D-Dimer in Systemic JRA

[Guest guest]

Hi everyone,

I found this article and wanted to get input as to what exactly it is

saying. How do you interprete it? My son always has a very high d-

dimer, just got a call about his recent blood results and the d-dimer

is very high.

Thanks

(Christian 16, systemic)

Titre du document / Document title

Fibrin D-dimer as a marker of disease activity in systemic onset

juvenile rheumatoid arthritis

Auteur(s) / Author(s)

BLOOM B. J. ; TUCKER L. B. ; MILLER L. C. ; SCHALLER J. G. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Section of Pediatric Rheumatology/Division of Ambulatory Pediatrics,

Hasbro Children's Hospital at Rhode Island Hospital and Brown

University School of Medicine, Providence, RI, ETATS-UNIS

Division of Pediatric Rheumatology, The Floating Hospital for

Children at New England Medical Center and Tufts University School of

Medicine, Boston, MA, ETATS-UNIS

Résumé / Abstract

Objective. To study the prevalence of coagulation abnormalities in

children with systemic juvenile rheumatoid arthritis (JRA) using a

sensitive marker of fibrin degradation, and to determine whether

serial levels of this variable parallel disease activity or predict

response to medications in this disease. Methods. Levels of d-dimer

were determined in 24 consecutive patients with systemic JRA in

conjunction with complete blood counts, erythrocyte sedimentation

rate, maximum fever. duration of morning stiffness, and swollen joint

count. Serial levels were then obtained in 11 patients. Linear

regression analyses were done to determine any correlations between d-

dimer and the other variables ; and paired t test was used to compare

levels before and after treatment interventions. Levels of d-dimer

were also compared against concurrent clinical events such as

pericarditis. Results. Elevated levels of d-dimer were found in 23/24

of the patients (96%). When serial levels were analyzed. there were

correlations between levels of d-dimer and fever (p = 0.03) and total

leukocyte count (p = 0.04), but not with other variables. There was a

significant reduction in levels before and after treatment in

patients deemed to be clinical responders to immunomodulatory agents

(p = 0.02). Elevated levels were also indicative of severe disease

over the remainder of followup; lack of d-dimer indicated a benign

disease course. Conclusion. With the use of a sensitive and specific

marker of fibrinolysis known as d-dimer, coagulation abnormalities

were more prevalent in children with systemic JRA than previously

reported. and are frequently found during periods of active disease.

Furthermore, serial levels of d-dimer appear to parallel response to

disease modifying agents, and may predict outcome over a short

followup period. Fibrin d-dimer may represent a novel marker that,

when used in combination with known variables, could enhance that

assessment of disease activity and response to medications in

children with systemic onset JRA.

Revue / Journal Title

Journal of rheumatology (J. rheumatol.) ISSN 0315-162X CODEN

JRHUA9

Source / Source

1998, vol. 25, no8, pp. 1620-1625 (20 ref.)

Langue / Language

Anglais

Editeur / Publisher

Journal of Rheumatology Publishing, Toronto, ON, CANADA (1974) (Revue)

Mots-clés anglais / English Keywords

Juvenile rheumatoid arthritis ; Child ; Evolutivity ; Exploration ;

Biological marker ; Fibrinolysis ; Coagulopathy ; Predictive factor ;

Treatment efficiency ; Biochemical analysis ; Chronic ; Human ;

Diseases of the osteoarticular system ; Inflammatory joint disease ;

Hemopathy ;

Mots-clés français / French Keywords

Arthrite chronique juvénile ; Enfant ; Evolutivité ; Exploration ;

Marqueur biologique ; Fibrinolyse ; Coagulopathie ; Facteur

prédictif ; Efficacité traitement ; Analyse biochimique ; Chronique ;

Homme ; Système ostéoarticulaire pathologie ; Rhumatisme

inflammatoire ; Hémopathie ;

Mots-clés espagnols / Spanish Keywords

Artritis crónica juvenil ; Niño ; Evolutividad ; Exploración ;

Marcador biológico ; Fibrinólisis ; Coagulopatía ; Factor

predictivo ; Eficacia tratamiento ; Análisis bioquímico ; Crónico ;

Hombre ; Sistema osteoarticular patología ; Reumatismo inflamatorio ;

Hemopatía ;

Localisation / Location

INIST-CNRS, Cote INIST : 16024, 35400007002786.0300

Copyright 2007 INIST-CNRS. All rights reserved

Toute reproduction ou diffusion même partielle, par quelque procédé

ou sur tout support que ce soit, ne pourra être faite sans l'accord

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No part of these records may be reproduced of distributed, in any

form or by any means, without the prior written permission of INIST-

CNRS.

Nº notice refdoc (ud4) : 2355147