EVALUATION OF THE ROLE OF D-DIMER IN ASSESSMENT OF SEVERITY AND OUTCOME OF ACUTE PANCREATITIS IN CHILDREN

Document Type : Original Article

Authors

1 pediatric gastroenterology department, Ain Shams University.+

2 pediatric intensive care resident at Egyptian ministry of health, Egypt.

3 Department of pediatrics, faculty of medicine, Ain shams university, Egypt.

Abstract

Background: Acute pancreatitis (AP) is the most common pathological entity affecting the pancreas in children. Multi-organ failure and/or pancreatic necrosis, can result from a severe episode of AP. Early severity stratification can result in aggressive treatment and prevent the development of persistent organ damage and multiple organ dysfunction. Multiple studies have evaluated the relationship between AP severity and d-dimer but most of these studies involved only adult population.
Aim of work: The aim of the present study is to find out the value of D-dimer as a marker of severity in acute pancreatitis.
Patients and methods: In this prospective cohort study 24 Children and adolescents were recruited with the diagnosis of AP among those attending gastroenterology unit Children’s hospital, Ain Shams University. All patient's clinical data were recorded, and they have all withdrawn serum D-dimer in the 1st, 3rd, and 7th days of admission together with other laboratory markers, abdominal ultrasound, and CT scan. and those were correlated with the outcome of cases. NASPGHAN pancreas committee criteria were used to classify severity into mild, and moderately severe to severe disease.
Results: Age of patients ranged from 4-15 years; Eight patients developed moderately severe to severe disease while16 patients had mild disease. D-dimer levels were higher among patients with severe disease, yet this was not statistically significant, while serum calcium level was significantly lower among moderately severe to severe cases.
Conclusion: D-dimer, although high in acute pancreatitis cannot be relied upon as a marker of severity or prognosis in pediatrics.

Keywords

Ain Shams Medical Journal
Volume 72, Issue 4
December 2021
Pages 935-844

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