Measurement of fibrinogen-fibrin-related antigen in serum as aid to diagnosis of deep vein thrombosis in outpatients.

Tibbutt, David; Chesterman, C N; Allington, M. J.; Williams, Eloise; Faulkner, Thomas P.

doi:10.1136/bmj.1.5954.367

Cited by 23 publications

(3 citation statements)

References 13 publications

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“…The test result was falsely abnormal in 93 of the 706 patients without proximal-vein thrombosis, for a specificity of 87%. Conse- Other Methods An array of various methods including strain gauge plethysmography [82,93], liquid crystal (contact) thermography [94][95][96][97][98], light reflection rheography [99], computed tomog raphy scanning, and magnetic resonance scanning [100][101][102][103], radionuclide venography [104][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119][120][121][122][123], as well as numerous blood tests (including measurements of fibrinopeptide A [124,125], fibrin(ogen) degradation products (FDP) [126,127], degradation products of cross-linked fibrin (Z)-dimer) [128][129][130][131][132][133][134][135][136][137], pro thrombin fragments 1+2 (F I+2) and thro...…”

Section: Doppler Ultrasonographymentioning

confidence: 99%

Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Cogo

Lensing²,

Wells³

et al. 1995

Pathophysiol Haemos Thromb

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Deep-vein thrombosis of the lower extremity is a frequent disorder associated with morbidity and mortality due to pulmonary embolism and the postthrombotic syndrome. It was not until the introduction of contrast venography that the inaccuracy of the clinical diagnosis became apparent. Since then, management decisions have usually been based on objective diagnostic test. Venography is generally considered the reference method for the diagnosis of deep-vein thrombosis, but it is invasive and associated with serious side effects. Several noninvasive or less invasive objective diagnostic methods have been developed. These diagnostic methods are distinctly different in technology and consequently in their ability to demonstrate or refute deep-vein thrombosis. In this review, a critical analysis is provided on the accurary of the current noninvasive diagnostic approaches to venous thrombosis in patients with a first episode of clinically suspected deep-vein thrombosis. Results of studies were considered only when their methodology fulfilled the essential criteria for evaluation of a diagnostic test.

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Section: Doppler Ultrasonographymentioning

confidence: 99%

Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Cogo

Lensing²,

Wells³

et al. 1995

Pathophysiol Haemos Thromb

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show abstract

“…Other diagnostic techniques, including other forms of plethysmography, thermography, and various isotopic methods, have been evaluated to a limited extent (Barnes et al, 1972;Cooke & Pilcher, 1974;Johnson et al, 1974;Tibutt et al, 1975). Sensitive blood tests that detect intravascular fibrin formation and lysis have also been evaluated (Wilde et al, 1989) but are of limited value.…”

Section: Othermentioning

confidence: 99%

Deep-vein thrombosis and pulmonary embolism

Collen

Quéré

Galanaud

1975

Injury

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Venous thromboembolism in this situation the embolism is detached from the thrombus (usually in the proximal veins of the thigh) and ends up obstructing the pulmonary arteries and therefore producing a pulmonary embolism (see above). Deep vein thrombosis (DVT) of the lower limb and its acute complication, pulmonary embolism (PE), are major causes of death and disability. In the general population, clinically recognised DVT and/or PE occurs in about 2 in 1000 persons each year. In the hospitalised population DVT and PE are much commoner. This is probably due to the contribution of acute injury, surgery or medical illness (which cause pooling of blood in the deep leg veins, within which activated clotting factors produce fibrin rich thrombi) (SIGN, 1995). A recent study in Sheffield (Thromboembolic Risk Factors (THRIFT) Consensus Group, 1992), found that 9 per cent of patients admitted to a general hospital died and that 10 per cent of these deaths (0.9 per cent of all admissions) were due to pulmonary embolism. This is approximately 77,000 deaths in 1992 (in 1995 it is estimated that the number of hospital deaths due to PE will have risen to 80,000; OHE, 1995). Clinical diagnosis The clinical diagnosis of DVT and PE has always been unreliable (Sharnoff, 1980), particularly with regard to physical symptoms and signs. Some of the physical symptoms and signs of DVT include pain and tenderness in the calf muscles, swelling of the calf or thigh and palpation of vein cords in the leg and thigh muscles, increase in temperature and skin discoloration (cyanosis). Objective tests have shown that the clinical physical signs are only 50 per cent or less accurate, with a frequent false-positive diagnosis (Weinmann and Salzman, 1994). Not only are some of these tests of limited sensitivity but a major difficulty is that other conditions besides deep vein thrombosis can cause a painful, swollen leg. In a study of 87 consecutive patients with clinically suspected deep vein thrombosis, who had a normal phlebogram (see Box 1), it was found that only 34 actually had a DVT. Of the remainder, 37 had a musculoskeletal cause, 12 had impaired venous or lymphatic flow, and 4 had popliteal cysts (Baker's cysts) (Hull et al, 1981). Therefore a diagnosis suspected on clinical grounds must be confirmed by a sensitive diagnostic test. The diagnosis of pulmonary embolism is also frequently inaccurate both clinically and radiographically. The most common clinical signs are dramatic, sudden collapse, air hunger, cyanosis and shock. Less common are pleuritic chest pain, apprehension, cough,

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“…They found a significantly higher incidence of pos itive tests in patients with DVT or pulmo nary embolism compared with normals. In a more recent study, they claim a sensitivity of 88% and a specificity of 66% [Foti and Gur ewich, 1980], For the test, Tibbutt et al [1975] used a latex flocculation inhibition method with antiserum directed against the D and E plasmin digests of fibrinogen. They observed an increased serum level of FDP in patients with DVT, especially when the thrombus extended above the knee.…”

Section: Introductionmentioning

confidence: 99%

Fibrinopeptide A, Beta-Thromboglobulin, and Fibrin Degradation Products as Screening Test for the Diagnosis of Deep Vein Thrombosis

Wojciechowski¹,

Olausson²,

Korsan-Bengtsen³

1983

Pathophysiol Haemos Thromb

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In a group of 111 consecutive patients (mean age 65 years) with suspected deep venous thrombosis (DVT) phlebography demonstrated DVT in 51. In all patients blood tests for fibrinopeptide A (FPA), fibrin degradation products (FDP) and beta-thromboglobulin (beta-Tg) were carried out. There was a significant difference in FPA concentration between the group of patients with a positive and a negative phlebography. However, there was a wide variation of individual values in both groups. The difference in FPA concentration between the groups was not related to differences in predisposing diseases, age or sex. FDP and beta-Tg did not differ between the groups and, again, a wide variation of individual values was found in both groups. In our hands, none of these three methods reflecting activities in the hemostasis seems to be useful to diagnose DVT in clinical routine work.

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Measurement of fibrinogen-fibrin-related antigen in serum as aid to diagnosis of deep vein thrombosis in outpatients.

Cited by 23 publications

References 13 publications

Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Deep-vein thrombosis and pulmonary embolism

Fibrinopeptide A, Beta-Thromboglobulin, and Fibrin Degradation Products as Screening Test for the Diagnosis of Deep Vein Thrombosis

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