Thromb Haemost 1994; 72(01): 089-091
DOI: 10.1055/s-0038-1648817
Original Article
Schattauer GmbH Stuttgart

D-Dimer Determination to Exclude Pulmonary Embolism: a Two-Step Approach Using Latex Assay as a Screening Tool

P de Moerloose
Division of Angiology and Haemostasis, Department of Medicine, University Cantonal Hospital of Geneva, Switzerland
,
Ph Minazio
Division of Angiology and Haemostasis, Department of Medicine, University Cantonal Hospital of Geneva, Switzerland
,
G Reber
Division of Angiology and Haemostasis, Department of Medicine, University Cantonal Hospital of Geneva, Switzerland
,
A Perrier
1   Division of Pneumology, Department of Medicine, University Cantonal Hospital of Geneva, Switzerland
,
H Bounameaux
Division of Angiology and Haemostasis, Department of Medicine, University Cantonal Hospital of Geneva, Switzerland
› Author Affiliations
Further Information

Publication History

Received 09 March 1994

Accepted after resubmission 22 March 1994

Publication Date:
12 July 2018 (online)

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Summary

D-dimer (DD), when measured by a quantitative enzyme-linked immunosorbent assay (ELISA), is a valuable test to exclude venous thromboembolism (VTE). However, DD ELISA technique is not appropriate for emergency use and the available agglutination latex assays are not sensitive enough to be used as an alternative to rule out the diagnosis of VTE. Latex assays could still be used as screening tests. We tested this hypothesis by comparing DD levels measured by ELISA and latex assays in 334 patients suspected of pulmonary embolism. All but one patient with a positive (DD ≥500 ng/ml) latex assay had DD levels higher than 500 ng/ml with the ELISA assay. Accordingly, ELISA technique could be restricted to patients with a negative result in latex assay. This two-step approach would have spared about 50% of ELISA in our cohort. In conclusion, our data indicate that a latex test can be used as a first diagnostic step to rule out pulmonary embolism provided a negative result is confirmed by ELISA and the performance of the latex assay used has been assessed properly.