Sorted By Test Name - Mayo Medical Laboratories

DLAC
8878
DLAU
8873
fibrinogen equivalent units [FEU]) are normal. Within the reportable normal range (110-250 ng/mL DDU;
0.22-0.50 mcg/mL FEU), measured values may reflect the activation state of the procoagulant and
fibrinolytic systems, but the clinical utility of such quantitation is not established. A normal D-dimer
result (< or =250 ng/mL DDU; < or =0.50 g/mL FEU) has a negative predictive value of approximately
95% for the exclusion of acute pulmonary embolism (PE) or deep vein thrombosis when there is low or
moderate pretest PE probability. Increased D-dimer values are abnormal but do not indicate a specific
disease state. D-dimer values may be increased as a result of: -Clinical or subclinical disseminated
intravascular coagulation/intravascular coagulation and fibrinolysis -Other conditions associated with
increased activation of the procoagulant and fibrinolytic mechanisms such as recent surgery, active or
recent bleeding, hematomas, trauma, or thromboembolism -Association with pregnancy, liver disease,
inflammation, malignancy or hypercoagulable (procoagulant) states The degree of D-dimer increase does
not definitely correlate with the clinical severity of associated disease states.
Reference Values:
< or =250 ng/mL D-Dimer Units (DDU)
< or =0.5 mcg/mL Fibrinogen Equivalent Units (FEU)
Clinical References: 1. Feinstein DI, Marder VJ, Colman RW: Consumptive thrombohemorrhagic
disorders. In Hemostasis and Thrombosis: Basic Principles and Clinical Practice. 4th edition. Edited by
RW Colman, J Hirsh, VJ Marder, et al. Philadelphia, PA, JB Lippincott Co., 2001, pp 1197-1234 2. Levi
M, ten Cate H: Disseminated intravascular coagulation. N Engl J Med 1999 August;341(8):586-592 3.
Brill-Edward P, Lee A: D-dimer testing in the diagnosis of acute venous thromboembolism. Thromb
Haemost 1999 August;82(2):688-694 4. Heit JA, Minor TA, Andrews JC, et al: Determinants of plasma
fibrin D-dimer sensitivity for acute pulmonary embolism as defined by pulmonary angiography. Arch
Pathol Lab Med 1999 March;123(3):235-240 5. Heit JA, Meyers BJ, Plumhoff EA, et al: Operating
characteristics of automated latex immunoassay tests in the diagnosis of angiographically-defined acute
pulmonary embolism. Thromb Haemost 2000 June;83(6):970 6. Bates SM, Grand'Maison A, Johnston M,
et al: A latex D-dimer reliably excludes venous thromboembolism. Arch Intern Med 2001
February;161(3):447-453
D-Lactate, Plasma
Clinical Information: D-lactate is produced from carbohydrates that were not absorbed in the small
intestine by bacteria residing in the colon. When large amounts are absorbed it can cause metabolic
acidosis, altered mental status (from drowsiness to coma), and a variety of other neurologic symptoms, in
particular dysarthria and ataxia. Although a temporal relationship has been described between elevations
of plasma and urine D-lactate and the accompanying encephalopathy, the mechanism of neurologic
manifestations has not been elucidated. D-lactic acidosis is typically observed in patients with short-bowel
syndrome and following jejunoileal bypass resulting in carbohydrate malabsorption. In addition, healthy
children presenting with gastroenteritis may also develop the critical presentation of D-lactic acidosis.
D-lactate is readily excreted in urine, which is the preferred specimen for D-lactate determinations.
Useful For: An adjunct to urine D-lactate (preferred), in the diagnosis of D-lactate acidosis
Interpretation: Increased levels are consistent with D-lactic acidosis. However, because D-lactate is
readily excreted, urine determinations are preferred.
Reference Values:
0.0-0.25 mmol/L
Clinical References: 1. Brandt RB, Siegel SA, Waters MG, Bloch MH: Spectrophotometric assay
for D-(-)-lactate in plasma. Anal Biochem1980;102(1):39-46 2. Petersen C: D-lactic acidosis. Nutr Clin
Pract 2005;20(6):634-645
D-Lactate, Urine
Clinical Information: D-lactate is produced from carbohydrates that are not absorbed in the small
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