Plasma D-dimer concentration in patients with systemic sclerosis

To verify whether SSc patients might display a prothrombotic condition, plasma D-dimer was assessed in 28 consecutive SSc patients and in 33 control subjects, matched for age, sex and environmental habit.When compared to healthy controls, geometric mean and 95% confidence interval (IC95%) of plasma D-dimer were significantly increased in SSc patients (362 ng/mL, IC 95%: 361–363 ng/mL vs 229 ng/mL, IC95%: 228–231 ng/mL, p = 0.005). After stratifying SSc patients according to disease subset, no significant differences were observed between those with limited cutaneous pattern and controls, whereas patients with diffuse cutaneous pattern displayed substantially increased values. No correlation was found between plasma D-dimer concentration and age, sex, autoantibody pattern, serum creatinine, erythrosedimentation rate, nailfold videocapillaroscopic pattern and pulmonary involvement.We demonstrated that SSc patients with diffuse subset are characterized by increased plasma D-dimer values, reflecting a potential activation of both the hemostatic and fibrinolytic cascades, which might finally predispose these patients to thrombotic complications.Systemic sclerosis (SSc) is an autoimmune disorder of the connective tissue characterized by widespread vascular lesions and fibrosis. In SSc, vasospasm causes frequent episodes of reperfusion injury and free radical-mediated endothelial dysfunction, which might finally influence the onset of local thrombotic complications. The characteristic vascular involvement affects primarily small arteries and capillaries, causing reduced blood flow and tissue ischemia and supporting the typical clinical manifestations of this unique autoimmune disorder [1]. However, mechanisms involved in the endothelial injury are as yet elusive and most biochemical evidences are often inconclusive or controversial. Some earlier investigations suggested that SSc patients might be characterized by a procoagulant state, reporting depressed basal and stimulat