Guest guest Posted May 26, 2004 Report Share Posted May 26, 2004 , Thank you so much for this information, I really appreciate it. Christain tested negative for RF, does that change or is always negative once negative? Christian's Doctor has always ordered the d-dimer test in his labwork. He told me that with systemic kids it can be one more test that supports the diagnosis, but like any other test it shouldn't be the only factor. > > : > Here is some info I found on d-dimer. > I have 2 guesses about why your doctor ordered this test for your child. > One, to possibly see if the JRA meds might be causing any > bleeding/clotting abnormality. The other, which is mentioned at the > bottom of the article, is that the test can be false positive in > individuals with positive rheumatoid factor. Perhaps this might be an > indicator of rheumatoid factor (in kind of a roundabout way)?? I really > don't know. I would suggest you ask the doctor at your next appointment. > And when you find out for sure, please let me know, too, as it has my > curiousity aroused! > Hope you are doing well tonight! > and Rob 15 Spondy > > > in the news > > > understanding > your tests > > inside the lab > > about this site > > site map > > send us your > comments > > home > > > > > > Genetic Tests > Home Testing > Reference Ranges > Screening > Test Reliability > Testing Tips > Tests to Market > Your Role > > > D-dimer > > > Also known as: Fragment D-dimer, Fibrin degradation fragment > Formally known as: D-dimer > Related tests: Fibrin Degradation Products (FDP), Prothrombin Time (PT), > Partial Thromboplastin Time (aPTT, or PTT), Fibrinogen, Platelet > Countemail this page > > print this article > > > The Test > > > How is it used? > When is it ordered? > What does the test result mean? > Is there anything else I should know? > > > How is it used? > D-dimer tests are ordered, along with other laboratory tests and imaging > scans, to help rule out, diagnose, and monitor diseases and conditions > that cause hypercoagulability, a tendency to clot inappropriately. One > of the most common of these conditions is DVT (Deep Vein Thrombosis) > which involves clot formation in the deep veins of the body, most > frequently in the legs. These clots may grow very large and block blood > flow in the legs, causing swelling, pain, and tissue damage. It is > possible for a piece of the clot to break off and travel to other parts > of the body, where the clot can cause a PE (Pulmonary embolism - blood > clot in the lungs). > Most clots travel in the body's veins, but clotting can also sometimes > occur in the oxygen-carrying arteries. The combination of these two parts > of thrombosis is sometimes referred to as venous thromboembolism (VTE). > If a blood clot blocks the flow of blood to a vital organ, such as a > kidney, the brain, ot the heart, it may cause irreversible damage > (infarction) and can lead to organ failure. D-dimer levels are generally > ordered to make sure that they are not elevated. They are used to help > rule out DVT, PE, VT, and AT. > Measurements of D-dimer may also be ordered, along with other tests, to > help diagnose DIC (Disseminated Intravascular Coagulation). DIC is a > complex acute condition that can arise from a variety of situations > including: some surgical procedures, septic shock, poisonous snake bites, > liver disease, and postpartum (after the delivery of a baby). With DIC, > clotting factors are activated and then used up throughout the body. This > creates numerous minute blood clots and at the same time leaves the > patient vulnerable to excessive bleeding. Steps are taken to support the > patient, while the underlying problem is addressed, and the underlying > condition resolved. D-dimer levels may be used to monitor the > effectiveness of DIC treatment. > > > [back to top] > > > > When is it ordered? > D-dimer may be ordered when a patient has symptoms of DVT, such as leg > pain, tenderness, swelling, discoloration, edema; or symptoms of PE, such > as labored breathing, coughing, and lung-related chest pain. D- dimer is > especially useful when the doctor thinks that something other than DVT or > PE is causing the symptoms. It is a quick, non-invasive way for the > doctor to help rule out abnormal or excess clotting. > When a patient has symptoms of DIC, such as bleeding gums, nausea, > vomiting, severe muscle and abdominal pain, seizures and oliguria > (decreased urine output), a D-dimer test may be ordered, along with a PT, > aPTT, fibrinogen, FDP, and platelet count to help diagnose the condition. > D-dimer may also be ordered at intervals when a patient is undergoing > treatment for DIC to help monitor its progress. > > > [back to top] > > > > What does the test result mean? > A positive D-dimer indicates the presence of an abnormally high level of > fibrin degradation products in your body. It tells your doctor that there > has been significant clot (thrombus) formation and breakdown in the body, > but it does not tell the location or cause. An elevated D-dimer may be > due to a VTE or DIC but it may also be due to a recent surgery, trauma, > or infection. Elevated levels are also seen with liver disease, > pregnancy, eclampsia, heart disease, and some cancers. > A normal D-dimer test means that it is most likely that you do not have > an acute condition or disease that is causing abnormal clot formation and > breakdown. Most doctors agree that a negative D-dimer is most valid and > useful when the test is done on patients that are considered to be > low-risk. The test is used to help rule out clotting as the cause for the > symptoms. > D-dimer is recommended as an adjunct test. It should not be the only test > used to diagnose a disease or condition. Both increased and normal > D-dimer levels may require follow-up and can lead to further testing. > PLEASE NOTE: Numerically reported test results are interpreted according > to the test's reference range, which may vary by the patient's age, sex, > as well as the instrumentation or kit used to perform the test. A > specific result within the reference (normal) range – for any test – does > not ensure health just as a result outside the reference range may not > indicate disease. To learn more about reference ranges, please see the > article, Reference Ranges and What They Mean. To learn the reference > range for your test, consult your doctor or laboratorian. Lab Tests > Online recommends you consult your physician to discuss your test results > as a part of a complete medical examination. > [back to top] > > > > Is there anything else I should know? > Anticoagulant therapy can cause a false negative D-dimer. There are > several different methods of testing for D-dimer. Most of the D- dimer > tests that yield quantitative results are done in a hospital lab, while > those that yield qualitative results are performed at the patient's > bedside. > D-dimer concentrations may rise in the elderly, and false positives may > be seen with high levels of rheumatoid factor (a protein seen in patients > with rheumatoid arthritis). Substances such as high triglycerides, > lipemia (a large amount of fats in the blood that can be caused by the > patient consuming a greasy meal prior to testing), and bilirubin can also > cause false positives as can hemolysis caused by improper collection and > handling. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 26, 2004 Report Share Posted May 26, 2004 D-Dimers (also called fibrin split products) are an indication of activation of the clotting system and are a worrisome sign of problems in children with systemic onset JRA. See page 105 in It's not Just Growing Pains Oxford Press 2004 (there is an entire section for families on understanding laboratory tests) J. A. Lehman MD, Chief Division of Pediatric Rheumatology, Hospital for Special Surgery, and Professor of Pediatrics Sanford Weill Cornell Medical Center giving the best care with great care HSS 535 E 70 St New York, NY 10021 goldscout@... 212-606-1151 212-606-1938 It's not just growing pains A guide to bone, joint, muscle, and arthritis pains in childhood J. A. Lehman MD Oxford University press 2004 www.goldscout.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2004 Report Share Posted May 27, 2004 , I read what you were asking about I didnt know the name but i am familar with the clotting factors and testing for it. Since my husband had a test called factor V lieden done which is a DNA test for clotting to see if its inherited On this paper it has APC-R he is positive so we are having tested for it also due to the history of the family Husband it shows on this paper is Heterozygous this means he will have to be monitored for the rest of his life with protime tests and be on coumadin ( blood thinner). He has had bouts with clots before. Look up Heterozygous Its good your asking about everything. Plus getting information. This is the only way we as parents can educate ourself. With us if 's tests do come back positive she also will be put on medication as her dad. The medications these kids take all have side effects so we have to make a choice. I do know some of these medications will cause bleeding which causes the change in the way blood clots either to thin or to thick the clotting vitamin we eat is Vitamin K when your blood clots to much you have to cut out vitamin K if it dont clot its best to eat as much of vitamin K as possible if you need anymore help let me know also please inform the group about what you find out Robbin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2004 Report Share Posted May 27, 2004 Weird thing - when I went to the website to check out this book, out of curiosity, I saw that my sons ped rheumy is one of the drs who recommended this book - Dr Spencer. He's the second reviewer listed. Just thought I'd pass that along, Michele ( 17, pauci & spondy) Re: : D-dimer info D-Dimers (also called fibrin split products) are an indication of activation of the clotting system and are a worrisome sign of problems in children with systemic onset JRA. See page 105 in It's not Just Growing Pains Oxford Press 2004 (there is an entire section for families on understanding laboratory tests) J. A. Lehman MD, Chief Division of Pediatric Rheumatology, Hospital for Special Surgery, and Professor of Pediatrics Sanford Weill Cornell Medical Center giving the best care with great care HSS 535 E 70 St New York, NY 10021 goldscout@... 212-606-1151 212-606-1938 It's not just growing pains A guide to bone, joint, muscle, and arthritis pains in childhood J. A. Lehman MD Oxford University press 2004 www.goldscout.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2004 Report Share Posted May 27, 2004 Abnormal D dimers always provoke some concern. However, there are many possible explanations. A slight elevation with everything else normal may not mean much. However, it's something that should make the doctors stop and look around carefully. It would also make me bring a patient back sooner than I otherwise had planned to. J. A. Lehman MD Chief, Division of Pediatric Rheumatology Hospital for Special Surgery, and Professor of Clinical Pediatrics Weill Cornell Medical Center New York, NY 10021 Email goldscout@... phone 212-606-1151 fax 212-606-1938 giving the best care with great careavailable at www.goldscout.com or your local book seller see www.goldscout.com/toc.html for details Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2004 Report Share Posted May 27, 2004 Thanks for the book info, I'll be sure to get one. If the d-dimers is elevated but all other labs are normal, should that still be a concern? > D-Dimers (also called fibrin split products) are an indication of activation > of the clotting system and are a worrisome sign of problems in children with > systemic onset JRA. See page 105 in It's not Just Growing Pains Oxford Press > 2004 (there is an entire section for families on understanding laboratory > tests) > > J. A. Lehman MD, Chief > Division of Pediatric Rheumatology, > Hospital for Special Surgery, and > Professor of Pediatrics > Sanford Weill Cornell Medical Center > > giving the best care with great care > > HSS > 535 E 70 St > New York, NY 10021 > > goldscout@a... > > 212-606-1151 > 212-606-1938 > > It's not just growing pains > A guide to bone, joint, muscle, and > arthritis pains in childhood > J. A. Lehman MD > Oxford University press 2004 > www.goldscout.com > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2004 Report Share Posted May 27, 2004 Sounds great!!!! > Weird thing - when I went to the website to check out this book, out of > curiosity, I saw that my sons ped rheumy is one of the drs who > recommended this book - Dr Spencer. He's the second reviewer > listed. Just thought I'd pass that along, Michele ( 17, pauci & > spondy) > > Re: : D-dimer info > > > D-Dimers (also called fibrin split products) are an indication of > activation > of the clotting system and are a worrisome sign of problems in children > with > systemic onset JRA. See page 105 in It's not Just Growing Pains Oxford > Press > 2004 (there is an entire section for families on understanding > laboratory > tests) > > J. A. Lehman MD, Chief > Division of Pediatric Rheumatology, > Hospital for Special Surgery, and > Professor of Pediatrics > Sanford Weill Cornell Medical Center > > giving the best care with great care > > HSS > 535 E 70 St > New York, NY 10021 > > goldscout@a... > > 212-606-1151 > 212-606-1938 > > It's not just growing pains > A guide to bone, joint, muscle, and > arthritis pains in childhood > J. A. Lehman MD > Oxford University press 2004 > www.goldscout.com > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2004 Report Share Posted May 27, 2004 Thanks for the reply. The d-dimers is >1000 NG/ML. I just called the bookstore, Borders and your book is sold out. I'll have to try other bookstores. My " motherly " feeling is the d-dimers could be an indicator for my son's active disease activity. All other labs are looking great but he still isn't feeling great...frustrating. > Abnormal D dimers always provoke some concern. However, there are many > possible explanations. A slight elevation with everything else normal may not mean > much. However, it's something that should make the doctors stop and look > around carefully. It would also make me bring a patient back sooner than I > otherwise had planned to. > > > > J. A. Lehman MD > Chief, Division of Pediatric Rheumatology > Hospital for Special Surgery, and > Professor of Clinical Pediatrics > Weill Cornell Medical Center > New York, NY 10021 > > Email goldscout@a... > phone 212-606-1151 > fax 212-606-1938 > > giving the best care with great careavailable at www.goldscout.com > or your local book seller > see www.goldscout.com/toc.html for details > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2004 Report Share Posted May 28, 2004 I'll yell at the publisher about the book being sold out from your local store. It is easily available from Amazon if you don't mind shopping on line and cheaper ($24.50) plus shipping. D-Dimers at that level and the child not feeling well should keep you a little edgy. I don't know which of the Cincinnati doctors you see (probably best you don't tell me), but a phone call to talk to them about it is certainly reasonable. J. A. Lehman MD Chief, Division of Pediatric Rheumatology Hospital for Special Surgery, and Professor of Clinical Pediatrics Weill Cornell Medical Center New York, NY 10021 Email goldscout@... phone 212-606-1151 fax 212-606-1938 giving the best care with great careavailable at www.goldscout.com or your local book seller see www.goldscout.com/toc.html for details Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2004 Report Share Posted May 28, 2004 Thanks for the info. We are located in Northern Virginia, not Cincinnati. It was the Manassas Virginia Borders that was out of the book, they offered to order it for us but I'm going to hit some other bookstores today to purchase one. Thanks > I'll yell at the publisher about the book being sold out from your local > store. It is easily available from Amazon if you don't mind shopping on line and > cheaper ($24.50) plus shipping. > > D-Dimers at that level and the child not feeling well should keep you a > little edgy. I don't know which of the Cincinnati doctors you see (probably best > you don't tell me), but a phone call to talk to them about it is certainly > reasonable. > > > > J. A. Lehman MD > Chief, Division of Pediatric Rheumatology > Hospital for Special Surgery, and > Professor of Clinical Pediatrics > Weill Cornell Medical Center > New York, NY 10021 > > Email goldscout@a... > phone 212-606-1151 > fax 212-606-1938 > > giving the best care with great careavailable at www.goldscout.com > or your local book seller > see www.goldscout.com/toc.html for details > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2004 Report Share Posted May 28, 2004 Hi , I'm so glad that others piped in with their two cents about the d-dimer. I got as far as knowing about the blood clotting and pulmonary embolism -- it says that right on the lab results, but still don't know exactly how it fits into the systemic JRA picture other than looking for indicaitons of MAS (not to mean that if it's high, the child has MAS). I think someone already said so, but I remember sometime in the late- Feb or March timeframe there being a few posts about MAS and someone even listed the symptoms to look for. As I recall, the most obvious ones were basically flu-like symptoms with possibly violent vomiting. I have imprinted that in my brain that anytime I suspect the flu, to give the ol' rheumy a call or go to ER. At our rheumy appt. the other day, the elevated d-dimer caused no visible concern to the rheumy, as everything else looked pretty good. I hope you have gotten some of your answers. Stacia and Hunter,8,systemic,iritis Quote Link to comment Share on other sites More sharing options...
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