Clinical Value Of D-Dimer In Diseases Related To Immediate Allergic Reaction

Objective: Immediate allergic reaction-related diseases include acute urticaria and urticarial drug rash,which are characterized by rapid onset,life-threatening laryngeal edema,anaphylaxis and other dangerous conditions.However,there are still no objective indicators to assess the severity of acute urticaria and urticaria drug rash and to predict whether life-threatening and dangerous diseases will occur.Therefore,we screened for biomarkers that can be used to assess and predict the severity and severity of immediate allergic reaction-related diseases in acute urticaria and urticarial drug rash from the laboratory indicators that are routinely tested in the clinic.Methods:(1)The basic clinical data,routine laboratory test indexes(including blood routine,liver function,kidney function,coagulation function,and D-dimer)of 138 patients with tachyphylaxis-related diseases(66 cases of acute urticaria and 72 cases of urticaria-type drug rash)admitted to the dermatology ward of the Third Xiangya Hospital of Central South University between January 2016 and October 2021 were retrospectively collected.First,acute urticaria and urticarial drug rash were divided into three groups: mild,moderate and severe according to the disease severity score,and whether there were differences in the levels of routine laboratory test indexes between the groups were analyzed.Based on the analysis results,logistic regression test was further used to analyze whether D-dimer was an independent risk factor for immediate allergic reaction-related diseases,and ROC curves were drawn to assess the diagnostic value of D-dimer in assessing the severity of immediate allergic reaction-related diseases.(2)The Spearman correlation test was used to analyze the correlation between D-dimer and the levels of key cells(lymphocytes,monocytes,and eosinophils)of the immediate allergic reaction-related diseases,platelets and neutrophils.Results:(1)(1)In acute urticaria and urticaria drug rash,D-dimer levels were significantly different(P<0.05)among all groups of patients with mild,moderate,and severe disease,while there were no significant differences in key indicators in blood routine,liver function,kidney function,and coagulation function.And the more laryngeal edema occurs,the higher the level of D-dimer.(2)Spearman’s correlation analysis showed a significant positive correlation between D-dimer levels and disease severity in acute urticaria and urticarial drug rash(P<0.05).(3)Logistic regression analysis showed that D-dimer was an independent risk factor for exacerbation of acute urticaria and urticarial drug rash(P<0.05)(4)The ROC curve suggested that the area under the curve for D-dimer to assess the severity of acute urticaria was 0.8626 with a 95% confidence interval of 0.7559-0.9694.The area under the curve for D-dimer to assess the severity of urticarial drug rash was 0.8947 with a 95%confidence interval of 0.8088-0.9805.(2)Spearman’s correlation analysis showed no significant correlation between D-dimer levels and lymphocytes,monocytes,eosinophils and platelets,but having certain correlation with neutrophils.Conclusions:(1)D-dimer was positively correlated with the severity of immediate allergic reaction-related diseases and with the appearance of the aggressive condition(laryngeal edema)in immediate allergic reactionrelated diseases.(2)D-dimer is an independent risk factor for exacerbation of immediate allergic reaction-related diseases and can be used as a biological marker to assess the severity of immediate allergic reaction-related diseases.(3)The elevation of D-dimer in immediate allergic reaction-related diseases was not significantly correlated with lymphocytes,monocytes,eosinophils and platelets but having certain correlation with neutrophils,suggesting that D-dimer may be involved in the development of immediate allergic reaction-related diseases independently of the classical cellular molecular pathway.