Vascular endothelial cell damage and alteration of a fibrinolytic system was suggested to play a role in the development of coronary artery abnormalities in Kawasaki disease (KD). D-dimer is one of the markers of endothelial damage and fibrinolysis. We evaluated the clinical usefulness of D-dimer to differentiate KD from other febrile diseases and predict coronary artery abnormalities in KD.

Sixty eight patients diagnosed as KD and twenty eight patients presented with acute febrile illnesses other than KD from September 2005 to July 2006 were included. Blood levels of D-dimer and various inflammatory markers were measured before treatment and the clinical course of KD was followed. Serial echocardiography was performed at the onset of disease and thereafter at a monthly interval for at least 2 months.

KD patients showed a higher D-dimer level than febrile controls, but the difference was not significant (1.21±0.77 mg/mL vs 0.92±0.71 mg/mL, P =0.083). Neither was the difference between KD patients who had coronary artery abnormalities and those who had not (1.49±0.98 mg/mL vs 1.15±0.71 mg/mL, P =0.169). D-dimer was significantly correlated with other inflammatory markers, such as C-reactive protein and erythrocyte sedimentation rate in both KD patients and febrile controls.

D-dimer was not specific for KD. But it may be useful as an inflammatory marker to assess the severity of KD.