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Itchy Limbs, Elevated D-dimer, Minor Fever. What Else Could Cause This? Liver Has Benign Hemangioma.

Posted on Sun, 17 Jun 2012

Question: Hi I am a 31 year old female, 167 lbs, 5'1", I have lost 27 lbs and am working on losing more. Anyhow I have been very winded lately, arms and legs very achy. I went to the ER yesterday and had a slighly elevated d-dimer (normal <230) mine was 237. They did a CT with contrast of my chest, came back good and had a doppler of legs today and it was good. What else could cause this, all other blood tests were good and so was urine. I did have a minor fever of 99 yesterday. Also worth mentioning that I have had a range of tests lately...CT of head, CT of abdomen, MRI of abdomen, MRI of head, colonoscopy and EGD. All coming back good except my liver has "benign hemangiomas". I do also have low potassium lowest has been 3.3 so far with normal starting at 3.5.

Answered by Dr. Ashish Mittal (3 hours later)

Hello,
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Your body ache may be due to anxiety or excessive exertion to reduce weight. If it is because of exertion, then rest will help you.

Common symptoms which can occur with anxiety disorder: nervousness, restlessness, mild irritability, excessive worry regarding own wellbeing and health (like fear of having some serious illness), tremor, muscle spasm leading to pain in multiple parts of body, heaviness in body, easy fatigability, dizziness, palpitation, sleep difficulty and dry mouth. You have several of these complaints. Presence of depression exacerbates all these symptoms.

In general for drug treatment of anxiety disorder two types of medicine used. For immediate relief from anxiety benzodiazepines group (like clonazepam) of medicines are used and for long term relief most commonly SSRI (selective serotonin reuptake inhibitors) is used. SSRI takes around 3-4 weeks to show its effect. Apart from that, meditation, yoga, gradual weight reduction and aerobic exercises help in reducing anxiety.

As your anxiety and depressive symptoms are not fully controlled, you can discuss this issue with your psychiatrist as you may require dose enhancement or addition of other drug depending on your case suitability.

I hope I have answered your query. Please accept my answer if you have no further queries.
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Ashish Mittal (47 minutes later)

Thank you for your reply! I know all about anxiety and depression, my real question was what would cause the d-dimer to be elevated if not a DVT or PE? Your help is much appreciated.

Thank you!

Sincerely,

Jennifer

Answered by Dr. Ashish Mittal (51 minutes later)

Hello XXXXXXX

Thanks again.

Since you do not have any symptoms and scans / doppler study of leg veins were normal, the D-dimer may be false positive. False positive D-dimer can occur if there is a back ground history of inflammation (you suffered fever yesterday), recent trauma and other causes.

So there is no need to worry for a slight elevation in D Dimer as other investigations are normal. Doppler of legs is a more specific investigation for DVT compare to D dimer.

Hope this answers your query. Please accept my answer if there are no follow ups.

Regards

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad