A disconcerting leg: a case of deep vein thrombosis with negative D-dimers

Thomas L, Sempere H. A disconcerting leg: a case of deep vein thrombosis with negative D-dimers. Med Emergency, MJEM 2015; 23:21-3.

Key words: D-dimers, deep vein thrombosis, false negative reactions, Wells score

  • Authors’ affiliation
  • Article history / info
  • Conflict of interest statement
Correspondent author: Léa THOMAS, MD

Centre médical des armées (CMA) de Vincennes, antenne médicale en gendarmerie de Maisons-Alfort

4 avenue Busteau 94700 Maisons-Alfort

lea.thomas@intradef.gouv.fr

Thomas L, MD1, Sempere H, MD2

1. CMA de Vincennes, antenne médicale de Maisons-Alfort, 4 avenue Busteau 94700 Maisons-Alfort

2. CMA de Vincennes, antenne médicale de Rosny-sous-bois, 1 boulevard Théophile Sueur 93111 Rosny-sous-bois

Category: Case report

Received: Apr. 29, 2015

Revised: May 20, 2015

Accepted: May 27, 2015

There is no conflict of interest to declare

ABSTRACT

The annual incidence of deep vein thrombosis (DVT) in the general population in France is about 1% to 1.6%. It can occur without triggering factor identified or in patients with risk factors. We report an original case study of a patient with DVT of the lower limb proven despite a negative D-dimers rate and low predictive score. When the predictive score of venous thromboembolic disease is low, the diagnostic strategy is that D-dimers are assayed for eliminating DVT, the negative predictive value being very high, around 94% to 100%. The use of Doppler ultrasound is then recommended. The cases of false negatives reported in the literature are few and question the false negative D-dimers etiologies.