Heterophilic antibodies leading to falsely positive D-dimer concentration in an adolescent

Danielle Verboogen; Bernd Granzen; Ciska Hudig; Daan van de Kerkhof; Paul Verhezen; Douwe de Boer; Yvonne Henskens

doi:10.1016/j.rpth.2022.100017

Heterophilic antibodies leading to falsely positive D-dimer concentration in an adolescent

Danielle Verboogen, Bernd Granzen, Ciska Hudig, Daan van de Kerkhof, Paul Verhezen, Douwe de Boer, Yvonne Henskens^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: We present the case of a 15-year-old adolescent with suspected pulmonary embolism and repeatedly elevated D-dimer levels.

KEY CLINICAL QUESTION: We aim to determine the cause for elevated D-dimer levels in a patient without venous thromboembolism.

CLINICAL APPROACH: When the D-dimer measurement was repeated with different assays, D-dimer levels were within the normal reference interval. Dilution series with assay diluent or low-affinity antibody blocking reagents either did not or only partially decreased the D-dimer value using the original reagent kit.

CONCLUSION: Analyses suggested the presence of interfering heterophilic antibodies in patient plasma, a known phenomenon with immunoturbidimetric D-dimer assays, which is rarely described. Prior to drawing this conclusion, the patient underwent extensive diagnostic testing, which led to uncertainty and discomfort for the health care providers, the patient, and their family.

Original language	English
Article number	100017
Number of pages	4
Journal	Research and practice in thrombosis and haemostasis
Volume	7
Issue number	1
DOIs	https://doi.org/10.1016/j.rpth.2022.100017
Publication status	Published - Jan 2023

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title = "Heterophilic antibodies leading to falsely positive D-dimer concentration in an adolescent",

abstract = "BACKGROUND: We present the case of a 15-year-old adolescent with suspected pulmonary embolism and repeatedly elevated D-dimer levels.KEY CLINICAL QUESTION: We aim to determine the cause for elevated D-dimer levels in a patient without venous thromboembolism.CLINICAL APPROACH: When the D-dimer measurement was repeated with different assays, D-dimer levels were within the normal reference interval. Dilution series with assay diluent or low-affinity antibody blocking reagents either did not or only partially decreased the D-dimer value using the original reagent kit.CONCLUSION: Analyses suggested the presence of interfering heterophilic antibodies in patient plasma, a known phenomenon with immunoturbidimetric D-dimer assays, which is rarely described. Prior to drawing this conclusion, the patient underwent extensive diagnostic testing, which led to uncertainty and discomfort for the health care providers, the patient, and their family.",

author = "Danielle Verboogen and Bernd Granzen and Ciska Hudig and {van de Kerkhof}, Daan and Paul Verhezen and {de Boer}, Douwe and Yvonne Henskens",

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year = "2023",

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doi = "10.1016/j.rpth.2022.100017",

language = "English",

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T1 - Heterophilic antibodies leading to falsely positive D-dimer concentration in an adolescent

AU - Verboogen, Danielle

AU - Granzen, Bernd

AU - Hudig, Ciska

AU - van de Kerkhof, Daan

AU - Verhezen, Paul

AU - de Boer, Douwe

AU - Henskens, Yvonne

PY - 2023/1

Y1 - 2023/1

N2 - BACKGROUND: We present the case of a 15-year-old adolescent with suspected pulmonary embolism and repeatedly elevated D-dimer levels.KEY CLINICAL QUESTION: We aim to determine the cause for elevated D-dimer levels in a patient without venous thromboembolism.CLINICAL APPROACH: When the D-dimer measurement was repeated with different assays, D-dimer levels were within the normal reference interval. Dilution series with assay diluent or low-affinity antibody blocking reagents either did not or only partially decreased the D-dimer value using the original reagent kit.CONCLUSION: Analyses suggested the presence of interfering heterophilic antibodies in patient plasma, a known phenomenon with immunoturbidimetric D-dimer assays, which is rarely described. Prior to drawing this conclusion, the patient underwent extensive diagnostic testing, which led to uncertainty and discomfort for the health care providers, the patient, and their family.

AB - BACKGROUND: We present the case of a 15-year-old adolescent with suspected pulmonary embolism and repeatedly elevated D-dimer levels.KEY CLINICAL QUESTION: We aim to determine the cause for elevated D-dimer levels in a patient without venous thromboembolism.CLINICAL APPROACH: When the D-dimer measurement was repeated with different assays, D-dimer levels were within the normal reference interval. Dilution series with assay diluent or low-affinity antibody blocking reagents either did not or only partially decreased the D-dimer value using the original reagent kit.CONCLUSION: Analyses suggested the presence of interfering heterophilic antibodies in patient plasma, a known phenomenon with immunoturbidimetric D-dimer assays, which is rarely described. Prior to drawing this conclusion, the patient underwent extensive diagnostic testing, which led to uncertainty and discomfort for the health care providers, the patient, and their family.

U2 - 10.1016/j.rpth.2022.100017

DO - 10.1016/j.rpth.2022.100017

M3 - Article

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SN - 2475-0379

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JO - Research and practice in thrombosis and haemostasis

JF - Research and practice in thrombosis and haemostasis

IS - 1

M1 - 100017

ER -

Heterophilic antibodies leading to falsely positive D-dimer concentration in an adolescent

Abstract

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