Circulating D-dimer and thrombomodulin levels in acute febrile phase of measles

Objectives: Circulating D-dieter and thrombomodulin (TM) levels are now routinely measured in clinical laboratories. Plasma levels of D-dieter 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-dieter 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-dieter in patients with measles to discuss whether fibrin formation and degradation occur and TM whether endothelial injury occur. Methods: The plasma levels of D-dieter 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-dieter 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-dieter 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-dieter 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. (C) 2002 The British Infection Society. Published by Elsevier Science Ltd. All rights reserved.