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What Causes Elevated D-dimer Levels?

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Posted on Mon, 12 Jun 2017
Question: Hi Dr,
I was recently seen in the ER this morning for chest pain. They did an EKG, CBC, CMP, d dimer, ct scan of my chest as well as ultrasound of my left leg r/t to varicosity. I am a healthy 27 year old female excercise 3-5 times a week. Only history I have is asthma. Cardiac enzymes and EKG CBC and cmp all came back normal. However, my D dimer came back as 447ng/ ml which is high. The normal levels are <250. They ordered ct scan which was normal and Doppler for my leg which was normal. So my question is why would my d dimer be high if I don't have evidence of any clots? Should I be worried? Or do further testing?
doctor
Answered by Dr. Geeta Sundar (15 minutes later)
Brief Answer:
possibly the D-dimer was raised because of a dissolving clot.

Detailed Answer:
Hi, welcome to HealthcareMagic,

It is possible that the D-dimer was raised because of a dissolving clot. Since the clot dissolved, it was not detected.

I would advise you to---
Repeat the D-dimer after a fortnight.
Get a Serum homocysteine level done also.

Feel free to ask further.

Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Geeta Sundar (12 minutes later)
Hi dr should I be concerned about the clot dissolving? Will this pose any risk? What is a serum homocysteine level? And did you say I should check my d dimer in four days?

Hi Dr, are there any instances where the d dimer can be high and not be related to clots but something else? I did get my period yesterday, and this hospital event happened today. I'm just so worried that maybe they should have put me on medication for clotting just in case the CT scan missed the clot?
doctor
Answered by Dr. Geeta Sundar (3 hours later)
Brief Answer:
No D dimer test is for clotting.

Detailed Answer:
No D dimer test is for clotting.
No clot dissolving is a good thing and no cause for concern.
I would suggest you do not worry but repeat test (after a fortnight) and if still high then they will put you on medication.
Serum homocysteine is a test for stickiness of blood and if high, folic acid supplements are given to lower it. Peas and tomatoes are high in folates.
Also make sure your lipid levels are normal.
regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Geeta Sundar (12 hours later)
Hi Dr,

Also at my ER visit, my white blood cell count was 4.0 ( normal range 4.5-11) my neutrophils were low 36% and lymphocytes were high 55%. What does this indicate? Should I be worried that my wbc count is low? I am currently taking an antidepressant, vitamin B 12, vitamin D, oregano oil, and a probiotic.
doctor
Answered by Dr. Geeta Sundar (10 hours later)
Brief Answer:
Hi this is called Leukopenia with relative lymphocytosis

Detailed Answer:
Hi this is called Leukopenia with relative lymphocytosis and is seen after any viral infection or typhoid. It is temporary and will improve--no need to worry.

Continue with the treatment you are taking. Avoid any supplements that are not Scientifically tested--regards

Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Geeta Sundar

Internal Medicine Specialist

Practicing since :1975

Answered : 1329 Questions

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What Causes Elevated D-dimer Levels?

Brief Answer: possibly the D-dimer was raised because of a dissolving clot. Detailed Answer: Hi, welcome to HealthcareMagic, It is possible that the D-dimer was raised because of a dissolving clot. Since the clot dissolved, it was not detected. I would advise you to--- Repeat the D-dimer after a fortnight. Get a Serum homocysteine level done also. Feel free to ask further. Regards