Serum Levels of Neuron-Specific Enolase in Children With Diabetic Ketoacidosis

2017 ◽  
Vol 32 (5) ◽  
pp. 475-481 ◽  
Author(s):  
Sherifa Hamed ◽  
Kotb Abbass Metwalley ◽  
Hekma Saad Farghaly ◽  
Tahra Sherief
Keyword(s):  
Diabetic Ketoacidosis ◽  
Neuronal Damage ◽  
Neuron Specific Enolase ◽  
Serum Levels ◽  
Time Points ◽  
Factors Associated ◽  
Neurologic Disorders ◽  
Younger Age ◽  
Serum Neuron Specific Enolase ◽  
Sensitive Marker

Neuron-specific enolase is a sensitive marker of neuronal damage in various neurologic disorders. This study aimed to measure serum neuron-specific enolase levels at different time points and severities of diabetic ketoacidosis. This study included 90 children (age 9.2 ± 3.4 years) with diabetic ketoacidosis. Neuron-specific enolase was measured at 3 time points (baseline and after 12 and 24 hours of starting treatment). Among patients, 74.4% had diagnosis of new diabetes, 60% had Glasgow Coma Scale score <15, and 75.6% had moderate/severe diabetic ketoacidosis. Compared with controls (n = 30), children with diabetic ketoacidosis had higher neuron-specific enolase levels at the 3 time points ( P = .0001). In multiple regression analysis, the factors associated with higher neuron-specific enolase levels were younger age, higher glucose, lower pH, and bicarbonate values. This study indicates that serum neuron-specific enolase is elevated in diabetic ketoacidosis and correlated with the severity of hyperglycemia, ketosis, and acidosis. This study indicates that diabetic ketoacidosis may cause neuronal injury from which the patients recovered partially but not completely.

Prediction of regaining consciousness despite an early epileptiform EEG after cardiac arrest

Neurology ◽  
2020 ◽  
Vol 94 (16) ◽  
pp. e1675-e1683 ◽  
Author(s):  
Giuseppina Barbella ◽  
Jong Woo Lee ◽  
Vincent Alvarez ◽  
Jan Novy ◽  
Mauro Oddo ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Operating Characteristic ◽  
Neuronal Damage ◽  
Cerebral Performance Category ◽  
Neuron Specific Enolase ◽  
Area Under The Curve ◽  
Performance Category ◽  
Receiver Operating Characteristic Curves ◽  
Normal Background ◽  
Serum Neuron Specific Enolase

ObjectiveAfter cardiac arrest (CA), epileptiform EEG, occurring in about 1/3 of patients, often but not invariably heralds poor prognosis. We tested the hypothesis that a combination of specific EEG features identifies patients who may regain consciousness despite early epileptiform patterns.MethodsWe retrospectively analyzed a registry of comatose patients post-CA (2 Swiss centers), including those with epileptiform EEG. Background and epileptiform features in EEGs 12–36 hours or 36–72 hours from CA were scored according to the American Clinical Neurophysiology Society nomenclature. Best Cerebral Performance Category (CPC) score within 3 months (CPC 1–3 vs 4–5) was the primary outcome. Significant EEG variables were combined in a score assessed with receiver operating characteristic curves, and independently validated in a US cohort; its correlation with serum neuron-specific enolase (NSE) was also tested.ResultsOf 488 patients, 107 (21.9%) had epileptiform EEG <72 hours; 18 (17%) reached CPC 1–3. EEG 12–36 hours background continuity ≥50%, absence of epileptiform abnormalities (p < 0.00001 each), 12–36 and 36–72 hours reactivity (p < 0.0001 each), 36–72 hours normal background amplitude (p = 0.0004), and stimulus-induced discharges (p = 0.0001) correlated with favorable outcome. The combined 6-point score cutoff ≥2 was 100% sensitive (95% confidence interval [CI], 78%–100%) and 70% specific (95% CI, 59%–80%) for CPC 1–3 (area under the curve [AUC], 0.98; 95% CI, 0.94–1.00). Increasing score correlated with NSE (ρ = −0.46, p = 0.0001). In the validation cohort (41 patients), the score was 100% sensitive (95% CI, 60%–100%) and 88% specific (95% CI, 73%–97%) for CPC 1–3 (AUC, 0.96; 95% CI, 0.91–1.00).ConclusionPrognostic value of early epileptiform EEG after CA can be estimated combining timing, continuity, reactivity, and amplitude features in a score that correlates with neuronal damage.

scholarly journals SURG-19. EVALUATION OF SERUM NEURON SPECIFIC ENOLASE, INTERFERON-ALPHA, AND INTERFERON-GAMMA IN RESPONSE TO LASER ABLATION OF HIGH GRADE GLIOMAS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii207-ii207
Author(s):  
Seamus Bartlett ◽  
Tavarekere Nagaraja ◽  
Lonni Schultz ◽  
James Ewing ◽  
Stephen Brown ◽  
...  
Keyword(s):  
Immune Response ◽  
Laser Ablation ◽  
Interferon Gamma ◽  
Interferon Alpha ◽  
Neuron Specific Enolase ◽  
Serum Levels ◽  
Serum Markers ◽  
High Grade ◽  
High Grade Gliomas ◽  
Serum Neuron Specific Enolase

Abstract BACKGROUND The blood-brain barrier (BBB) is a formidable obstacle in the treatment of gliomas. It has been speculated that the BBB may be temporarily disrupted in laser ablation, a relatively new treatment used for newly diagnosed and recurrent high grade gliomas (HGG). BBB disruption can be measured non-invasively through serum neuron specific enolase (NSE) levels. In addition to disrupting the BBB, laser ablation could trigger an immune response in brain that has yet to be studied. Interferon-alpha (IFN-α) and interferon-gamma (IFN-ɣ) are cytokines used as serum markers for an immune response. OBJECTIVE To measure NSE and IFN-α and IFN-ɣ as serum markers for BBB disruption and brain immune response activation, respectively, in patients undergoing laser ablation for recurrent high grade gliomas. METHODS Sixteen patients with recurrent HGG underwent laser ablation from 2/2017 to 12/2019. All 16 patients had gross total ablation of the contrast enhancing mass. Serum levels of NSE, IFN-α, IFN-ɣ were measured pre-operatively and at 24 hours, 2 weeks, and 8-16 weeks post-operatively, depending on adjuvant treatment received post-operatively. RESULTS Levels of NSE consistently increased 24 hours post-operatively (2.28±0.37 ng/ml) compared to pre-operative levels (1.62±0.29 ng/ml), p=0.032. Afterwards, NSE decreased and reached baseline by 2 weeks postoperatively (2 weeks- 1.67±0.29 ng/ml, 8 weeks- 1.85±0.91 ng/ml, 12 weeks- 0.81±0.33 ng/ml, 16 weeks- 1.23±0.93 ng/ml). Compared to their pre-operative levels, IFN-α and IFN-ɣ (85.46±35.29 and 1.62±0.47 pg/ml, respectively) did not display a significant difference in their serum levels (p=0.26-0.72 and 0.14-0.60, respectively, for IFN-α and IFN-ɣ) at any post-operative measurement time. Conclusions: Elevated NSE levels following laser ablation in HGG indicate a temporary disruption of the BBB that persists for approximately 2 weeks without eliciting an accompanying immune reaction in brain. Correlation studies with DCE-MRI are on-going.

Cerebrospinal Fluid and Serum Neuron-Specific Enolase in Acute Benign Headache

Cephalalgia ◽  
2008 ◽  
Vol 28 (5) ◽  
pp. 506-509 ◽  
Author(s):  
M Casmiro ◽  
E Scarpa ◽  
P Cortelli ◽  
L Vignatelli
Keyword(s):  
Cerebrospinal Fluid ◽  
Neuronal Damage ◽  
Hypertensive Crisis ◽  
Neuron Specific Enolase ◽  
Hypertensive Encephalopathy ◽  
Tension Type Headache ◽  
Type Headache ◽  
Head Computed Tomography ◽  
Serum Ratio ◽  
Serum Neuron Specific Enolase

We determined the cerebrospinal fluid (CSF) and serum neuron-specific enolase (NSE) concentrations in 19 patients with acute benign headache. All patients had normal neurological examination, CSF and head computed tomography scan. The final diagnoses were: primary thunderclap headache ( n = 7), primary exertional headache ( n = 3), primary cough headache ( n = 1), migraine without aura ( n = 4), headache unspecified ( n = 2), probable infrequent episodic tension-type headache ( n = 1), headache attributed to hypertensive crisis without hypertensive encephalopathy ( n = 1). A group of 108 healthy subjects served as controls. CSF NSE concentration was 14.16 ng/ml [95% confidence interval (CI) 11.86, 16.47)] in the headache sample (controls 17.19 ng/ml, 95% CI 16.23, 18.15). Serum NSE concentration was 7.50 ng/ml (95% CI 5.20, 9.80) in the headache sample (controls 8.45 ng/ml, 95% CI 7.67, 9.23). CSF/serum ratio was 2.81 (95% CI 2.21, 3.40) in the headache sample (controls 2.23, 95% CI 2.03, 2.42). Acute benign headache is not associated with neuronal damage as estimated by means of CSF and serum NSE concentration.

scholarly journals Serum Neuron-specific Enolase and S100 Calcium-binding Protein B in Pediatric Diabetic Ketoacidosis

2019 ◽  
Vol 11 (4) ◽  
pp. 374-387 ◽  
Author(s):  
Hatem Hamed Elshorbagy ◽  
Naglaa Fathy Barseem ◽  
Akram Elshafey Elsadek ◽  
Ashraf Hamed Al-shokary ◽  
Yehia Hamed Abdel Maksoud ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Calcium Binding ◽  
Binding Protein ◽  
Neuron Specific Enolase ◽  
Calcium Binding Protein ◽  
S100 Calcium Binding Protein ◽  
Serum Neuron Specific Enolase ◽  
Protein B

scholarly journals Brain injury markers (S100B and NSE) in chronic cocaine dependents

2007 ◽  
Vol 29 (2) ◽  
pp. 134-139 ◽  
Author(s):  
Felix Henrique Paim Kessler ◽  
George Woody ◽  
Luís Valmor Cruz Portela ◽  
Adriano Bretanha Lopes Tort ◽  
Raquel De Boni ◽  
...  
Keyword(s):  
Brain Damage ◽  
Illicit Drugs ◽  
Cell Injury ◽  
Neuron Specific Enolase ◽  
Serum Levels ◽  
Blood Levels ◽  
Probabilistic Sampling ◽  
Chronic Cocaine ◽  
Cocaine Users ◽  
Serum Neuron Specific Enolase

OBJECTIVE: Studies have shown signs of brain damage caused by different mechanisms in cocaine users. The serum neuron specific enolase and S100B protein are considered specific biochemical markers of neuronal and glial cell injury. This study aimed at comparing blood levels of S100B and NSE in chronic cocaine users and in volunteers who did not use cocaine or other illicit drugs. METHOD: Twenty subjects dependent on cocaine but not on alcohol or marijuana, and 20 non-substance using controls were recruited. Subjects were selected by consecutive and non-probabilistic sampling. Neuron specific enolase and S100B levels were determined by luminescence assay. RESULTS: Cocaine users had significantly higher scores than controls in all psychiatric dimensions of the SCL-90 and had cognitive deficits in the subtest cubes of WAIS and the word span. Mean serum S100B level was 0.09 ± 0.04 µg/l among cocaine users and 0.08 ± 0.04 µg/l among controls. Mean serum neuron specific enolase level was 9.7 ± 3.5 ng/l among cocaine users and 8.3 ± 2.6 ng/l among controls. CONCLUSIONS: In this first study using these specific brain damage markers in cocaine users, serum levels of S100B and neuron specific enolase were not statistically different between cocaine dependent subjects and controls.

scholarly journals Serum neuron-specific enolase measurement for neuro-prognostication post out-of-hospital cardiac arrest: Determination of the optimum testing strategy in routine clinical use

2019 ◽  
Vol 57 (1) ◽  
pp. 69-76
Author(s):  
Oliver Clifford-Mobley ◽  
Frances Palmer ◽  
Kieron Rooney ◽  
Agnieszka Skorko ◽  
Graham Bayly
Keyword(s):  
Cardiac Arrest ◽  
Characteristic Curve ◽  
Neuron Specific Enolase ◽  
Receiver Operator Characteristic Curve ◽  
Receiver Operator Characteristic ◽  
Testing Strategy ◽  
Time Points ◽  
Icu Discharge ◽  
Hospital Cardiac Arrest ◽  
Serum Neuron Specific Enolase

Background Measurement of serum neuron-specific enolase (NSE) for neuro-prognostication post out-of-hospital cardiac arrest (OHCA) is recommended by international guidelines. There is, however, a lack of consensus regarding the cut-offs and time points to use. In addition, NSE is particularly susceptible to haemolysis interference. This study aimed to define the optimum NSE testing strategy to support the intensive care unit (ICU). Methods Patients admitted to ICU post-OHCA over 16 months had NSE measured. The outcome was survival to ICU discharge. NSE at 0 h, 24 h, 48 h, 72 h and change in NSE (ΔNSE) were assessed for prognostic accuracy using receiver operator characteristic curve analysis. The magnitude of haemolysis interference was quantified by spiking haemolysate into paired serum. Results There is a consistent linear increase in NSE with increasing haemolysis, independent of baseline NSE concentration. A haemolysis index acceptance threshold was defined as 20. There were 142 patients, and 82 survived to ICU discharge. The NSE parameter with best predictive performance was ΔNSE at 48 h, which had an area under the receiver operator characteristic curve of 0.91. A cut-off of >0 μg/L at this time point had sensitivity of 80% and specificity of 97% for predicting death on ICU. When patients who died of non-neurological causes were removed, the sensitivity increased to 91%. Conclusions Application of a stringent haemolysis interference threshold and measurement of NSE at two time points enabled us to achieve excellent discrimination. Increasing NSE over the first 48 h, suggestive of an ongoing reperfusion injury to the brain, is a strong predictor of poor outcome.

scholarly journals The effect of doxycycline on neuron-specific enolase in patients with traumatic brain injury: a randomized controlled trial

2021 ◽  
Vol 12 ◽  
pp. 204062232110243
Author(s):  
Noha O. Mansour ◽  
Mohamed A. Shama ◽  
Rehab H. Werida
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neuronal Damage ◽  
Controlled Trial ◽  
Neuron Specific Enolase ◽  
Serum Levels ◽  
Secondary Brain Injury ◽  
Control Groups ◽  
Standard Management ◽  
And Control

Objective: We aimed to examine the effect of doxycycline on serum levels of neuron-specific enolase (NSE), a marker of neuronal damage in traumatic brain injury (TBI) patients. Methods: Patients were randomly assigned into two groups ( n = 25 each) to receive either placebo or doxycycline (200 mg daily), with their standard management for 7 days. Results: NSE serum levels in the doxycycline and control groups on day 3 were 14.66 ± 1.78 versus 18.09 ± 4.38 ng/mL, respectively ( p = 0.008), and on day 7 were 12.3 ± 2.0 versus 16.43 ± 3.85 ng/mL, respectively ( p = 0.003). Glasgow Coma Scale (GCS) on day 7 was 11.90 ± 2.83 versus 9.65 ± 3.44 in the doxycycline and control groups, respectively ( p = 0.031). NSE serum levels and GCS scores were negatively correlated ( r = −0.569, p < 0.001). Conclusion: Adjunctive early use of doxycycline might be a novel option that halts the ongoing secondary brain injury in patients with moderate to severe TBI. Future larger clinical trials are warranted to confirm these findings.

scholarly journals Diagnostic Value of Serum Neuron-Specific Enolase Level in Patients With Acute Ischemic Stroke; A Systematic Review and Meta-Analysis

2019 ◽  
Vol 6 (2) ◽  
pp. 36-41
Author(s):  
Elham Najmi ◽  
Eshak I. Bahbah ◽  
Ahmed Negida ◽  
Ahmed Afifi ◽  
Aireza Baratloo
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Meta Analysis ◽  
Neuron Specific Enolase ◽  
Serum Levels ◽  
Control Group ◽  
Effect Estimate ◽  
Stroke Patients ◽  
Serum Neuron Specific Enolase

Background: We aim to assess the predictive value of serum neuron-specific enolase (NSE) level in patients with acute ischemic stroke referring to the emergency department. Methods: This systematic review and meta-analysis performed, considering the PRISMA and MOOSE statement guidelines. A computerized literature search of the known medical database conducted by using the relevant keywords. We included studies published before November 2016 in which stroke patients compared with non-stroke controls and also studies evaluating the serum levels of NSE in the study groups. Statistical analysis was pooled in a random effect model analysis using the Comprehensive Meta-Analysis software. Results: We included 12 articles in the qualitative and quantitative analysis, that their quality acceptable based on the Newcastle Ottawa Scale (NOS scale). The pooled effect estimates showed that NSE is significantly higher in ischemic stroke patients in comparison with their controls with a high effect estimate [OR 9.68, 95% CI (3.06 to 30.6)]. The effect estimate remained statistically significant under the fixed and random effects model. Conclusion: Our results show higher levels of NSE in patients with stroke than in the control group, indicating that NSE plays a role in the diagnosis of stroke. In terms of prognosis, there is evidence regarding the direct and indirect relationship; and it founded that serum levels of NSE is higher in larger stroke volume, which needs further research.

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