Rheumatology Medical News about JIA;persistent elevation of fibrin D-dimer

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Persistent elevation of fibrin D-dimer predicts longterm outcome in systemic juvenile idiopathic arthritis
Journal of Rheumatology, 03/18/09

Bloom BJ et al – Findings show that a paradigm of risk of severe disease based upon persistent elevation of fibrin D-dimer on first measurements is promising to predict poor longer-term outcome in systemic juvenile idiopathic arthritis (sJIA).

Methods

Aim was to investigate if persistence of D-dimer elevation over a longer f/u period, would signal poor outcome
31 children; assigned a risk category based on their first obtained D-dimer concn
Normalization of D-dimer in pts no longer taking immunosuppressive therapy predicted good short-term outcome
Persistent D-dimer elevation while taking immunosuppressives predicted bad outcome or a severe systemic manifestation
Outcome was determined at the last f/u visit, a min of 2 yrs after measurement of initial D-dimer level

Results

10 children had a severe outcome during the study period
all 10 had a study baseline risk category of “high”
Of the 14 subjects who had a high risk category at study baseline, none had a mild outcome

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