Association of Thrombotic Markers with Severity of Pediatric-Onset Systemic Lupus Erythematosus

ObjectiveTo assess the relation of thrombotic markers, thrombomodulin and D-dimer levels to the disease severity in pediatric onset systemic lupus erythematosus (p-SLE) measured by the Systemic Lupus Erythematous Disease Activity Index (SLEDAI).Methods40 children with p-SLE were grouped according to SLEDAI into: low activity SLE group (laSLE) and moderate-high activity SLE group (mhaSLE). 40 healthy children were included as control group. Serum thrombomodulin, and D-dimer levels were measured for all enrolled children.ResultsThe low activity and moderate-high activity SLE groups had significantly higher mean (SD) thrombomodulin [7.2 (1.83) mg/mL and 9.86 (3.29) mg/mL, respectively vs 5.85 (1.41) mg/mL; P<0.001] and D-dimer (r=0.42, P=0.006) levels than controls. Furthermore, the mhaSLE group had significantly higher thrombomodulin levels and D-dimer (r = 0.42, P= 0.006) levels than the laSLE group (P=0.008 and 0.006). Thrombomodulin and D-dimer had significant positive correlations with SLEDAI.ConclusionThrombomodulin and D-dimer are valuable markers for p-SLE activity, discriminating children with severe disease activity from those with low disease activity.