All issues > Volume 50(2); 2007

Original Article

Korean J Pediatr. 2007;50(2):205-208. Published online February 15, 2007.

Clinical application of D-dimer in Kawasaki Disease

Jae Joon JJ Han¹, Hong Ki HK Ko¹, Young Y Yoo¹, JungHwa JH Lee¹, Kwang Chul KC Lee¹, Chang Sung CS Son¹, Joo Won JW Lee¹

¹Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea

Correspondence JungHwa JH Lee ,Email: leejmd@chol.com

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.

Keywords :Mucocutaneous mymph node syndrome , Coronary aneurysm , D-dimer