Thromb Haemost 1989; 62(04): 1043-1045
DOI: 10.1055/s-0038-1647113
Original Article
Clinical Studies
Schattauer GmbH Stuttgart

Is Quantitative Determination of Fibrin(ogen) Degradation Products and Thrombin-Antithrombin III Complexes Useful to Diagnose Deep Venous Thrombosis in Outpatients?

Paul F M M van Bergen
1   The Center for Clinical Decision Making/Department of Internal Medicine II, University Hospital “Dijkzigt”, Rotterdam, The Netherlands
,
Eduard A R Knot
1   The Center for Clinical Decision Making/Department of Internal Medicine II, University Hospital “Dijkzigt”, Rotterdam, The Netherlands
,
Jan J C Jonker
2   The Thrombosis Service Center Rotterdam, Rotterdam, The Netherlands
,
Auke C de Boer
3   The Department of Internal Medicine, Bergweg Municipal Hospital, Rotterdam, The Netherlands
,
Moniek P M de Maat
1   The Center for Clinical Decision Making/Department of Internal Medicine II, University Hospital “Dijkzigt”, Rotterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 02 January 1989

Accepted after revision 22 August 1989

Publication Date:
24 July 2018 (online)

Summary

We studied the diagnostic value of recently introduced ELISA’s for the determination of thrombin-antithrombin III (TAT) complexes, fibrin degradation products (FbDP), fibrinogen degradation products (FgDP) and total degradation products (TDP) for deep venous thrombosis (DVT) in plasma of 239 consecutive outpatients, suspected for DVT by their family doctor. DVT was confirmed by impedance plethysmography in 60 patients. Using the 95th percentile range of 42 healthy volunteers the sensitivity for the detection of DVT was: 37% for TAT, 95% for TDP, 92% for FbDP and 90% for FgDP. Specificity was: 88% for TAT, 16% for TDP, 20% for FbDP and 25% for FgDP.

We conclude that these assays are of little value in the diagnosis of DVT in outpatients.

 
  • References

  • 1 Cranley JJ, Canos AJ, Sull WJ. The diagnosis of deep vein thrombosis. Fallibility of clinical symptoms and signs Arch Surg 1976; 111: 34-36
  • 2 Simpson FG, Robinson PJ, Bark M, Losowsky MS. Prospective study of thrombophlebitis and “pseudothrombophlebitis”. Lancet 1980; 1: 331-333
  • 3 O’Donnell TF, Abbott WM, Athansasoulis CA, Millan VG, Callow AD. Diagnosis of deep vein thrombosis in the out-patient by venography. Surg Gynecol Obstet 1980; 150: 69-74
  • 4 Haeger K. Problems of acute deep vein thrombosis. The interpretation of signs and symptoms Angiology 1969; 20: 219-223
  • 5 Wojciechowski J, Olausson M, Korsan-Bengtsen K. Fibrinopeptide A, β-thromboglobulin and fibrin degradation products as screening test for the diagnosis of deep vein thrombosis. Thromb Haemostas 1983; 13: 254-261
  • 6 Holvoet P, De Boer A, Verstraeten M, Collen D. An enzyme linked immunosorbent assay (ELISA) for the measurement of plasmin-α2- antiplasmin complex in human plasma, application to the detection of in vivo activation of the fibrinolytic system. Thromb Haemostas 1986; 56: 124-127
  • 7 Merskey C, Lalezazi P, Johnson AJ. A rapid, simple, sensitive method for measuring fibrinolytic split products in human serum. Proc Soc Exp Biol Med New York 1969; 131: 871-875
  • 8 Pelzer H, Schwarz A, Heimburger N. Enzyme immunoassay for determination of human thrombin/antithrombin III complex. Thromb Res Suppl (Suppl. 06) 1986; No 99
  • 9 Blanke H, Praetorius G, Leschke M, Seitz R, Egbring R, Strauer BE. Significance of the thrombin-antithrombin III complex in the diagnosis of pulmonary embolism and deep venous thrombosis; comparison with fibrinopeptide A, platelet factor 4 and beta-thromboglobulin. Klin Wschr 1987; 65: 757-763
  • 10 Gaffney PJ, Perry MJ. Unreliability of current serum fibrin degradation products (FDP) assays. Thromb Haemostas 1985; 53: 301-302
  • 11 Hull R, van Aken WG, Hirsch J, Gallus AS, Hoicka G, Turpie AG G, Walker I, Gent M. Impedance Plethysmography using the occlusive cufftechnic in the diagnosis of DVT. Circulation 1976; 53: 696-700
  • 12 Koopman J, Haverkate F, Koppert PW, Nieuwenhuizen W, Brommer EJ P, van der Werf WG C. New enzyme immunoassay of fibrinfibrinogen degradation products in plasma using a monoclonal antibody. J Lab Clin Med 1987; 109: 75-84
  • 13 Hull RD, Hirsch J, Carter CJ, Jay MR, Ockelford PA, Buller HR, Turpie AG, Powers P, Kinch D, Dodd PE, Gill GJ, Leclerc JR, Gent M. Diagnostic efficacy of impedance plethysmography for clinically suspected deep-vein thrombosis. Ann Intern Med 1985; 102: 21-28
  • 14 Huisman MV, Buller HR, Ten Cate JW, Vreeken J. Serial impedance plethysmography for suspected deep venous thrombosis in outpatients. The Amsterdam general practitioner study N Engl J Med 1986; 314: 823-828
  • 15 Ott P, Astrup L, Jensen RH, Nyeland B, Pedersen B. Assessment of D-dimer in plasma: Diagnostic value in suspected deep venous thrombosis of the leg. Acta Med Scand 1988; 224: 263-267