Clinical Usefulness of D-dimer Test with Semiquantitative Latex Agglutination Method in Pulmonary Embolism.
10.4046/trd.2005.59.6.651
- Author:
Dong Kyun KIM
1
;
Kang II CHUN
;
Yang Ki KIM
;
Young Mok LEE
;
Ki Up KIM
;
Soo taek UH
;
Yong Hoon KIM
;
Choon Sik PARK
;
No Jin PARK
;
Tae Youn CHOI
Author Information
1. Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea. uhs@hosp.sch.ac.kr
- Publication Type:Original Article
- Keywords:
Pulmonary embolism;
D-dimer;
ELISA;
Latex agglutination
- MeSH:
Agglutination*;
Diagnosis;
Enzyme-Linked Immunosorbent Assay;
Female;
Fibrin;
Humans;
Latex*;
Male;
Mass Screening;
Middle Aged;
Pulmonary Embolism*;
Retrospective Studies;
Tomography, X-Ray Computed
- From:Tuberculosis and Respiratory Diseases
2005;59(6):651-655
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Diagnosing a pulmonary embolism is difficult because its presenting symptoms are nonspecific and there are limitations with all of the objective tests. The D-dimer is known to be a marker of the lysis of intravascular cross-linked fibrin as a result of the activation of the endogenous fibrinolytic pathways, and the D-dimer assay is these an objective method for diagnosing a pulmonary embolism. This study assessed the benefits of the D-dimer test for diagnosing a pulmonary embolism using semiquantitative latex agglutination. METHODS: The latex agglutination results of 185 patients were retrospectively reviewed. The D-dimer test was performed at the time a pulmonary embolism was suspected. Ninety patients(group I) were diagnosis with PE through spiral chest CT or a chest CT angiogram, perfusion/ventilation scans, and/or pulmonary angiogram. Ninety-five patients (group II) were found not to have a pulmonary embolism through the above tests. RESULTS: The male to female ratio and mean age in groups I and II was 37:55, and 57 years old to 50:45 and 52 years old, respectively. When the cut off value for a positive D-dimer assay was set to 500 microgram, the sensitivity, positive predictive value, negative predictive value and specificity was 86.7%, 61.4%, 79.3%, and 48.4%, respectively. CONCLUSION: The semiquantitative latex agglutination method in the D-dimer test has a lower sensitivity and negative predictive value than the well known ELISA test particularly for small emboli. Therefore, this test is not a suitable screening test for excluding a pulmonary embolism.
