1例D-二聚体高于FDP的原因分析

One case analysis of cause of D-dimer higher than FDP

目的报道1例由异嗜性抗体影响,导致患者血浆D-二聚体(D-dimer)高于纤维蛋白(原)降解产物(FDP)的病例,为临床诊疗提供帮助。方法主要采用更换检测系统的平行试验,多倍稀释试验,异嗜性抗体阻断剂(Heterophilic antibody blocking reagent,HBR)或二硫苏糖醇(dithiothreitol,DTT)处理的方法识别并纠正假性增高的D-二聚体。结果更换检测系统后,D-二聚体的测定结果在正常范围内;稀释试验提示D-二聚体和稀释倍数之间无线性关系,随着稀释倍数的增加,D-二聚体呈先上升后下降的趋势;HBR或DTT处理后D-二聚体分别为0.60 mg/L FEU、0.50 mg/L FEU,均显著低于初始结果。结论该病例D-二聚体高于FDP的原因为异嗜性抗体引起的D-二聚体假性增高,可通过更换检测系统、HBR或DTT处理的方法纠正。

Objective This report presents a case in which the patient's plasma D-dimer levels were higher than fibrin-ogen degradation product(FDP)due to the presence of heterophilic antibodies,providing insights for clinical diagnosis and treatment.Methods Parallel testing using a different detection system,serial dilution testing,and interventions such as heterophilic antibody blocking reagent(HBR)or dithiothreitol(DTT)treatment were employed to identify and correct the falsely elevated D-dimer level.Results After changing the detection system,the D-dimer measurements fell within the normal range.Dilution testing showed a non-linear relationship between D-dimer levels and dilution multiples,with D-dimer levels initially increasing and then decreasing with increasing dilution multiples.Following HBR or DTT treatment,D-dimer levels were significantly lower than the initial result,measuring 0.60 mg/L FEU and 0.50 mg/L FEU.Conclusion The cause of elevated D-dimer level above FDP in this case was falsely elevated levels due to heterophilic antibodies,which can be corrected by changing the detection system and employing HBR or DTT treatment.