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Circulating D-dimer and thrombomodulin levels in acute febrile phase of measles
1Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan. snow-crystal@mri.biglobe.ne.jp
Objectives:
Circulating D-dimer and thrombomodulin (TM) levels are now routinely measured in clinical laboratories. Plasma levels of D-dimer are used as a marker of fibrin formation and degradation, and serum TM is used to assess the state of endothelial cell injuries. While the levels of circulating D-dimer and TM have been investigated in many diseases, to our knowledge they have not been studied in patients with measles. We measured circulating levels of D-dimer in patients with measles to discuss whether fibrin formation and degradation occur and TM whether endothelial injury occur.
Methods:
The plasma levels of D-dimer and serum levels of alanine aminotransferase (ALT) and creatinine were measured of 14 adolescent and adult Japanese patients with measles, and the serum or plasma levels of TM of 10 of these 14 patients were measured in the acute febrile phase and convalescent afebrile phase with commercially available kits.
Results:
Plasma D-dimer levels were significantly higher in the acute febrile phase than in the convalescent afebrile phase in patients with measles, and no significant difference was shown in serum and plasma TM levels between the two phases. Plasma D-dimer levels were not correlated with serum or plasma TM levels in either phase. No significant differences were identified in the serum ALT and creatinine levels between the acute febrile and convalescent afebrile phases, and the levels of plasma D-dimer were not significantly correlated with the serum ALT levels.
Conclusions:
Our results indicate that while clot formation and fibrinolysis may tend to occur in patients with the acute febrile phase of measles, there may be little risk that such patients will suffer endothelial injury.
Insights
Measles patients show increased D-dimer, indicating clot formation and breakdown during fever. However, thrombomodulin levels suggest minimal endothelial injury risk in measles patients.
Area of Science:
- Clinical Medicine
- Hematology
- Virology
Background:
- Circulating D-dimer and thrombomodulin (TM) are established clinical markers.
- D-dimer reflects fibrin formation/degradation; TM indicates endothelial cell injury.
- Previous studies have not investigated these markers in measles patients.
Purpose of the Study:
- To measure circulating D-dimer and TM levels in measles patients.
- To investigate potential fibrin formation, degradation, and endothelial injury during measles.
- To correlate these markers with disease phases.
Main Methods:
- Measured plasma D-dimer, serum alanine aminotransferase (ALT), and creatinine in 14 measles patients.
- Assessed serum/plasma TM levels in 10 patients during acute febrile and convalescent afebrile phases.
- Utilized commercially available kits for all measurements.
Main Results:
- Plasma D-dimer levels were significantly higher in the acute febrile phase compared to the convalescent phase.
- No significant differences were observed in serum/plasma TM levels between the two phases.
- Plasma D-dimer levels did not correlate with TM levels or ALT/creatinine levels.
Conclusions:
- Clot formation and fibrinolysis may occur during the acute febrile phase of measles.
- Measles patients appear to have a low risk of endothelial injury.
- D-dimer may serve as a marker for the acute phase of measles.