USE OF FIBRINOGEN-FIBRIN DEGRADATION PRODUCTS AND SOLUBLE FIBRIN COMPLEXES FOR DIFFERENTIATING PULMONARY-EMBOLISM FROM NON-THROMBOEMBOLIC LUNG-DISEASE

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Abstract
To help differentiate pulmonary embolism from other lung diseases, the degradation products of fibrinogen and fibrin and soluble fibrin complexes were measured in normal control subjects and patients with pulmonary embolism, lung cancer, pneumonia, chronic obstructive pulmonary disease, tuberculosis, asthma and several miscellaneous disorders. A separate group of patients, who were suspected of having pulmonary embolism but had negative pulmonary angiography, were also tested. Many nonthromboembolic lung diseases frequently were associated with positive fibrinogen/fibrin degradation products or soluble fibrin complexes, but those with high positivity rates for 1 test tended to have low rates for the other test. Both fibrinogen/fibrin degradation products and soluble fibrin complexes were positive in 55% of patients with pulmonary embolism but only in 4% with nonthromboembolic conditions (P < 0.001), in 7% of patients with negative pulmonary angiography (P < 0.001), and in none of the normal subjects (P < 0.001). Both tests were negative in only 3% of patients with pulmonary embolism but in 35% of nonthromboembolic diseases (P < 0.005), 54% of those with negative pulmonary angiography (P < 0.001), and 79% of normal control subjects (P < 0.001). The combination of fibrinogen-fibrin degradation products and soluble fibrin complexes is more valuable than either test alone in the diagnostic separation of thromboembolic from nonthromboembolic pulmonary diseases.