SOVREMENNAYA PEDIATRIYA.2018.1(89):90-96; doi 10.15574/SP.2018.89.90

Markov  A.
Bogomolets National Medical University, Kyiv, Ukraine

Infectious diseases are traditionally associated with activation of the haemostatic system and increased thrombogenic function. In order to evaluate the activity of the haemostatic system in recent years the D-dimer is widely studied, which reflects the current activity of the haemostasis system and is a highly sensitive marker of intravascular clotting.
Objective — to study the D-dimer parameters in blood serum of children with infectious diseases of different aetiologies to determine the degree of haemostatic system activation and evaluation of its diagnostic capabilities.
Material and methods. Children aged from 1 month to 18 years, in1patiently treated for acute infectious diseases, were under supervision. In the complex examination at the first day of hospitalisation, the determination of D-dimer in blood plasma was included.
Results. There were examined 23 children aged from 5 months to 17 years. Chickenpox was diagnosed in 26.0% of children, including complicated with cerebellar ataxia in 13.0%, EBV infectious mononucleosis in 56.5%, meningococcal infection (meningococcemia+meningitis) 8.7% and scarlatina in 8.7%. In all patients, the level of D1dimer exceeded the reference level (>0.5 µg/ml). It was 1.07±0.30 µg/ml (M±SD) in patients with chickenpox, infectious mononucleosis — 1.90±1.14, meningococcal infection — 9.11±0.15, and scarlatina — 9.12±4.36. There was a significant difference between this indicator level in children with chickenpox and meningococcal disease, chickenpox and scarlatina, infectious mononucleosis and meningococcal infection, infectious mononucleosis and scarlatina, between groups of patients depending upon viral or bacterial aetiology of the disease.
Conclusions. Determining the level of D-dimer may be important for the integral assessment of coagulation disorders, severity index and the development of complications in acute infectious diseases in children, as well as for the differential diagnosis of viral and bacterial diseases.
Key words: haemostasis, D-dimer, infections, children.

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