Abstract
Biomarkers that reliably identify or even predict disease manifestations in systemic lupus erythematosus (SLE) are needed. In a recent issue of the Clinical Journal of the American Society of Nephrology, Wu and colleagues reported on the predictive value of routine D-dimer measurements for future thromboembolic events in patients enrolled in the Ohio SLE study, a unique prospective, longitudinal evaluation of individuals with recurrently active SLE. As in other disease settings, low D-dimer levels (<0.5 µg/ml) excluded clotting at a given time point and identified a zero risk of future clotting events. Conversely, 42% of patients with a high D-dimer level (>2.0 µg/ml) subsequently experienced a clinically relevant clotting event, in some cases in the absence of antiphospholipid antibodies or lupus anticoagulant. This Practice Point commentary considers whether the D-dimer assay will remain simply a tool to rule out thrombosis in symptomatic patients with SLE or whether it could eventually be used to initiate preventive anticoagulation in asymptomatic patients.
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References
Ruiz-Irastorza G et al. (2004) Antiphospholipid antibodies predict early damage in patients with systemic lupus erythematosus. Lupus 13: 900–905
Wu H et al. (2008) D-dimer level and the risk for thrombosis in systemic lupus erythematosus. Clin J Am Soc Nephrol 3: 1628–1636
Di Nisio M et al. (2007) Diagnostic accuracy of D-dimer test for exclusion of venous thromboembolism: a systematic review. J Thromb Haemost 5: 296–304
Glassock RJ (2007) Prophylactic anticoagulation in nephrotic syndrome: a clinical conundrum. J Am Soc Nephrol 18: 2221–2225
Acknowledgements
The author is supported by grants from the Deutsche Forschungsgemeinschaft (AN372/9-1, AN372/10-1 and GRK 1202).
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Anders, HJ. Predicting thrombosis in systemic lupus erythematosus. Nat Rev Nephrol 5, 68–69 (2009). https://doi.org/10.1038/ncpneph1021
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DOI: https://doi.org/10.1038/ncpneph1021
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