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Raised D-dimer levels in acute sickle cell crisis and their correlation with chest X-ray abnormalities
Javeed Dar1, Inam Mughal, Hilali Hassan
1Armed Forces Hospital, Southern Region, Khamis Mushayt, Kingdom of Saudi Arabia.
Objective:
Quantitation of D-dimer level during a sickling crisis and its correlation with other clinical abnormalities.
Design:
Prospective longitudinal study.
Setting:
Armed Forces Hospital, Southern Region, Kingdom of Saudi Arabia.
Patients:
Adult patients (12 years and older) admitted acutely with a sickle cell crisis who consent to taking part in the study. Candidates may re-participate if they are readmitted with a further acute painful crisis.
Results:
36 patients with homozygous sickle cell disease consented to take part in the study. D-dimer levels were raised in 31 (68.9%) of 45 episodes of painful crisis of whom 13 had an abnormal chest X-ray. Of those with a normal chest X-ray only one patient had a raised D-dimer level: sensitivity of 92.3%, specificity 40.6%, positive predictive value 38.7% and negative predictive value of 92.9% for an abnormal chest X-ray.
Conclusion:
D-dimer levels are frequently raised during an acute painful crisis. A normal level has a high negative predictive value for an abnormal chest X-ray.
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