Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
American Academy of Pediatrics
Article

Focus on Diagnosis

A Primer on D-dimer

Cristyn N. Camet and Donald L. Yee
Pediatrics in Review January 2011, 32 (1) 31-33; DOI: https://doi.org/10.1542/pir.32-1-31
Cristyn N. Camet
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Donald L. Yee
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF
  1. Cristyn N. Camet, MD*
  2. Donald L. Yee, MD†
  1. *Pediatric Resident.
  2. †Department of Pediatrics, Hematology-Oncology Section, Baylor College of Medicine, Houston, TX.
  • Author Disclosure

    Drs Camet and Yee have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Introduction

The D-dimer antigen is a degradation byproduct of the fibrinolytic process (Figure) and is commonly used as a biomarker in various clinical settings such as the evaluation of venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC). Much more literature on and collective experience with use of the D-dimer assay exists for adult than pediatric patients. However, thrombotic complications are becoming increasingly recognized in infants and children, and reports on this assay's utility in a variety of other pediatric applications are increasing. This review examines the biochemical basis of D-dimer formation, issues raised by the varied testing methods used to measure D-dimer, and the scenarios in which this assay may provide information useful for medical management.

Figure.

Sequential process of fibrinogen cleavage, fibrin polymerization, cross-linking, and fibrinolysis that leads to degradation products containing the D-dimer antigen. This diagram is simplified by depicting only a single fibrin strand and degradation products of uniform composition. Adapted from Adam SS, Key NS, Greenberg CS. D-dimer antigen: current concepts and future prospects. Blood. 2009;113:2878–2887.

D-dimer Formation

D-dimer formation begins with cleavage of fibrinogen molecules by activated thrombin into fibrin monomers, which then polymerize. Thrombin activates fibrin-bound factor XIII to form factor XIIIa that, in turn, catalyzes formation of covalent bonds between D-domains of the polymerized fibrin. Finally, during fibrinolysis, plasminogen is activated to plasmin, which cleaves the fibrin polymers at specific locations and releases fibrin degradation products that vary in molecular weight and size but include moieties containing the exposed D-dimer antigen. Thus, D-dimer concentrations are increased under any conditions of increased fibrin formation, as with hemostasis, …

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics in Review: 32 (1)
Pediatrics in Review
Vol. 32, Issue 1
1 Jan 2011
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Focus on Diagnosis
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Focus on Diagnosis
Cristyn N. Camet, Donald L. Yee
Pediatrics in Review Jan 2011, 32 (1) 31-33; DOI: 10.1542/pir.32-1-31

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Focus on Diagnosis
Cristyn N. Camet, Donald L. Yee
Pediatrics in Review Jan 2011, 32 (1) 31-33; DOI: 10.1542/pir.32-1-31
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Introduction
    • D-dimer Formation
    • Laboratory Considerations
    • Clinical Uses of D-dimer Antigen Assay
    • Future Considerations
    • References
    • Suggested Reading
  • Figures & Data
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Review of Scabies Infestation and Selected Common Cutaneous Infections
  • Pediatric Ingestions: New High-Risk Household Hazards
  • Iron Deficiency: Implications Before Anemia
Show more Articles

Similar Articles

Subjects

  • Rheumatology/Musculoskeletal Disorders
    • Rheumatology/Musculoskeletal Disorders
    • Collagen Vascular & Other Multisystem Disorders
  • Hematology/Oncology
    • Hematology/Oncology
    • Blood Disorders
  • Journal Info
  • Editorial Board
  • ABP Content Specifications Map
  • Overview
  • Licensing Information
  • Authors
  • Author Guidelines
  • Submit My Manuscript
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
American Academy of Pediatrics

© 2021 American Academy of Pediatrics