Association between plasma D-dimer levels and disease severity in chronic spontaneous urticaria
Main Article Content
Abstract
A cross-sectional study was conducted in 146 patients with chronic spontaneous urticaria (CSU) and 30 healthy adults to determine the association between plasma D-dimer levels and disease severity as well as related factors. The results showed that the median (IQR) plasma D-dimer level in CSU patients was 546.5 (291 - 1353) ng/ml, which was significantly higher than the control group at 270 (270 - 270) ng/ml (p < 0.001). Plasma D-dimer levels were positively correlated with the UAS7 score, with a Spearman correlation coefficient of 0.46 (p < 0.001). ROC analysis revealed the cut-off value of D-dimer of 633 ng/ml for differentiating severe from non-severe CSU. This differential level was strengthened through both univariate and multivariate logistic regression analyses. In addition, D-dimer levels were associated with age, CRP level, and a positive autologous serum skin test. These findings suggest that plasma D-dimer may be a potential biomarker for predicting disease severity in patients with CSU.
Article Details
Keywords
Chronic spontaneous urticaria, D-dimer, severity, biomarker
References
2. Church MK, Kolkhir P, Metz M, et al. The role and relevance of mast cells in urticaria. Immunol Rev. 2018;282(1):232-247. doi:10.1111/imr.12632
3. Yanase Y, Takahagi S, Hide M. Chronic spontaneous urticaria and the extrinsic coagulation system. Allergology International. 2018;67(2):191-194. doi:10.1016/j.alit.2017.09.003
4. Farres MN, Refaat M, Melek NA, et al. Activation of coagulation in chronic urticaria in relation to disease severity and activity. Allergologia et Immunopathologia. 2015;43(2):162-167. doi:10.1016/j.aller.2014 .04.002
5. Grzanka R, Damasiewicz-Bodzek A, Kasperska-Zajac A. Interplay between acute phase response and coagulation/fibrinolysis in chronic spontaneous urticaria. Allergy Asthma Clin Immunol. 2018;14:27. doi:10.1186/s13223-018-0255-8
6. Beyaz Ş, Belkaya S, Öztop N. Circulating Pentraxin-3 and its association with C-reactive protein levels and disease activity in patients with chronic spontaneous urticaria. Allergol Immunopathol (Madr). 2023;51(4):87-93. doi:10.15586/aei.v51i4.894
7. Di Pino M, Ruberto MF, Costanzo G, et al. Chronic spontaneous urticaria: a low-grade disseminated intravascular coagulation only partially reversed by Omalizumab. Clin Exp Med. 2023;23(2):495-502. doi:10.1007/s10238-022-00838-9
8. Dabas G, Thakur V, Bishnoi A, et al. Causal Relationship between D-Dimers and Disease Status in Chronic Spontaneous Urticaria and Adjuvant Effect of Oral Tranexamic Acid. Indian Dermatol Online J. 2021;12(5):726-730. doi:10.4103/idoj.IDOJ_106_21
9. Criado RF, Bensi CG, Criado PR, et al. Evaluation of serum levels of C-reactive protein, D-Dimer and Autologous Serum Skin Test in patients with Chronic Spontaneous Urticaria in a Brazilian tertiary center : a cross-sectional study. An Bras Dermatol. 2021;96(2):148-154. doi:10.1016/j.abd.2020.07.006
10. Chintada D, Vudayana K, Chaduvula J, et al. Clinicoepidemiological Profile of Patients with Chronic Urticaria and its Association with D-dimer Levels at a Tertiary Care Centre: A Prospective Cohort Study. JCDR. Published online 2023. doi:10.7860/JCDR/2023/66909.18780
11. Relvas M, Silva J, Matos AL, et al. Concomitant evaluation of D-dimer and C-reactive protein in chronic spontaneous urticaria may show divergent values. Eur Ann Allergy Clin Immunol. 2024;56(2):89-92. doi:10.23822/EurAnnACI.1764-1489.259
12. Plavsic A, Tomic-Spiric V, Arandjelovic S, et al. Biomarkers of disease activity in patients with chronicspontaneous urticaria. pdia. 2021;38(6):1017-1022. doi:10.5114/ada.2021.112276
13. Kitao R, Oda Y, Washio K, et al. Lower efficacy of omalizumab in older adults with chronic spontaneous urticaria. J Dermatol. 2022;49(7):729-731. doi:10.1111/1346-8138.16370
14. Kasperska-Zajac A, Grzanka A, Misiolek M, et al. Pentraxin-3 as a local inflammatory marker in chronic spontaneous urticaria. Cytokine. 2015;76(2):566-568. doi:10.1016/j.cyto.2015.04.016
15. Kolkhir P, Altrichter S, Hawro T, et al. C-reactive protein is linked to disease activity, impact, and response to treatment in patients with chronic spontaneous urticaria. Allergy. 2018;73(4):940-948. doi:10.1111/all.13352