other
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
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
d-Dimer in PREGNANCY:
For pregnant women, the following D-Dimer reference value ranges are proposed: Preg- 1st trimester: 167-721 ng/mL
- 2nd trimester: 298-1653 ng/mL
- 3rd trimester: 483-2256 ng/mL
Author: Dr Dylan Jenkins Oct 2023.