Clinical Use of D-Dimer Measurement for the Diagnosis of Disseminated Intravascular Coagulation in Dogs
Tatsuhiko MACHIDA, Hiromitsu KOKUBU, Kenji Matsuda, Kenjirou MIYOSHI, Eiji Uchida
Abstract
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Tatsuhiko MACHIDA, Hiromitsu KOKUBU, Kenji Matsuda, Kenjirou MIYOSHI, Eiji Uchida
Abstract
Open-access reader
We measured the plasma D-dimer (DD) concentration in 205 dogs. Simultaneously, fibrinogen/fibrin degradation products (FDPs) concentration, platelet (PLT) count, prothrombin time (PT), activated partial thromboplastin time (APTT), and plasma concentrations of fibrinogen (Fib) were measured in the same dogs. From these results, we were able to divide the animals into four groups: control (healthy dogs, n=18), pre-disseminated intravascular coagulation (preDIC) (n=20), disseminated intravascular coagulation (DIC) (n=21), and other (n=146). Significant differences in plasma DD concentration were found among the four groups: control, 0.45 ± 0.46 µg/ml (reference range, 0-1.37); preDIC, 5.0 ± 4.8 µg/ml; DIC, 16.3 ± 12.2 µg/ml; and other, 1.5 ± 2.7 µg/ml. A weak positive correlation (r=0.62) was found between FDPs and DD concentrations in the DIC group. As a DIC diagnostic test, the PLT/APTT/FDPs/DD combination had the highest accuracy of 100%, with a sensitivity of 73% and a specificity of 97%. We propose the use of FDPs and DD concentrations as part of the DIC diagnostic test panel, with DD and FDPs to provide accurate diagnosis.
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We measured the plasma D-dimer (DD) concentration in 205 dogs. Simultaneously, fibrinogen/fibrin degradation products (FDPs) concentration, platelet (PLT) count, prothrombin time (PT), activated partial thromboplastin time (APTT), and plasma concentrations of fibrinogen (Fib) were measured in the same dogs. From these results, we were able to divide the animals into four groups: control (healthy dogs, n=18), pre-disseminated intravascular coagulation (preDIC) (n=20), disseminated intravascular coagulation (DIC) (n=21), and other (n=146). Significant differences in plasma DD concentration were found among the four groups: control, 0.45 ± 0.46 µg/ml (reference range, 0-1.37); preDIC, 5.0 ± 4.8 µg/ml; DIC, 16.3 ± 12.2 µg/ml; and other, 1.5 ± 2.7 µg/ml. A weak positive correlation (r=0.62) was found between FDPs and DD concentrations in the DIC group. As a DIC diagnostic test, the PLT/APTT/FDPs/DD combination had the highest accuracy of 100%, with a sensitivity of 73% and a specificity of 97%. We propose the use of FDPs and DD concentrations as part of the DIC diagnostic test panel, with DD and FDPs to provide accurate diagnosis.
Key concepts: Disseminated intravascular coagulation, Partial thromboplastin time, Fibrinogen, Prothrombin time, D-dimer, Fibrin, Platelet, Internal medicine