Plasma levels of D‑dimer in a 5‑year‑old girl with systemic juvenile idiopathic arthritis: A case report and literature review

Xu,Qiang; Lin,Chang‑Song

doi:10.3892/etm.2016.3009

Plasma levels of D‑dimer in a 5‑year‑old girl with systemic juvenile idiopathic arthritis: A case report and literature review

Authors:
- Qiang Xu
- Chang‑Song Lin
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Affiliations: Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
Published online on: January 20, 2016 https://doi.org/10.3892/etm.2016.3009
Pages: 1027-1030

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Abstract

The present study reported high levels of D‑dimer associated with multiple joint pain in a 5‑year‑old patient with systemic juvenile idiopathic arthritis (JIA). While treatment with methotrexate (MTX), hydroxychloroquine and methylprednisolone was found to reduce the D‑dimer level and alleviated joint pain, the fever was not effectively controlled. Addition of etanercept to the treatment regimen from week 2 resulted in a clinical remission. Following 4‑6 months of therapy, the D‑dimer level of the patient returned to the normal range, and symptoms of noticeable joint pain and fever were absent. A literature search showed that the levels of D‑dimer may be associated with JIA disease severity, and can serve as a prognostic biomarker for JIA treatment. In conclusion, the present study demonstrated that, while MTX therapy effectively reduced D‑dimer levels, addition of etanercept to the treatment regimen was required to achieve a long‑lasting remission of clinical symptoms, including fever.

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