D Dims Blood test.

[South123]

Had Polymyagia for 5 years but have remained active throughout. I Recently had a severe calf pain with associated swelling. Went to A & E and had a d dimer blood test which showed raised levels. Put on blood thinners and sent home. Waited 10 days for a doppler scan which shows I haven't got a DVT but no clear diagnosis. My question is does PMR cause raised levels in a d dimer blood test?

[PMRpro Ambassador]

Not sure they can be that definitive when the scan was delayed for 10 days after starting blood thinners. But autoimmune disorders can also raise D-dimer levels. Do you smoke?

[South123 in reply to PMRpro]

No I don't. My BMI is 24 and I walk every day. Go to the gym 4 times a week, cycle and swim. My initial assessment by a practice nurse was it was definitely not DVT but they use the blood test results as a positive indication until your doppler scan. So 10 days on blood thinners may of made my condition much worse if it was a muscle tear with a bleed into my leg. Very annoying!

[PMRpro Ambassador in reply to South123]

On the other hand - better they treated and it wasn't than the other way round. A member of staff in my husband's department had the signs of DVT ignored because they assumed it was a muscle injury from football - and he died.

[South123 in reply to PMRpro]

Very true. We seem to have a severe lack of Vascular scientists, even private ones.

[PMRpro Ambassador in reply to South123]

It is a difficult field - and at least one vascular scientist retired early because he was so fed up with not being a medical scientist any more as the paper trail for his NHS post grew and grew and money sources shrank and shrank so he wasn't working with patients but stingy admins in his fight for replacement equipment to run the department. I don't think he missed the NHS much!

[Ridge]

How interesting. When I was first diagnosed with GCA and PMR my CRP and EST were not particularly high but my D-Dimers were! They set off a whole load of searches for a DVT which were clear so conclusion was the D-Dimers were inflammatory. I have never heard of anyone else with the same profile.

[South123 in reply to Ridge]

Yes interesting. The problem seems to be that because Vascular scans are so difficult to get they rely on the d dimers as the trigger for DVT treatment. It allways seem to be the same with me. Not sure if you have Polymyagia so give you steroids and if you show improvement then that's it diagnosis over. Exactly the same with my Asthma.

[PMRpro Ambassador in reply to South123]

"The problem seems to be that because Vascular scans are so difficult to get they rely on the d dimers as the trigger for DVT treatment"

Who says? Vascular scans and DVT scans can be 2 different things and while vascular scans probably are on a waiting list these days, DVT scans should be walk-ins, If they are that difficult to get - how is the mighty NHS fallen ...

[South123 in reply to PMRpro]

My doppler DVT scan was a 10 day wait. I tried to go private in my local area but 7 day wait and £380 was the best I could do. When I finally got my scan the department was completely empty i was the only patient and nothing much seemed to be happening. There was 1 nurse, 1 receptionist and a very young apprentice scientist in what seemed to be a large modern department . In the hospital It took me over 30 mins to find the place as I was missed directed 3 times by receptionists. The patient before me never turned up (presume they got lost) an an ambulance crew arrived to collect a patient who had gone missing and wasn't there.

[PMRpro Ambassador in reply to South123]

That's a right piece of nonsense. Hope you told them to get some signposting out - no wonder there's a wait with all the repeat appointments they have to send out.

[AtopicGuy]

Well done to you and NHS A&E! All the evidence suggests you did have a DVT (blood clot) in your calf, you acted correctly, the medication helped your body to break it down safely, and 10 days latter your blood vessels were clear.

As this link explains, the D-dimer test reveals when your body is already trying to break down a blood clot. Serious consequences can follow if a chunk of a blood clot comes loose and lodges somewhere worse.

medlineplus.gov/lab-tests/d...

[South123 in reply to AtopicGuy]

Yes I will probably never know. The doppler scan should by all medical advice be given as soon as you fail the d dimmer blood test. As that wasn't done for 10 days it has not helped with the diagnosis. The Vascular Scientist has recommended a further scan of the large lump on my leg but I am not sure that will happen unless I have it done privately. The physio thinks I have a torn calf so for the moment that is it. I am speaking to my GP tomorrow to see if I can get a further ultrasound or MRI.

[AtopicGuy in reply to South123]

I know four people who survived DVTs that broke up and lodged in the lung (a pulmonary embolism). The first had recently started on HRT (hormone replacement therapy). The problems of the other three each began with a leg injury: two with badly twisted and bruised ankles, and the third a varicose vein in the calf. None of them took the initial swelling seriously, so they all ended up in hospital with breathing problems.

[South123 in reply to AtopicGuy]

I took the original injury very seriously. That's why I walked into casualty with a very slightly swollen leg with mild pain. I was told it was DVT based solely on a D Dimer blood test . After Ten days of agony in bed with a hugely swollen lower leg I am told I don't have DVT based on a scan. What happend in between nobody can tell me. I still don't know the cause of that injury with any certainly. If it had been DVT I believe I would have to be on blood thinners for at the very least 3 months but I was told to stop after 10 days !

[AtopicGuy]

A DVT is a blood clot. You don't have a DVT any more because the drugs given to you dissolved it away. Now you are being told that there is no sign of new clots forming. This proves the medicines you are on are working. It's good news. I'm glad you caught it early.