Can you suggest treatment for my elevated D-dimer levels?
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have been having some shortness of breath. I am really bad with panic attacks. Routine blood work shows D-dimmer still elevated after eight months. Last year, the results were in a normal range under 230 in the hospital. A few months later after I had a stillbirth, it was elevated to 0.51 the normal being 0.00 to 0.49. I rechecked it again and it was 0.55. I am currently on Zantac and Ativan. I was on Zoloft and an allergy pill in the past. I have done a VQ scan and an X-ray of the chest and an ultrasound of the legs. Please help me understand why my D-dimer levels are elevated when I do not have DVT and PE?
Hello,
Welcome to icliniq.com.
1. D-dimer test is used to exclude deep vein thrombosis like thrombotic disorder.
2. Your D-dimer value (fibrin degradation product) is slightly high.
3. If clinically and from other investigations, thrombosis is not present then other causes for high false positive D-dimer can be ruled out.
4. False positive causes for elevated D-dimer are inflammation, malignancy, surgery, trauma, and liver disease, etc.
Patient's Query
Thank you doctor,
I am scared to death as I am going to drop dead because this has been elevated so long with no reasoning.
Hello,
Welcome back to icliniq.com.
1. From your history, it seems that your breathlessness is because of anxiety-induced panic attack.
2. For that, you can continue a prescribed medication regularly and it will definitely help in relieving you from the panic attack.
3. SGPT (serum glutamate-pyruvate transaminase), SGOT (serum glutamic oxaloacetic transaminase), ultrasound of the abdomen, and CBC (complete blood count) with peripheral smear examination can be investigated to rule out any other cause if present.
4. Your physical examination of the liver, spleen and lymph nodes should be done.
Patient's Query
Thank you doctor,
I am sorry can you give me the list? I lost the previous message.
Hello,
Welcome back to icliniq.com.
1. Your breathlessness is from panic attacks by anxiety issue. For that, prescribed medication from a psychiatrist can be continued regularly.
2. With regular intake of medicine and yoga, the anxiety will be less and you will have fewer panic attacks.
3. For high D-dimer, preliminary investigations like SGPT (serum glutamate-pyruvate transaminase), SGOT (serum glutamic oxaloacetic transaminase), ultrasound of the abdomen, and CBC (complete blood count) with peripheral smear examination can be done.
4. In addition, your physical examination of the liver and spleen should be done for lymph nodes palpation.
5. For physical examination and to discuss your case, you can consult a nearby physician.
Patient's Query
Thank you doctor,
These four are the blood tests?
Hello,
Welcome back to icliniq.com.
1. For deep vein thrombosis of the legs, a color Doppler investigation can be done and for pulmonary embolism, a CT (computed tomography) angiography can be done only if needed.
2. SGPT (serum glutamate-pyruvate transaminase), SGOT (serum glutamic oxaloacetic transaminase), and CBC (complete blood count) are the blood tests.
Patient's Query
Thank you doctor,
For the examination of the liver, spleen and lymph nodes, do I actually have to see a doctor?
Hello,
Welcome back to icliniq.com.
Ultrasound of the abdomen is a scan test.
Patient's Query
Thank you doctor,
I had a VQ scan and an ultrasound of both the legs to rule out DVT.
Hello,
Welcome back to icliniq.com.
Yes, liver, spleen and lymph nodes are palpated by a doctor during examination and treatment is needed if they are enlarged.
Patient's Query
Thank you doctor,
I appreciate your response.
Hello,
Welcome back to icliniq.com.
So, you mean to say you have investigated for pulmonary embolism as well as deep vein thrombosis?
Patient's Query
Thank you doctor,
Yes, I had them two nights ago at a hospital. The VQ scan was done because I am allergic to contrast.
Hello,
Welcome back to icliniq.com.
1. Do the above discussed four basic investigations and discuss the results with your physician for physical examination.
2. If needed further workup accordingly can be done.
3. Do not directly think aboutdeath.
Patient's Query
Thank you doctor,
That is why I am worried as to why the D-dimmer is elevated for a long period of time. Thank you very much for helping me out. I am a little frustrated.
Hello,
Welcome back to icliniq.com.
1. For panic attacks, behavioral counseling and drugs are very useful.
2. Yoga and meditation also have a good effect.
3. We will discuss further after examination and investigations are done.
Patient's Query
Thank you doctor,
I really appreciate your support and guidance given.
Hello,
Welcome back to icliniq.com.
You are most welcome. We are there to help you.
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