplastin time are less sensitive and specific for DIC.
Key Considerations
- Variability in D-dimer assays: Different assays may have varying sensitivity and specificity, which can affect test results 1.
- Units of measurement: D-dimer can be reported in different units, such as fibrinogen equivalent units (FEU) or D-dimer units (DDU), which can lead to confusion if not properly interpreted 1.
- Clinical context: D-dimer levels should be interpreted in the context of the patient's clinical presentation and other laboratory results 1.
- Cutoff values: The cutoff value for D-dimer may vary depending on the assay and clinical context, and age-related cutoffs should be considered 1.
From the Research
Diagnostic Markers for Disseminated Intravascular Coagulation (DIC)
The most sensitive marker for DIC is a topic of interest in the medical field, with various studies investigating the efficacy of different diagnostic tests.
- D-dimer is considered a valuable marker for the diagnosis of DIC, with high sensitivity and specificity 2, 3, 4, 5.
- The study by 2 found that D-dimer had an area under the receiver-operating characteristic curve of 0.97 and 0.98 for diagnosing DIC and nonovert DIC, respectively.
- Another study by 5 concluded that the D-dimer assay was abnormal in 93.7% of patients with DIC, making it a useful molecular marker of hemostasis in diagnosing DIC.
- However, it is essential to note that D-dimer testing may not always be positive in cases of DIC, as seen in the case report by 6, which presented a patient with paraneoplastic DIC and a false-negative D-dimer test.
Comparison of Diagnostic Markers
- The study by 2 compared the diagnostic efficacy of D-dimer with other coagulation indicators, such as fibrinogen degradation products (FDP), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), thrombin time (TT), antithrombin (AT), and blood platelet count (PLT).
- The results showed that combining D-dimer with FDP increased the sensitivity and specificity for the diagnosis of DIC and nonovert DIC.
- The study by 5 also compared the diagnostic efficacy of the D-dimer assay with other tests, including antithrombin-III assay, FDP titer, fibrinopeptide-A level, protamine sulfate test, fibrinogen, prothrombin time, and activated partial thromboplastin time.
- The results indicated that the D-dimer assay was the most useful test, followed by the fibrinopeptide-A titer, AT-III level, and FDP titer, in descending order of efficacy.