Last revised by Daniel J Bell on 9 Sep 2021

D-dimer is a commonly tested biological marker which is produced by the enzymatic breakdown of cross-linked fibrin which forms the fibrous mesh of a blood clot. The measurement of D-dimer in the circulation acts as a marker of coagulation and fibrinolysis, which can be useful in the diagnosis of multiple diseases.

Validated uses of D-dimer
Unvalidated uses of D-dimer
Conditions associated with a raised D-dimer
Conditions associated with an extremely high D-Dimer

In a large study in 2016 an extreme elevated level was arbitrarily defined as >5,000 µg/L FEU 4. An older study from 2011, defined an extreme elevated D-dimer as >50,000 µg/L FEU 9. A study series of adult-onset Still disease only, found very high D-dimers in four of 22 patients, defined in this case as >5,000 µg/L FEU 11.

The vast majority of cases were associated with severe disease:

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