Delta Neutrophil Index: A Potential Diagnostic Marker of Multisystem Inflammatory Syndrome in Children (MIS-C)

2021 ◽  
Author(s):  
Cuneyt Karagol ◽  
Ali Kansu Tehci ◽  
Ali Gungor ◽  
Zahide Ekici Tekin ◽  
Elif Çelikel ◽  
...  
Keyword(s):  
Platelet Count ◽  
Predictive Value ◽  
Diagnostic Marker ◽  
Absolute Lymphocyte Count ◽  
Control Group ◽  
Reactive Protein ◽  
Life Threatening ◽  
Sensitivity Specificity ◽  
Inflammatory Syndrome ◽  
Delta Neutrophil Index

Abstract Background Multisystem inflammatory syndrome in children (MIS-C) is a life threatening hiperinflamation syndrome emerging after COVID-19. The serum delta neutrophil index (DNI), reflects the fraction of circulating immature granulocytes and elevated in infection and inflammation. The aim of this study is to evaluate the usefulness of DNI as a diagnostic marker in patients with MIS-C and to assess its role in determining the severity of MIS-C. Methods This retrospective, observational study included 83 patients of MIS-C and 113 patients of COVID-19 and control group. C-reactive protein, absolute neutrophil count, absolute lymphocyte count, DNI and platelet count were recorded. Results The DNI levels were 4.60 ± 5.70% in the MIS C group and 0.30 ± 0.99% in the COVID group and 0.20 ± 0.56% in the control group (p < 0.001). According to the severity of MIS-C, the DNI level was found 1,22% in mild MIS-C, 4,3% in moderate MIS-C and 5,7% in severe MIS-C. There was a statistically significant correlation between the DNI levels and the severity of MIS-C. The cutoff value of DNI for predicting MIS-C was 0.45%. In the correlation analysis of DNI with CRP, ANC, ALC and platelet count, sensitivity, specificity, positive predictive value and negative predictive value were found to be 79.5%, 97.1%, 95.7%, and 85.3%, respectively. Conclusions DNI was identified as a predictive factor for diagnosis of MIS-C such as ANC, ALC, platelet count and CRP. DNI levels in hemogram analysis may guide clinicians in determining the diagnosis and severity of MIS-C.

scholarly journals Soluble myeloid triggering receptor expressed on myeloid cell 1 might have more diagnostic value for bacterial ascites than C-reactive protein

2018 ◽  
Vol 13 (1) ◽  
pp. 456-462
Author(s):  
Qiang Guo ◽  
Chuanqin Xu ◽  
Chao Sun ◽  
Yubao Zhao ◽  
Weifu Zhang
Keyword(s):  
Predictive Value ◽  
Myeloid Cell ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Control Group ◽  
Health Examination ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Sensitivity Specificity ◽  
Medical University

AbstractThe timely and accurate diagnosis of ascites is of great significance for early treatment and prognostication. This study explored the value of soluble myeloid triggering receptor expressed on myeloid cell 1 (sTREM-1) and C-reactive protein (CRP) for assessing ascites. A total of 133 patients with ascites who received treatment at the Affiliated Hospital of Taishan Medical University between September 2015 and September 2017 were retrospectively analyzed. The ascites in 22, 45, 33 and 33 patients were tuberculous, bacterial, tumorous, and transudative, respectively. Healthy volunteers (n=30) who received a health examination at the same hospital during the same period constituted the control group. Before treatment, both ascitic sTREM-1 and CRP showed significant differences among the ascites subgroups (P<0.001), with the highest levels in the bacterial subgroup. Serum sTREM-1 and CRP also showed significant differences among the groups. A correlation analysis showed a positive correlation between sTREM-1 and CRP. ROC curves of the bacterial subgroup showed that when the optimal cutoff point was set to 20.2, the sensitivity, specificity, positive predictive value, and negative predictive value of the serum sTREM-1 index were 0.933, 0.955, 0.914, and 0.965, respectively. sTREM-1 may provide more diagnostic value than CRP for the diagnosis of bacterial ascites.

scholarly journals Delta Neutrophil Index as a Diagnostic Marker of Neonatal Sepsis

2021 ◽  
Vol 16 (03) ◽  
pp. 099-105
Author(s):  
Nuriye Asli Melekoglu ◽  
Seyma Yasar ◽  
Mehmet Keskin
Keyword(s):  
Neonatal Sepsis ◽  
Diagnostic Marker ◽  
Diagnostic Value ◽  
Tertiary Hospital ◽  
Control Group ◽  
Roc Curve Analysis ◽  
Suspected Sepsis ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Delta Neutrophil Index

Abstract Objective Sepsis diagnosis is challenging due to nonspecific symptomatology in newborns. Timely diagnosis is essential for reducing sepsis-related morbidity and mortality. This study was performed to determine the diagnostic value of the delta neutrophil index (DNI) for detection of neonatal sepsis and to compare its efficacy with other conventional markers. Methods This study was conducted at a tertiary hospital in newborns with confirmed sepsis (n = 59), suspected sepsis (n = 46), and in age- and weight-matched controls (n = 49). DNI, white blood cell count, C-reactive protein (CRP) level, and platelet measurements were determined, and blood cultures were performed at the onset of symptoms. Results The mean DNI was significantly higher in confirmed and clinical sepsis groups compared with the control group. (6.9 ± 9.3, 1.9 ± 2.1, and 0.4 ± 0.5, respectively, p < 0.001). ROC curve analysis also showed that the combination of DNI and CRP had the highest sensitivity (86%), specificity (100%), and positive predictive value (100%) for predicting neonatal sepsis. DNI values were significantly higher in nonsurvivors (p < 0.05). Conclusion DNI could be used as a reliable diagnostic marker for neonatal sepsis, and high DNI could predict sepsis development and unfavorable outcomes. The diagnostic capability of DNI may be increased by assessing CRP measurements simultaneously.

scholarly journals Fecal Calprotectin in Combination With Standard Blood Tests in the Diagnosis of Inflammatory Bowel Disease in Children

2021 ◽  
Vol 8 ◽  
Author(s):  
Shaun S. C. Ho ◽  
Michael Ross ◽  
Jacqueline I. Keenan ◽  
Andrew S. Day
Keyword(s):  
Inflammatory Bowel Disease ◽  
Platelet Count ◽  
Bowel Disease ◽  
Predictive Value ◽  
Screening Test ◽  
Fecal Calprotectin ◽  
Non Invasive ◽  
Blood Tests ◽  
Inflammatory Bowel ◽  
Sensitivity Specificity

Introduction: Fecal calprotectin (FC) is a useful non-invasive screening test but elevated levels are not specific to inflammatory bowel disease (IBD). The study aimed to evaluate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FC alone or FC in combination with other standard blood tests in the diagnosis of IBD.Methods: Children aged &lt;17 years who had FC (normal range &lt;50 μg/g) measured and underwent endoscopy over 33 months in Christchurch, New Zealand were identified retrospectively (consecutive sampling). Medical records were reviewed for patient final diagnoses.Results: One hundred and two children were included; mean age was 12.3 years and 53 were male. Fifty-eight (57%) of the 102 children were diagnosed with IBD: 49 with Crohn's disease, eight with ulcerative colitis and one with IBD-unclassified. FC of 50 μg/g threshold provided a sensitivity of 96.6% [95% confident interval (CI) 88.3–99.4%] and PPV of 72.7% (95% CI 61.9–81.4%) in diagnosing IBD. Two children with IBD however were found to have FC &lt;50 μg/g. Sensitivity in diagnosing IBD was further improved to 98.3% (95% CI 90.7–99.1%) when including FC &gt;50 μg/g or elevated platelet count. Furthermore, PPVs in diagnosing IBD improved when FC at various thresholds was combined with either low albumin or high platelet count.Conclusion: Although FC alone is a useful screening test for IBD, a normal FC alone does not exclude IBD. Extending FC to include albumin or platelet count may improve sensitivity, specificity, PPV and NPV in diagnosing IBD. However, prospective studies are required to validate this conclusion.

scholarly journals Predictive value of the aspartate aminotransferase to platelet ratio index and aspartate aminotransferase to alanine aminotransferase ratio in early diagnosis of intrahepatic cholestasis in pregnancy

2021 ◽  
Vol 8 (11) ◽  
pp. 650-654
Author(s):  
İbrahim Kale
Keyword(s):  
Platelet Count ◽  
Intrahepatic Cholestasis ◽  
Predictive Value ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
First Trimester ◽  
Control Group ◽  
Third Trimester ◽  
Apri Score ◽  
In Pregnancy

Objective: We aimed to investigate the predictive value of the first-trimester aspartate aminotransferase/platelet count ratio index (APRI) and aspartate aminotransferase/alanine aminotransferase ratio for intrahepatic cholestasis in pregnancy (ICP). Material and Methods: The clinical data of patients who admitted to the Obstetrics Department of Umraniye Training and Research Hospital, between 2015-2020 were analyzed retrospectively. The study group consisted of 44 patients with ICP and the control group consisted of randomly selected 92 healthy pregnant women. Results: The two groups were similar in terms of age, BMI, first and third-trimester platelet count and third-trimester hemoglobin level. Patients with ICP had a significantly higher first-trimester APRI and a lower first trimester AST/ALT ratio than the healthy controls (p <0.001, p = 0.001, respectively). According to the ROC analysis, the optimal cut-off value of the APRI to predict ICP was 0.191, with the sensitivity of 0.66 and specificity of 0.66 (AUC: 0,727), and the optimal cut-off value for AST/ALT ratio was 1.07, with the sensitivity of 0.64, and specificity of 0.62 (AUC: 0,681). Conclusion: The first-trimester APRI score and AST/ALT ratio is an easy, inexpensive, and non-invasive tool that may be useful in predicting ICP early.

Clinical Assessment of Three Common Tests for Superior Labral Anterior-Posterior Lesions

2002 ◽  
Vol 30 (6) ◽  
pp. 810-815 ◽  
Author(s):  
Edward G. McFarland ◽  
Tae Kyun Kim ◽  
Richard M. Savino
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Shoulder Arthroscopy ◽  
Control Group ◽  
Type I ◽  
Specific Test ◽  
Slide Test ◽  
Posterior Lesion ◽  
Sensitivity Specificity ◽  
Anterior Posterior

Background Three tests (active compression, anterior slide, and compression rotation) are commonly used to diagnose superior labral anterior-posterior lesions. Hypothesis We hypothesized that the accuracy, sensitivity, and specificity for these tests was less than that previously reported and that a click in the shoulder during manipulation was not specific for the study lesion. Study Design Case-control study. Methods The three tests were performed on 426 patients who subsequently underwent shoulder arthroscopy. The results of physical examination were compared with the arthroscopic findings and analyzed for sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. Results At arthroscopy, 39 patients had type II to IV lesions (study group); the remaining 387 patients had type I lesion or no lesion (control group). The incidences of positive results were not statistically different between the groups (P > 0.05). Our findings were as follows: most sensitive test, active compression (47%); most specific test, anterior slide (84%); highest positive predictive value, active compression (10%); highest overall accuracy, anterior slide test (77%); lowest overall accuracy, active compression test (54%). The presence of a click and the location of the pain were not reliable diagnostic indicators. Conclusions The results of such tests should be interpreted with caution when considering surgery for a possible superior labral anterior-posterior lesion.

Association Between 45° Flexion Anteroposterior Elbow Radiographs and Diagnostic Accuracy of Capitellum Osteochondritis Dissecans

2021 ◽  
pp. 036354652110271
Author(s):  
Michael G. Saper ◽  
Viviana Bompadre ◽  
Gregory A. Schmale ◽  
Sarah Menashe ◽  
Monique Burton ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Osteochondritis Dissecans ◽  
Predictive Value ◽  
Interobserver Reliability ◽  
Intraobserver Reliability ◽  
Control Group ◽  
Level Of Evidence ◽  
Level Of Confidence ◽  
High Level ◽  
Sensitivity Specificity

Background: An anteroposterior (AP) radiograph of the elbow in 45° of flexion has been suggested to increase the diagnostic accuracy of capitellum osteochondritis dissecans (OCD). Purpose: To assess the diagnostic performance, inter- and intraobserver reliability, and confidence level for identifying capitellum OCD using plain radiographs (AP, lateral, and 45° flexion AP). Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: This was a retrospective study of pediatric and adolescent patients with capitellum OCD and a control group. Six independent clinicians who were blinded to the official radiologists’ reports reviewed images on 2 separate occasions, 1 week apart. A 5-point Likert scale was used to assess the clinicians’ level of confidence. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for individual and combinations of radiographic views. Inter- and intraobserver reliability was determined using Cohen kappa (κ) coefficients. Results: A total of 28 elbows (mean age, 12.5 ± 2 years) were included. There were no differences in age ( P = .18), sex ( P = .62), or laterality ( P > .999) between groups. There were marked variations in the diagnostic accuracy between views: sensitivity (AP, 85.1; lateral, 73.2; 45° flexion AP, 91.7), specificity (AP, 89.3; lateral, 91.7; 45° flexion AP, 91.1), PPV (AP, 88.8; lateral, 89.8; 45° flexion AP, 91.1), NPV (AP, 85.7; lateral, 77.4; 45° flexion AP, 91.6), and accuracy (AP, 87.2; lateral, 82.4; 45° flexion AP, 91.4). Standard radiographs (AP and lateral views) failed to diagnose capitellum OCD in 4.8% of cases. The sensitivity of the 3 combined views was 100%. Confidence intervals in the clinicians’ diagnostic assessments were similar for each view (AP, 4.0; lateral, 4.0; and 45° flexion AP, 4.1). Interobserver reliability was substantial for AP and lateral views (κ = 0.65 and κ = 0.60, respectively) but highest for the 45° flexion AP radiographs (κ = 0.72). Intraobserver reliability for the 45° flexion AP view was moderate to almost perfect (κ = 0.45 to 0.93). Conclusion: The 45° flexion AP view can detect capitellum OCD with excellent accuracy, a high level of confidence, and substantial interobserver agreement. When added to standard AP and lateral radiographs, the 45° flexion AP view aids in the identification of capitellum OCD.

Predictive significance of absolute lymphocyte count and morphology in adults with a new onset peripheral blood lymphocytosis

2014 ◽  
Vol 67 (12) ◽  
pp. 1062-1066 ◽  
Author(s):  
Ping Sun ◽  
Emilia M Kowalski ◽  
Calvino K Cheng ◽  
Allam Shawwa ◽  
Robert S Liwski ◽  
...  
Keyword(s):  
Predictive Value ◽  
Lymphocyte Count ◽  
Lymphoproliferative Disorder ◽  
Absolute Lymphocyte Count ◽  
Laboratory Evaluation ◽  
Characteristic Analysis ◽  
Reactive Process ◽  
The Difference ◽  
Sensitivity Specificity ◽  
Lymphocyte Number

AimsLymphocytosis is commonly encountered in the haematology laboratory. Evaluation of blood films is an important screening tool for differentiating between reactive and malignant processes. The optimal lymphocyte number to trigger morphological evaluation of the smear has not been well defined in the literature. Likewise, the significance of lymphocyte morphology has not been well studied and there are no consensus guidelines or follow-up recommendations available. We attempt to evaluate the significance of lymphocyte morphology and to define the best possible cut-off value of absolute lymphocyte count for morphology review.Methods71 adult patients with newly detected lymphocytosis of 5.0×109/L or more were categorised to either a reactive process or a lymphoproliferative disorder. We performed statistical analysis and morphology review to compare the difference in age, gender, lymphocyte count and morphological features between the two groups. Receiver operating characteristic analysis was performed to determine an optimal lymphocyte number to trigger morphology review.ResultsLymphoproliferative disorders are associated with advanced age and higher lymphocyte count. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of lymphocyte morphology as a screening test were 0.9, 0.59, 0.60, 0.58 and 0.71, respectively. The optimal cut-off of lymphocyte number for morphology review was found to be close to 7×109/L.ConclusionsWe found a moderate interobserver agreement for the morphological assessment. ‘Reactive’ morphology was very predictive of a reactive process, but ‘malignant’ morphology was a poor predictor of a lymphoproliferative disorder.

scholarly journals Prognostic Value of C-Reactive Protein in Patients With Coronavirus 2019

2020 ◽  
Vol 71 (16) ◽  
pp. 2174-2179 ◽  
Author(s):  
Xiaomin Luo ◽  
Wei Zhou ◽  
Xiaojie Yan ◽  
Tangxi Guo ◽  
Benchao Wang ◽  
...  
Keyword(s):  
Platelet Count ◽  
Blood Cell ◽  
Neutrophil Count ◽  
Predictive Value ◽  
Prognostic Value ◽  
Operating Characteristic ◽  
Adverse Outcome ◽  
Elevated Serum ◽  
C Reactive Protein ◽  
Reactive Protein

Abstract Background An elevated serum C-reactive protein (CRP) level was observed in most patients with coronavirus disease 2019 (COVID-19). Methods Data for COVID-19 patients with clinical outcome in a designated hospital in Wuhan, China, were retrospectively collected and analyzed from 30 January 2020 to 20 February 2020. The prognostic value of admission CRP was evaluated in patients with COVID-19. Results Of 298 patients enrolled, 84 died and 214 recovered. Most nonsurvivors were male, older, or with chronic diseases. Compared with survivors, nonsurvivors showed significantly elevated white blood cell and neutrophil counts, neutrophil to lymphocyte ratio (NLR), systemic immune inflammation index (defined by platelet count multiplied by NLR), CRP, procalcitonin, and D-dimer and showed decreased red blood cell, lymphocyte, and platelet counts. Age, neutrophil count, platelet count, and CRP were identified as independent predictors of adverse outcome. The area under the receiver operating characteristic (ROC) curve (AUC) of CRP (0.896) was significantly higher than that of age (0.833), neutrophil count (0.820), and platelet count (0.678) in outcome prediction (all P &lt; .05). With a cutoff value of 41.4, CRP exhibited sensitivity of 90.5%, specificity of 77.6%, positive predictive value of 61.3%, and negative predictive value of 95.4%. CRP was also an independent discriminator of severe/critical illness on admission with an AUC (0.783) comparable to age (0.828) and neutrophil count (0.729) (both P &gt; .05). Conclusions In patients with COVID-19, admission CRP correlated with disease severity and tended to be a good predictor of adverse outcome.

scholarly journals Evaluating the Use of Serum Inflammatory Markers for Preoperative Diagnosis of Infection in Patients with Nonunions

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Song Wang ◽  
Peng Yin ◽  
Chenliang Quan ◽  
Kamran Khan ◽  
Guoqi Wang ◽  
...  
Keyword(s):  
Predictive Value ◽  
Inflammatory Markers ◽  
Positive Culture ◽  
Serum Levels ◽  
Infected Nonunion ◽  
Reactive Protein ◽  
Number Of Patients ◽  
Sensitivity Specificity ◽  
Diagnosis Of Infection ◽  
Serum Inflammatory Markers

Purpose. The aim of this study is to evaluate the effectiveness of laboratory serum tests in the diagnosis of infected nonunion.Methods. Forty-two patients suspected of having infected nonunion were investigated in the study. The serum levels of white blood-cell count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and interleukin-6 (IL-6) were measured. A positive diagnosis of infection was made on the basis of the positive culture results. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each test were calculated.Results. The sensitivity and specificity of CRP both were higher than IL-6: 60.0% versus 57.1% and 85.7% versus 57.1%, respectively. With one, two, three, and four positive tests, the predicted probabilities of infection were 66.7%, 90.9%, 100%, and 100%, respectively, but the number of patients who had three or four positive tests was small.Conclusions. The diagnostic utility of IL-6 is inferior to CRP and the finding conflicts with previous conclusions drawn from periprosthetic infections. Laboratory analysis of serum inflammatory markers alone is not an effective screening tool for patients suspected of having an infected nonunion.

Sign in / Sign up

Export Citation Format

Share Document