High D-dimer causes

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D-Dimer Microchapters


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Causes of High D-dimer

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]


Elevated levels of D-dimer signify the activation of hemostasis and fibrinolytic pathway. It is a non-specific marker that has been widely implicated in acute venous thromboembolism (VTE). However, D-dimer levels are also increased in patients with other conditions, such as cancer, pregnancy, infections, trauma, and recent surgery.[1]


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Acute coronary syndrome, acute limb ischemia, aortic aneurysm, aortic dissection, arterio-venous malformations, atrial fibrillation, congestive heart failure, deep vein thrombosis, intracardiac thrombus, ischemic heart disease, left ventricular aneurysm, Lemierre syndrome, myocardial infarction, NSTEMI, peripheral arterial disease, STEMI, Trousseau's syndrome
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic Chronic urticaria
Drug Side Effect Acenocoumarol, alteplase, chloroquine, epsilon-aminocaproic acid, foam sclerosants, lanoteplase, recombinant human urokinase, recombinant tissue type plasminogen activator, reteplase, streptokinase, tecarfarin, tenecteplase, tranexamic acid, warfarin
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental Cadmium exposure, viper snake venoms
Gastroenterologic Acute liver failure, acute pancreatitis, cirrhosis, colorectal carcinoma, gastric carcinoma, hepatosplenic schistosomiasis, portal vein thrombosis
Genetic Factor V Leiden mutation, Klippel Trenaunay syndrome, methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms, 6p trisomy, paroxysmal nocturnal hemoglobinuria, protein C deficiency, protein S deficiency, prothrombin gene G20210A variant, sickle cell disease
Hematologic Antiphospholipid antibody syndrome, disseminated intravascular coagulation, factor V Leiden mutation, leukemia, methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms, prothrombin gene G20210A variant, vasoocclusive episode of sickle cell disease
Iatrogenic Arterial catheters, artificial heart valve, pacemaker, pancreatic surgery, splenectomy, surgery, ultrasound-guided sclerotherapy
Infectious Disease HIV, influenza, sepsis, tuberculosis
Musculoskeletal/Orthopedic No underlying causes
Neurologic Alzheimer's disease, Cerebral venous sinus thrombosis, migraine, stroke
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Eclampsia, endometrial cancer, polycystic ovarian syndrome, pre-eclampsia, preterm infants, pregnancy
Oncologic Malignancy
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric Acute mental stress
Pulmonary COPD exarcebations, lung cancer, mycoplasma pneumonia, primary pulmonary hypertension, pulmonary embolism
Renal/Electrolyte Acute renal failure, chronic renal failure, ESRD, nephrotic syndrome, renal vein thrombosis
Rheumatology/Immunology/Allergy Behçet disease, drug induced lupus, hemophagocytic syndrome, Still's disease, systemic lupus erythematosus
Sexual No underlying causes
Trauma Head injury, trauma
Urologic No underlying causes
Miscellaneous False positives lab results, systemic inflammatory response syndrome, ultra marathon

Causes in Alphabetical Order


  1. Lippi G, Franchini M, Targher G, Favaloro EJ (2008). "Help me, Doctor! My D-dimer is raised". Ann Med. 40 (8): 594–605. doi:10.1080/07853890802161015. PMID 18608117.
  2. Castiglione A, Guaran V, Astolfi L, Orioli E, Zeri G, Gemmati D; et al. (2013). "Karyotype-Phenotype Correlation in Partial Trisomies of the Short Arm of Chromosome 6: A Family Case Report and Review of the Literature". Cytogenet Genome Res. doi:10.1159/000353846. PMID 23942271.
  3. von Känel R, Hamer M, Malan NT, Scheepers K, Meiring M, Malan L (2013). "Procoagulant reactivity to laboratory acute mental stress in Africans and Caucasians, and its relation to depressive symptoms: The SABPA Study". Thromb Haemost. 110 (5). doi:10.1160/TH13-05-0383. PMID 23965941.
  4. Akbal E, Demirci S, Koçak E, Köklü S, Başar O, Tuna Y (2013). "Alterations of platelet function and coagulation parameters during acute pancreatitis". Blood Coagul Fibrinolysis. 24 (3): 243–6. doi:10.1097/MBC.0b013e32835aef51. PMID 23425662.
  5. Bhatia S, Jenner AM, Li H, Ruberu K, Spiro AS, Shepherd CE; et al. (2013). "Increased apolipoprotein D dimer formation in Alzheimer's disease hippocampus is associated with lipid conjugated diene levels". J Alzheimers Dis. 35 (3): 475–86. doi:10.3233/JAD-122278. PMID 23455990.
  6. Siennicka A, Drozdzynska M, Chelstowski K, Cnotliwy M, Jastrzebska M (2013). "Haemostatic factors and intraluminal thrombus thickness in abdominal aortic aneurysm. Is secondary fibrinolysis relevant?". J Physiol Pharmacol. 64 (3): 321–30. PMID 23959729.
  7. Fernández-Bello I, López-Longo FJ, Arias-Salgado EG, Jiménez-Yuste V, Butta NV (2013). "Behçet's disease: new insight into the relationship between procoagulant state, endothelial activation/damage and disease activity". Orphanet J Rare Dis. 8: 81. doi:10.1186/1750-1172-8-81. PMC 3669042. PMID 23711081.
  8. Nasiadek M, Kilanowicz A, Darago A, Lazarenkow A, Michalska M (2013). "The effect of cadmium on the coagulation and fibrinolytic system in women with uterine endometrial cancer and myoma". Int J Occup Med Environ Health. 26 (2): 291–301. doi:10.2478/s13382-013-0089-z. PMID 23690264.
  9. Bijker EM, Bastiaens GJ, Teirlinck AC, van Gemert GJ, Graumans W, van de Vegte-Bolmer M; et al. (2013). "Protection against malaria after immunization by chloroquine prophylaxis and sporozoites is mediated by preerythrocytic immunity". Proc Natl Acad Sci U S A. 110 (19): 7862–7. doi:10.1073/pnas.1220360110. PMC 3651438. PMID 23599283.
  10. Criado PR, Antinori LC, Maruta CW, dos Reis VM (2013). "Evaluation of D-dimer serum levels among patients with chronic urticaria, psoriasis and urticarial vasculitis". An Bras Dermatol. 88 (3): 355–60. doi:10.1590/abd1806-4841.20131532. PMC 3754365. PMID 23793207.
  11. Song YJ, Zhou ZH, Liu YK, Rao SM, Huang YJ (2013). "Prothrombotic state in senile patients with acute exacerbations of chronic obstructive pulmonary disease combined with respiratory failure". Exp Ther Med. 5 (4): 1184–1188. doi:10.3892/etm.2013.919. PMC 3627458. PMID 23596488.
  12. 12.0 12.1 Connor D, Joseph J, Exner T, Ma D, Parsi K (2013). "Infusion of foam sclerosants results in a distance-dependent procoagulant activity, haemoconcentration and elevation of D-dimer levels". Phlebology. doi:10.1177/0268355513502333. PMID 24002013.
  13. Wakabayashi K, Inokuma S, Matsubara E, Onishi K, Asashima H, Nakachi S; et al. (2013). "Serum β2-microglobulin level is a useful indicator of disease activity and hemophagocytic syndrome complication in systemic lupus erythematosus and adult-onset Still's disease". Clin Rheumatol. 32 (7): 999–1005. doi:10.1007/s10067-013-2220-8. PMID 23504210.
  14. Leite LA, Pimenta Filho AA, Martins da Fonseca CS, Santana dos Santos B, Ferreira Rde C, Montenegro SM; et al. (2013). "Hemostatic dysfunction is increased in patients with hepatosplenic schistosomiasis mansoni and advanced periportal fibrosis". PLoS Negl Trop Dis. 7 (7): e2314. doi:10.1371/journal.pntd.0002314. PMC 3715409. PMID 23875049.
  15. Davey RT, Lynfield R, Dwyer DE, Losso MH, Cozzi-Lepri A, Wentworth D; et al. (2013). "The association between serum biomarkers and disease outcome in influenza A(H1N1)pdm09 virus infection: results of two international observational cohort studies". PLoS One. 8 (2): e57121. doi:10.1371/journal.pone.0057121. PMC 3584122. PMID 23468921.
  16. Oduber CE, van Beers EJ, Bresser P, van der Horst CM, Meijers JC, Gerdes VE (2013). "Venous thromboembolism and prothrombotic parameters in Klippel-Trenaunay syndrome". Neth J Med. 71 (5): 246–52. PMID 23799311.
  17. Kumar M, Singh R, Sawlani KK, Kumar S (2013). "Atypical presentation of Lemierre syndrome: role of imaging". BMJ Case Rep. 2013. doi:10.1136/bcr-2012-007647. PMID 23345481.
  18. 18.0 18.1 Nishank SS, Singh M, Yadav R (2013). "Clinical impact of Factor V Leiden, Prothrombin G20210A and MTHFR C677T mutations among sickle cell disease patients of Central India". Eur J Haematol. doi:10.1111/ejh.12190. PMID 23992124.
  19. Yucel Y, Tanriverdi H, Arıkanoglu A, Varol S, Kaplan I, Akil E; et al. (2013). "Increased fibrinogen, D-dimer and galectin-3 levels in patients with migraine". Neurol Sci. doi:10.1007/s10072-013-1542-2. PMID 24057117.
  20. Guo SC, Xu CW, Liu YQ, Wang JF, Zheng ZW (2013). "[Changes in plasma levels of thrombomodulin and D-dimer in children with different types of Mycoplasma pneumoniae pneumonia]". Zhongguo Dang Dai Er Ke Za Zhi. 15 (8): 619–22. PMID 23965872.
  21. Christensen RD, Baer VL, Lambert DK, Henry E, Ilstrup SJ, Bennett ST (2013). "Reference intervals for common coagulation tests of preterm infants". Transfusion. doi:10.1111/trf.12322. PMID 23834237.
  22. Shen Y, Yang T, Jia L, Wang T, Chen L, Wan C; et al. (2013). "A potential role for D-dimer in the diagnosis of tuberculous pleural effusion". Eur Rev Med Pharmacol Sci. 17 (2): 201–5. PMID 23377808.
  23. Kupchak BR, Volk BM, Kunces LJ, Kraemer WJ, Hoffman MD, Phinney SD; et al. (2013). "Alterations in coagulatory and fibrinolytic systems following an ultra-marathon". Eur J Appl Physiol. doi:10.1007/s00421-013-2709-5. PMID 23974848.
  24. Maduwage K, Scorgie FE, Silva A, Shahmy S, Mohamed F, Abeysinghe C; et al. (2013). "Hump-nosed pit viper (Hypnale hypnale) envenoming causes mild coagulopathy with incomplete clotting factor consumption". Clin Toxicol (Phila). 51 (7): 527–31. doi:10.3109/15563650.2013.811589. PMID 23879180.

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