title: D-dimer levels in pleural effusions.
abstract: BACKGROUND
  D-dimer is a degradation product of cross-linked fibrin. We hypothesized that hemorrhagic pleural effusions would have greater D-dimer levels than non-hemorrhagic pleural effusions, and that persistently bloody effusions would be distinguishable from thoracentesis-induced bloody effusions by the D-dimer level.
  
  
  METHODS
  Forty pleural effusions were studied. D-dimer levels (measured by ELISA), red blood cell (RBC) count, white blood cell (WBC) count, lactate dehydrogenase (LDH), and protein level was measured for each effusion. Ten effusions, five non-bloody, and five bloody were studied for each of the following disease states: parapneumonic effusion, congestive heart failure, post-coronary artery bypass grafting, and lung cancer.
  
  
  RESULTS
  No significant difference of the D-dimer level was noted between bloody and non-bloody effusions of different disease states (P=0.286). There was no significant difference in the median D-dimer levels between all the bloody and all the non-bloody effusions (P=0.88). There was no significant difference (P=0.51) in D-dimer levels between five diseases groups when the bloody and non-bloody fluids were combined. The D-dimer levels did not correlate with the RBC count (r=0.11, P=0.48), WBC count (r=0.13, P=0.53), LDH (r=0.01, P=0.93), or protein levels (r=-0.01, P=0.93) in any of the groups.
  
  
  CONCLUSIONS
  Measurement of pleural fluid D-dimer levels does not distinguish persistently bloody effusions from non-bloody effusions, and does not aid in narrowing the differential diagnosis of an effusion.
authors.affiliation: Saint Thomas Hospital, 4220 Harding Road, and Vanderbilt University, Nashville, TN 37232, USA.
authors.forename: O
authors.initials: O
authors.lastname: Dikensoy
authors.forename: G T
authors.initials: GT
authors.lastname: Stathopoulos
authors.forename: Z
authors.initials: Z
authors.lastname: Zhu
authors.forename: R W
authors.initials: RW
authors.lastname: Light
mesh_terms: D001026:Coronary Artery Bypass; D003937:Diagnosis, Differential; D004906:Erythrocyte Count; D005122:Exudates and Transudates / Q000737:chemistry; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006333:Heart Failure / Q000378:metabolism; D006470:Hemorrhage; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D007958:Leukocyte Count; D008175:Lung Neoplasms / Q000378:metabolism; D010996:Pleural Effusion / Q000097:blood / Q000737:chemistry* / Q000175:diagnosis
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D007770:L-Lactate Dehydrogenase