Others

• Normally plasma is negative for D-dimer.
• Qualitative: It is negative
• Quantitative : < 250 ng/mL or < 250  µg/L ( SI unit)
• Critical value >40 mg/L (40 µg/mL).

Increased Level Of D-Dimer :

1. Primary and secondary fibrinolysis.
   1. DIC
   2. Thrombolytic therapy.
   3. Deep vein thrombosis.
   4. Pulmonary embolism.
   5. Arterial thromboembolism.
   6. Vaso-occlusive crises of sickle cell anemia.
   7. Pregnancy (Especially the postpartum period).
   8. Malignancy.
   9. Surgery.

The Positive Coomb’s Direct Test :

1. Autoimmune hemolytic anemia.
   1. Warm reactive autoantibody.
   2. Cold reactive autoantibody.
   3. Cold haemagglutinin disease is seen in Lymphoma and pneumonia.
   4. Paroxysmal cold hemoglobinuria.
   5. Systemic lupus erythematosus.
2. Drug-induced hemolytic anemia, e.g., penicillin, quinidine, Cephalosporin, and α-methyldopa.
   1. α-methyldopa hemolytic reaction occurs in <30% of the patient with therapy, but only <1% shows hemolysis; rarely in the first 6 months of the treatment.
   2. If it is not found within 12 months of the treatment, then less likely to see the reaction.
   3. A reversal takes place from weeks to months after stopping the drugs.
3. Hemolytic anemia: Transfusion reaction to incompatible RBC and hemolytic anemia of the newborn.
   1. Erythroblastosis fetalis.
   2. Incompatible blood transfusion.
   3. Delayed hemolytic blood transfusion reaction.
4. Malignant diseases:
   1. Lymphoma.
   2. Chronic lymphocytic leukemia.
   3. Acute and chronic leukemias.
5. Infections :
   1. Infectious mononucleosis.
   2. Mycoplasma pneumoniae
6. Weak positive tests are seen in:
   1. Renal diseases.
   2. Rheumatoid arthritis.
   3. Inflammatory bowel disease.
   4. Epithelial malignancy.
   5. Weak positive tests usually have no clinical significance.

Normal

• Negative, and there is no agglutination.

 Positive Indirect Coombs’ Test Indicates:

1. Incompatible blood transfusion.
2. Mother has anti-Rh antibodies.
   1. Erythroblastosis fetalis.
3. Acquired hemolytic anemia.
4. due to drugs and cold antibodies.

Normal Value: 125-220 U/L

Causes of increase LDH:

1.Liver Diseases

2.Haemolysis

3. sarcoidosis.

4.Acute Myocardial Infarction

5.Malignant diseases: