Clinical application of D-dimer in Kawasaki Disease / 소아과

ABSTRACT

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+/-0.77 mg/mL vs 0.92+/-0.71 mg/mL, P=0.083). Neither was the difference between KD patients who had coronary artery abnormalities and those who had not (1.49+/-0.98 mg/mL vs 1.15+/-0.71 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.