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High fibrin/fibrinogen degradation product and D-dimer levels for the diagnosis of invasive group A streptococcal infections during pregnancy |
N. Matsumoto1, *( ), Y. Mori2 |
1Matsumoto Women’s Health Clinic, Saitama, Japan 2Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan |
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Abstract Objective: Invasive group A streptococcal (GAS) infections during pregnancy are uncommon, and, thus, their early diagnosis remains challenging. The present study was performed to assess fibrin/fibrinogen degradation product (FDP) and D-dimer levels in pregnant women with invasive GAS infections and establish whether they contribute to a diagnosis. Materials and Methods: Laboratory data, including FDP and D-dimer levels, measured between fulmination and just before delivery in 46 cases, consisting of 45 previously published cases and the present case, were examined. Results: Fetal/neonatal and maternal mortality rates were 61 and 28%, respectively. Laboratory data obtained from 24 cases just before delivery were as follows: white blood cell count ≥ 12,000/μL, 46% of cases; platelet count ≤ 100,000/μL, 55% of cases, and C-reactive protein (CRP) level ≥ 10 mg/dL, 40% of cases. These variables showed no sensitivity for the diagnosis of invasive GAS infections. However, 100% of cases were positive for FDP (≥ 10 μg/dL) and D-dimer (≥ 2 μg/dL), the levels of which were extremely high in many cases. Conclusion: FDP and D-dimer levels may contribute to the diagnosis of invasive GAS infections during pregnancy.
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Submitted: 27 June 2019
Accepted: 23 September 2019
Published: 15 August 2020
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*Corresponding Author(s):
N. Matsumoto
E-mail: research@matsumotoc.org
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