Prognostic Importance of D-Dimer Level in Acute Infantile Hemorrhagic Edema

Abstract

Acute infantile hemorrhagic edema is characterized by a triad of purpuric rash, fever and edema. The disease has a fulminant onset, a benign course and spontaneous resolution in a couple of weeks. It differs from Henoch-Schonlein purpura with several features such as being seen at less than 2 years of age, size of cutaneous lesion and mostly being limited to skin, rare recurrence and gastrointestinal-renal involvement. Our patient had typical acute infantile hemorrhagic edema symptoms and undetectably high D-dimer levels at the beginning. During the course of treatment, the patient's D-dimer level diminished dramatically and it went back to normal by the end of the therapy. Since this observation has not been reported before, it was considered appropriate to present. It is known that there is no specific therapy to this disease. The use of antihistaminics and systemic corticosteroids are debatable and they were reported not to change the course of disease. However, our patient responded well to systemic corticosteroid therapy, and this is seen in decreased D-dimer level. We believe that D-dimer level may be a follow-up marker for the severity of the disease and response to the therapy.