[Assay of products of fibrin and fibrinogen degradation in disseminated intravascular coagulations. Evaluation of a new technique].

OBJECTIVES

An increase in fibrin or fibrinogen degradation products (FDP) is highly indicative of the diagnosis of disseminated intravascular coagulation (DIC). We assessed the sensitivity and specificity of a recently developed method (FDP plasma) with respect to other classical methods.

METHODS

FDP plasma was compared to another semi-quantitative method using monoclonal antibodies (D-di test), a semi-quantitative method on serum using polyclonal antibodies (Spli-prest) and a quantitative ELISA (D-dimer). The results from 34 patients with DIC were compared with those of several control groups (30 healthy volunteers, 34 women at the end of an uneventful pregnancy, and 24 of them after delivery), in order to assess sensitivity and specificity of each test.

RESULTS

The 3 plasma tests using monoclonal antibodies demonstrated similar sensitivities (88-100%), which was clearly higher than the sensitivity of serum test, using polyclonal antibodies. Specificity was identical (97-98%) for the 3 semi-quantitative tests when normal ranges were defined according to the results of the control groups. It was higher than the sensitivity of the ELISA test.

CONCLUSION

Due to their higher specificity, and to their rapidity, FDP semi-quantitative tests are the most suitable tests for the diagnosis of DIC. Spli-prest, which showed a low sensitivity, should be replaced by D-di test or FDP-plasma, which displayed similar good results.