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Tuberculosis & Respiratory Diseases

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Vol.59 No.6
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Clinical Usefulness of D-dimer Test with Semiquantitative Latex Agglutination Method in Pulmonary Embolism

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2005, v.59 no.6, pp.651-655










& (2005). Clinical Usefulness of D-dimer Test with Semiquantitative Latex Agglutination Method in Pulmonary Embolism. Tuberculosis & Respiratory Diseases, 59(6), 651-655.
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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 μg, 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. (Tuberc Respir Dis 2005; 59: 651-655)

keywords
Pulmonary embolism, D-dimer, ELISA, Latex agglutination, Pulmonary embolism, D-dimer, ELISA, Latex agglutination

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