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Anne Dompmartin, MD; Pascal Thibon, MD; Miikka Vikkula, MD, PhD; Laurence M. Boon, MD, PhD

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Dr Kittisupamongkol noted that oral contraceptive medication is an important factor involved in the elevation of D-dimer levels. We agree, but this elevation is much lower than what we reported in our patients with venous malformations.¹ In addition, the elevation that we observed was not associated with sex. Kluft et al,² Johnson et al,³ and others (eg, Quehenberger et al⁴) have demonstrated slight elevation of D-dimer levels in patients taking contraceptive medication (mean level increases from 0.172 µg/mL to 0.351 µg/mL, which is still within the normal limits, <0.500 µg/mL). Among our patients, 42% had repeated D-dimer measurements higher than 0.500 µg/mL, and 61% of those D-dimer levels above 1.000 µg/mL. (To convert D-dimers to nanomoles per liter, multiply by 5.476.) Of our 140 patients with venous malformations, 43 were male, 43 . . . [Full Text of this Article]

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