Acute exacerbation of COPD with pulmonary embolism: A new D-dimer cut-off value

What is it about?

COPD exacerbation may be similar to pulmonary embolism in symptoms and signs, also may be associated with each other. D-Dimer is a blood analysis which rises in cases of pulmonary embolism, but it is found to be elevated also during exacerbation of COPD. so if a patient presents with COPD exacerbation associated with Pulmonary embolism, D-Dimer will be misleading if used in its usual reference values, and a new cut-off value is needed to judge further investigations which could be done unnecessarily in patients with COPD exacerbation just for elevated D-Dimer over its normal (traditional) current cut-off value.

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Why is it important?

If pulmonary embolism is suspected due to just elevation of D-Dimer, it may be false positive in cases of COPD exacerbation where D-Dimer is found to be higher than normal. In addition, further investigations as CT chest with pulmonary angiography can be saved when using the new D-Dimer level, so avoiding some unnecessary hazards of radiation, allergy from contrast as well as its negative impact on renal function.

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