Correlation of plasma D-dimer concentration with severity of patients systemic sclerosis
DOI:
https://doi.org/10.66344/jpad.v31i3.1622Keywords:
Plasma D-dimer, Systemic SclerosisAbstract
Objective To find out the relationship between the level of plasma D-dimer concentration and severity of systemic sclerosis.
Methods This cross-sectional study was conducted in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from September, 2015 to August, 2017. Forty four patients of systemic sclerosis were included in this study through consecutive sampling. All of the patients were diagnosed by the dermatologist as systemic sclerosis on the basis of American College of Rheumatology (ACR) criteria. Using modified Rodnan Skin Scoring (mRSS) the patients were divided into three groups: mild, moderate and severe. All the patients in each group were tested for plasma D-dimer concentration and then plasma D-dimer concentration was correlated with the severity of disease. Statistical analysis was done by using Windows based computer software devised with statistical package for social sciences (SPSS-22, inc Chicago IL, USA). The results were obtained by using t-test, Chi-square test, ANOVA and Pearson’s Correlation Coefficient test.
Results Among 44 patients, 21 (47.7%) had Diffuse Cutaneous Systemic Sclerosis (dcSSc) and 23 (52.3%) had Limited Cutaneous Systemic Sclerosis (lcSSc). According to mRSS 23 (52.3%) patients had mild, 15 (34.1%) had moderate and 6 (13.6%) had severe disease. Female patients were predominant in this study. D-dimer concentrations were increased in parallel with severity of the disease. Significant positive correlation was observed between D-dimer concentration and mRSS (p=0.009). Mean plasma D-dimer concentrations found to be significantly increased in patients with dcSSc in comparison with lcSSc (1.31±0.95 vs. 0.78±0.37, p=0.018).
Conclusion Plasma D-dimer concentration is directly related to the severity of the systemic sclerosis and it might be a helpful additional test to identify patients with systemic sclerosis at risk of developing thrombotic complications.
References
1. Moinzadeh P, Denton CP, Krieg T, Black CM. Scleroderma. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffel DJ, Wolf K, editors. Fitzpatrick’s dermatology in general medicine. 8th edition. New york. McGrawHill.2012.p1942-1956.
2. Ho M, Veale D, Eastmond C, Nuki G, Belch J. Macrovascular disease and systemic sclerosis. Ann Rheum Dis.2000;59:39-43.
3. Kahaleh MB. Vascular involvement in systemic sclerosis (SSc). Clin Exp Rheumatol.2004;22(Suppl.33): S19-S23.
4. Ames PR, Lupolis S, Alves J, Atsumi T, Edwards C, Iannccone L, Khamashta MA, Hughes GR, Brancaccio V. The coagulation / Fibrinolysis balance in systemic sclerosis: Evidence for a haematological stress syndrome. Br J Rheumatol.1997;36:1045-50.
5. Cerinic MM, Valentini G, Sorano GG, D’Angelo S, Cuomo G, Fenu L, Generini S, Cinotti S, Morfini M, Pignone A, Guiducci S, Rosso AD, Kalfin R, Das D, Marongiu F. Blood Coagulation, Fibrinolysis, and Markers of Endothelial Dysfunction in Systemic Sclerosis. Semin Arthritis Rheum.2003;32:285-95.
6. Prisco D, Antonucci E, Marcucci R, Pepe G. D-dimer in the year 2000: current data and new perspectives. Ann Ital Med Int. 2000;15:267-72.
7. Marie I, Ducrotte P, Denis P, Hellot MF, Levesque H. Oesophageal mucosal involvement in patients with systemic sclerosis receiving proton pump inhibitor therapy. Aliment Pharmacol Ther.2006;24:1593-1601
8. Falanga V, Kruskal JB, Franks JJ. Fibrin and fibrinogen-related antigens in systemic sclerosis (scleroderma). J Am Acad Dermatol.1991;25:771-5.
9. Komarov AL, Panchenko EP, Dobrovolsky AB , Yu. A. Karpov YA, Deev AD , Titaeva EV, Davletov KK , Eshkeeva AR, Markova LA. D-dimer and platelet aggregability are related to thrombotic events in patients with peripheral arterial occlusive disease. Eur Heart J. 2002;23:1309–16.
10. Lowe GDO. Can haematological tests predict cardiovascular risk? The 2005 Kettle Lecture. Br J Haematol.2006;133:232–250
11. Morange PE, Bickel C, Nicaud V, Schnabel R, Rupprecht HJ, Peetz D, Lackner KJ, Cambien F, Blankenberg S, Tiret L. Haemostatic Factors and the Risk of Cardiovascular Death in Patients With Coronary Artery Disease. Arterioscler Thromb Vasc Biol.2006;26:2793-9.
12. Rudnicka AR, Rumley A, Lowe GDO, Strachan DP. Diurnal, Seasonal, and Blood-Processing Patterns in Levels of Circulating Fibrinogen, Fibrin D-Dimer, C-Reactive Protein, Tissue Plasminogen Activator, and von Willebrand Factor in a 45-Year-Old Population. Circulation.2007;115:996-1003.
13. Tzoulaki I , Gordon D, Murray GD, Price JF, Smith FB, Lee AJ, Rumley A, Lowe GDO, Fowkes FGR. Hemostatic Factors, Inflammatory Markers, and Progressive Peripheral Atherosclerosis. The Edinburgh Artery Study. Am J Epidemiol.2006;163:334–41.
14. LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA, Rowell N, Wollheim F. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol.1988;15:202-5.
15. Lippi G, Volpe A, Caramaschi P, Salvagno GL, Montagnana M, Guidi GC. Plasma D-dimer concentration in patients with systemic sclerosis. Thromb J. 2006;4:2.
16. Maeda M, Kachi H, Mori S. Plasma levels of molecular markers of blood coagulation and fibrinolysis in progressive systemic sclerosis (PSS). J Dermatol Sci. 1996;11:223-7.
17. Marie I, Borg J-Y, Hellot M-F, Levesque H. Plasma D-dimer concentration in patients with systemic sclerosis. Br J Dermatol. 2008;158:392-5.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Tabassum Nasrin, Nargis Akhtar, Nandita Ghosh, Harasit Kumar Paul
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.
