Clinical application of D-dimer in Kawasaki Disease |
Jae Joon Han, Hong Ki Ko, Young Yoo, JungHwa Lee, Kwang Chul Lee, Chang Sung Son, Joo Won Lee |
Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea |
가와사끼병에서 D-dimer의 임상적 응용 |
한재준, 고홍기, 유영, 이정화, 이광철, 손창성, 이주원 |
고려대학교 의과대학 소아과학교실 |
Correspondence:
JungHwa Lee, Email: leejmd@chol.com |
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Abstract |
Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
Purpose : Vascular endothelial cell damage and alteration of a fibrinolytic system was suggested to play a role in the development of coronary artery abnormalities in Kawasaki disease (KD). D-dimer is one of the markers of endothelial damage and fibrinolysis. We evaluated the clinical usefulness of D- dimer to differentiate KD from other febrile diseases and predict coronary artery abnormalities in KD.
Methods : Sixty eight patients diagnosed as KD and twenty eight patients presented with acute febrile illnesses other than KD from September 2005 to July 2006 were included. Blood levels of D- dimer and various inflammatory markers were measured before treatment and the clinical course of KD was followed. Serial echocardiography was performed at the onset of disease and thereafter at a monthly interval for at least 2 months.
Results : KD patients showed a higher D-dimer level than febrile controls, but the difference was not significant (1.21?.77 mg/mL vs 0.92?.71 mg/mL, P=0.083). Neither was the difference between KD patients who had coronary artery abnormalities and those who had not (1.49?.98 mg/mL vs 1.15?.71 mg/mL, P=0.169). D-dimer was significantly correlated with other inflammatory markers, such as C-reactive protein and erythrocyte sedimentation rate in both KD patients and febrile controls.
Conclusion : D-dimer was not specific for KD. But it may be useful as an inflammatory marker to assess the severity of KD. |
Key Words:
Mucocutaneous mymph node syndrome , Coronary aneurysm , D-dimer |
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