Other blood results

Prostate-Specific Antigen (PSA)

• not specific for prostate cancer
• may be raised with inflammation, benign enlargement and post procedure
• PSA levels: 3-10mcg/L - approximately 25% prostate cancer on biopsy, >10mcg/L - 50% chance
• no agreed surveillance program but should be discussed with patient as potential benefit as well as harm from screening
• high levels should be repeated after 6-8weeks to reduce false +ve before initiating a urological referral

UptoDateBAUS

d-Dimer

• raised d-Dimer needs to be interpreted in context and VTE can be found despite a -ve d-Dimer result eg. small or matured clots or in patients with deranged fibrinolysis eg Factor XIII def.
• Often raised in conditions other than 'pure' VTE:
  • 60% older patients have d-Dimer value higher than classical cutoff. An age related formula is useful for patients >50y: Age (years) x 10 µg/L
  • trauma
  • upper GI haemorrhage and liver disease
  • stroke
  • ACS, AF, lipaemia
  • consumptive coagulopathy - DIC, VICC (venom induced consumptive coagulopathy)
  • later stages of pregnancy & pre-eclampsia
  • inflammatory disorders, malignancy, sickle cell disease
  • often raised in elderly and , cigarette smokers, Afro-Americans, post-op
  • Afro-Caribbean patients, especially women, typically have much higher d-Dimer levels. However, also associated with other co-morbidities and poor outcomes

J of Thromb
J of Gerontol

d-Dimer in PREGNANCY:

• 1st trimester: 167-721 ng/mL
• 2nd trimester: 298-1653 ng/mL
• 3rd trimester: 483-2256 ng/mL