Systemic inflammatory response syndrome without systemic inflammation in acutely ill patients admitted to hospital in a medical emergency

1999 ◽  
Vol 96 (3) ◽  
pp. 287-295 ◽  
Author(s):  
Annika TAKALA ◽  
Irma JOUSELA ◽  
Klaus T. OLKKOLA ◽  
Sten-Erik JANSSON ◽  
Marjatta LEIRISALO-REPO ◽  
...  
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Systemic Inflammation ◽  
Interleukin 6 ◽  
Systemic Inflammatory Response ◽  
Composite Score ◽  
C Reactive Protein ◽  
Cd11b Expression ◽  
Reactive Protein ◽  
Markers Of Inflammation

Criteria of the systemic inflammatory response syndrome (SIRS) are known to include patients without systemic inflammation. Our aim was to explore additional markers of inflammation that would distinguish SIRS patients with systemic inflammation from patients without inflammation. The study included 100 acutely ill patients with SIRS. Peripheral blood neutrophil and monocyte CD11b expression, serum interleukin-6, interleukin-1β, tumour necrosis factor-α and C-reactive protein were determined, and severity of inflammation was evaluated by systemic inflammation composite score based on CD11b expression, C-reactive protein and cytokine levels. Levels of CD11b expression, C-reactive protein and interleukin-6 were higher in sepsis patients than in SIRS patients who met two criteria (SIRS2 group) or three criteria of SIRS (SIRS3 group). The systemic inflammation composite score of SIRS2 patients (median 1.5; range 0–8, n = 56) was lower than that of SIRS3 patients (3.5; range 0–9, n = 14, P = 0.013) and that of sepsis patients (5.0; range 3–10, n = 19, P< 0.001). The systemic inflammation composite score was 0 in 13/94 patients. In 81 patients in whom systemic inflammation composite scores exceeded 1, interleukin-6 was increased in 64 (79.0%), C-reactive protein in 59 (72.8%) and CD11b in 50 (61.7%). None of these markers, when used alone, identified all patients but at least one marker was positive in each patient. Quantifying phagocyte CD11b expression and serum interleukin-6 and C-reactive protein concurrently provides a means to discriminate SIRS patients with systemic inflammation from patients without systemic inflammation.

scholarly journals AB0739 MULTISYSTEM INFLAMMATORY SYNDROME ASSOCIATED WITH SARS-COV-2 INFECTION AND E.COLI SEPSIS: THE POTENTIAL ROLE OF PROCALCITONINE AS A RAPID DIAGNOSTIC BIOMARKER TO DISTINGUISH TWO DIFFERENT PHASES OF SYSTEMIC INFLAMMATORY RESPONSE SYNDROME

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1399.1-1399
Author(s):  
M. Gilio ◽  
S. B. Morella ◽  
F. Picaro ◽  
C. Acierno ◽  
D. Palazzo ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Critically Ill ◽  
Systemic Inflammatory Response ◽  
Critically Ill Children ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Inflammatory Syndrome

Background:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is typically very mild and often asymptomatic in children. A complication is the rare multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, presenting 4-6 weeks after infection as high fever, organ dysfunction, and strongly elevated markers of inflammation. The pathogenesis is unclear but has overlapping features with Kawasaki disease suggestive of vasculitis and a likely autoimmune etiology.Objectives:We report a case of multisystem inflammatory syndrome in children (MIS-C) in patient with SARS-CoV-2 infection and Enteropathogenic Escherichia coli (EPEC) sepsis due to acute enteritis, observed at end of December 2020 to a tertiary-care center (San Carlo Hospital), in Basilicata region (Italy).Methods:This healthy 12-year- old male patient was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Clinical presentations was characterized by fever, abdominal pain, gastrointestinal complaints and evanescent rash. Laboratory values were remarkable for high levels of procalcitonin, C-reactive protein (CRP), D-dimers, B-type natriuretic peptide (BNP), and troponin. He also had low albumin levels. Autoantibodies tests were negative. Chest tomography showed ground-glass opacities in less than 25% of the lungs, small bilateral pleural effusion and increased cardiac area; abdominal tomography showed enlargement of the lymphnodes and ascites. Evaluation for other infectious etiologies showed molecular test positivity on fecal samples for EPEC E. coli. He received broad spectrum intravenous antibiotics (macrolids and quinolones and then carbapenems). On the seventh day the enteritis resolved and procalcitonin normalized, however he continued to have lymphopenia, thrombocytopenia, hypoalbuminemia, elevated levels of CRP, D-dimers, ferritin, troponin, and increased BNP. On the ninth day he was feverish again and developed severe cardiac and respiratory failure requiring advanced respiratory support and admission to the intensive care unit. He received IVIG (intravenous immunoglobulin at 2 g/Kg, glucocorticoids (Methylprednisolone 1mg/kg) and enoxaparin.Results:The patient was discharged asymptomatic at home after 28 days of hospital stay.Conclusion:We observed multisystem inflammatory syndrome in children (MIS-C) in a previously healthy patient with SARS-CoV-2 infection and E.coli sepsis, who became critically ill with multisystem involvement. In this case viral and bacterial infections could be considered as a double hit for the etiopathogenesis of MIS-C. The trend of procalcitonin was better than C-reactive protein for differentiating bacterial from non-bacterial phase of systemic inflammatory response syndrome (SIRS) in this critically ill child. Although the accuracy of both tests is moderate. Diagnostic accuracy could be enhanced by combining these tests with bedside clinical judgment.References:[1]Consiglio CR, Cotugno N, Sardh et al. The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19. Cell. 2020 Nov 12;183(4):968-981.e7. doi: 10.1016/j.cell.2020.09.016. Epub 2020 Sep 6. PMID: 32966765; PMCID: PMC7474869.[2]Nakra NA, Blumberg DA, Herrera-Guerra A, Lakshminrusimha S. Multi-System Inflammatory Syndrome in Children (MIS-C) Following SARS-CoV-2 Infection: Review of Clinical Presentation, Hypothetical Pathogenesis, and Proposed Management. Children (Basel). 2020 Jul 1;7(7):69. doi: 10.3390/children7070069. PMID: 32630212; PMCID: PMC7401880.[3]Simon L, Saint-Louis P, Amre DK, Lacroix J, Gauvin F. Procalcitonin and C-reactive protein as markers of bacterial infection in critically ill children at onset of systemic inflammatory response syndrome. Pediatr Crit Care Med. 2008 Jul;9(4):407-13. PMID: 18496408.Disclosure of Interests:None declared

Use of C-reactive protein to predict outcome in dogs with systemic inflammatory response syndrome or sepsis

2009 ◽  
Vol 19 (5) ◽  
pp. 450-458 ◽  
Author(s):  
Constance Gebhardt ◽  
Johannes Hirschberger ◽  
Stefanie Rau ◽  
Gisela Arndt ◽  
Karen Krainer ◽  
...  
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Systemic Inflammatory Response ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Procalcitonin and C-reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children

2007 ◽  
Vol 33 (6) ◽  
pp. 1108-1109 ◽  
Author(s):  
Corsino Rey ◽  
Marta Los Arcos ◽  
Andrés Concha ◽  
Alberto Medina ◽  
Soledad Prieto ◽  
...  
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Critically Ill ◽  
Systemic Inflammatory Response ◽  
Critically Ill Children ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals High Sensitivity C-Reactive Protein sebagai Parameter Diagnostik dan Prediktor Luaran Sepsis pada Anak yang Menderita Systemic Inflammatory Response Syndrome

Sari Pediatri ◽  
2016 ◽  
Vol 16 (4) ◽  
pp. 278
Author(s):  
Sofni Sarmen ◽  
Mayetti Mayetti ◽  
Hafni Bachtiar
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Immunosorbent Assay ◽  
High Sensitivity ◽  
Systemic Inflammatory Response ◽  
Enzyme Linked Immunosorbent Assay ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp ◽  
Elisa Data

Latar belakang. Sepsis merupakan salah satu penyebab morbiditas dan mortalitas pada anak. Diagnosissepsis ditegakkan berdasarkan gejala Systemic Inflammatory Response Syndrome (SIRS) dan penemuan bakteripada kultur darah. Kultur bakteri darah memiliki sensitifitas yang rendah dan membutuhkan waktu yanglama sehingga sering menyebabkan terjadinya overdiagnosis dan overtreatment. C-reactive protein adalahreaktan fase akut yang kadarnya meningkat pada keadaan infeksi. High sensitivity C-reactive protein (hs-CRP) adalah metode yang lebih sensitif untuk mengukur kadar CRP dalam jumlah kecil.Tujuan. Mengetahui peran hs-CRP sebagai parameter diagnostik dan prediktor luaran sepsis pada anakyang menderita SIRS.Metode. Penelitian uji diagnostik dengan desain potong lintang terhadap 85 anak dengan gejala SIRS berusia1 bulan sampai dengan 15 tahun dan dirawat di bangsal anak RS.Dr.M.Djamil Padang sejak Juni sampaiNovember 2012. Pemeriksaan hs-CRP dilakukan dengan metode enzyme-linked immunosorbent assay (ELISA).Data dianalisis dengan SPSS serta dilakukan uji diagnostik. Baku emas sepsis adalah biakan darah.Hasil. Cut off point hs-CRP untuk menentukan sepsis adalah 15,55 ng/ml, (sensitivitas 90,9% dan spesivisitas53,8%). Kadar rata-rata hs-CRP meningkat sesuai dengan beratnya penyakit.Kesimpulan. High sensitivity C-reactive protein dapat dijadikan sebagai parameter diagnostik sepsis padapasien SIRS dengan cut off point 15,55 ng/ml, serta dapat dipakai sebagai prediktor luaran sepsis.

scholarly journals SERUM ZINC AND C-REACTIVE PROTEIN LEVELS AS RISK FACTORS FOR MORTALITY IN SYSTEMIC INFLAMMATORY RESPONSE SYNDROME

2018 ◽  
Vol 24 (1) ◽  
pp. 1
Author(s):  
Dwi Retnoningrum ◽  
Banundari Rachmawati ◽  
Dian Widyaningrum
Keyword(s):  
Risk Factors ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Serum Zinc ◽  
Latex Agglutination ◽  
Systemic Inflammatory Response ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Kondisi Systemic Inflammatory Response Syndrome (SIRS) berkebahyaan terjadinya sepsis dan kegagalan multi organ. Inflamasidapat menyebabkan terjadinya redistribusi zinc ke jaringan sehingga terjadi penurunan kadar zinc plasma. Kadar CRP pada SIRSmeningkat sebagai respons peningkatan protein tahap akut. Tujuan penelitian ini untuk mengetahui apakah kadar zinc dan CRP serummerupakan faktor kebahayaan kematian di pasien SIRS. Penelitian observasional analitik dengan pendekatan kohort prospektif di 30pasien SIRS berusia 27–64 tahun. Kadar zinc serum diperiksa dengan metode atomic absorbance spectrophotometer (AAS) dan CRPserum dengan metode latex agglutination immunoassay menggunakan alat autoanaliser. Kejadian kematian subjek dinilai setelah 28hari perawatan. Data dilakukan uji statistik Chi-Kwadrat, bila tidak memenuhi maka dilakukan uji alternatif Fisher. Besarnya nilaifaktor kebahyaan dilakukan perhitungan kebahayaan relatif. Rerata kadar zinc dan CRP berturut-turut 81,24 ± 8,72 μg/dL, dan 8,13± 8,12 mg/dL. Kematian dalam 28 hari adalah 33,3%. Penelitian ini menunjukkan bahwa kadar zinc plasma < 80 μg/dL bukanmerupakan faktor kebahayaan terjadinya kematian (p=0,114), sedangkan kadar CRP ≥ 10 mg/dL merupakan faktor kebahayaanterjadinya kematian di pasien SIRS (RR=3,28, 95% CI 1,33-8,13, p=0,015). Kadar zinc plasma bukan merupakan faktor kebahayaanterjadinya kematian pada SIRS, sedangkan kadar CRP merupakan faktor kebahayaan terjadinya kematian di pasien SIRS.

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