OC79 THE ROLE OF PROCALCITONIN, C-REACTIVE PROTEIN AND WHITE BLOOD CELLS IN THE DIFFERENTIAL DIAGNOSIS BETWEEN SEPSIS AND SIRS IN CARDIAC SURGERY PATIENTS

2018 ◽  
Vol 19 ◽  
pp. e32
Author(s):  
D. Brugnetti ◽  
K. Reeve ◽  
U. Held ◽  
H. Löblein ◽  
D. Odavic ◽  
...  
2017 ◽  
Vol 11 (1) ◽  
pp. 41
Author(s):  
Giampiera Bertolino ◽  
Federica Quaglia ◽  
Luigia Scudeller ◽  
Iride Ceresa ◽  
Carlo L. Balduini

Leukocytosis is regarded as a reliable marker of a serious disorder requiring hospitalization. However, leukocytosis often disappears once the patient is admitted to a medical ward; differential diagnosis of leukocytosis is often overlooked in the busy Emergency Room (ER) routine. We retrospectively evaluated the clinical records of 565 consecutive patients admitted to the Department of Internal Medicine (DIM) after examination in ER. Mean leukocyte count was 11.4×109/L in ER and 10.1×109/L in DIM (P<0.001). Leukocytosis was found in 53.1% of patients in ER, but in 33% of these it was no longer evident on the following day, unrelated to baseline white blood cells (WBC) count, age, sex, diagnosis, C-reactive protein level and early antibiotic treatment. A reduction in WBC count larger than 40% from baseline occurred in 13.6% of all subjects, and in 31.7% of those with transient leukocytosis. Leukocytosis in ER is frequent, but it is often transient and not associated with an infectious cause. Other causes, including psychological stress caused by the ER access itself, should be considered in the differential diagnosis.


Author(s):  
Andriy Zhydkov ◽  
Mirjam Christ-Crain ◽  
Robert Thomann ◽  
Claus Hoess ◽  
Christoph Henzen ◽  
...  

AbstractThe added value of biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC), as adjuncts to clinical risk scores for predicting the outcome of patients with community-acquired pneumonia (CAP) is in question. We investigated the prognostic accuracy of initial and follow-up levels of inflammatory biomarkers in predicting death and adverse clinical outcomes in a large and well-defined cohort of CAP patients.We measured PCT, CRP and WBC on days 1, 3, 5, and 7 and followed the patients over 30 days. We applied multivariate regression models and area under the curve (AUC) to investigate associations between these biomarkers, the clinical risk score CURB-65, and clinical outcomes [i.e., death and intensive care unit (ICU) admission].Of 925 patients with CAP, 50 patients died and 118 patients had an adverse clinical outcome. None of the initial biomarker levels significantly improved the CURB-65 score for mortality prediction. Follow-up biomarker levels showed significant independent association with mortality at days 3, 5, and 7 and with improvements in AUC. Initial PCT and CRP levels were independent prognostic predictors of adverse clinical outcome, and levels of all biomarkers during the course of disease provided additional prognostic information.This study provides robust insights into the added prognostic value of inflammatory markers in CAP. Procalcitonin, CRP, and to a lesser degree WBC provided some prognostic information on CAP outcomes, particularly when considering their kinetics at days 5 and 7 and when looking at adverse clinical outcomes instead of mortality alone.


2007 ◽  
Vol 24 (5) ◽  
pp. 1068-1077 ◽  
Author(s):  
Emine Akinci ◽  
Gulbin Aygencel ◽  
Ayfer Keles ◽  
Ahmet Demircan ◽  
Fikret Bildik

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jun Nishimura ◽  
Parag Dharap ◽  
Sebastien Raimbault

Abstract Background Hematology analyzers display abnormal parameters during malaria infection providing insightful information for suspecting and assessing malaria infection. The goal of this study is to demonstrate the potential of a three-part differential hematology analyzer to assess malaria, provide information about the parasitemia, and discuss the importance of combining C-reactive protein (CRP) with hematology parameters to obtain further information about the malaria infection. Methods The present study shows the results of a case–control study during the monsoon season of years 2018 and 2019 in Mumbai, India. The study considers 1008 non-malaria febrile cases, 209 P. vivax and 31 P. falciparum positive malaria samples, five cases of mixed P. vivax and P. falciparum infection, and three co-infection cases of P. vivax and dengue. Raw data from the three-part analyzer LC-667G CRP (HORIBA) and the corresponding microscopic findings (golden standard for diagnosis of malaria) were obtained for each sample. Results The medians of platelet counts (PLT) were 102.5, 109.0, and 223.0 × 103/µL, while CRP medians were 67.4, 81.4 and 10.4 mg/L in P. vivax, P. falciparum and control groups respectively (p < 0.001 in Mann–Whitney U tests between malaria and control groups). Compared with negative samples, platelets counting less than 161.5 × 103/µL were observed on malaria patients (OR 19.12, 95% CI 11.89–30.75). Especially in P. vivax cases, an abnormal peak was frequently observed in the white blood cells (WBC) histogram around the 37fL channel. The events counted around that channel showed a linear correlation with the counting of red blood cells infected predominantly with larger parasitic forms. Parameters like CRP (rs = 0.325, p < 0.001), WBC (rs = 0.285, p < 0.001) and PLT (rs = − 0.303, p < 0.001) were correlated with the parasitemia of P. vivax samples. Between the malaria and dengue groups, the highest area under the receiver operating characteristic curve was observed on CRP (0.867, CRP ≥ 26.85 mg/L). Conclusions A three-part differential hematology analyzer has the potential to not only trigger malaria diagnosis confirmation but also assess the severity of the infection when CRP is considered.


2021 ◽  
Vol 16 (4) ◽  
pp. 190-193
Author(s):  
Shahida Khatoon ◽  
Mujeeb ur Rehman ◽  
Sohail Ahmed Memon

Objective: Role of C-reactive protein value in the diagnosis of appendicitis by correlating with severity of appendicitis on histopathological findings. Methodology: This descriptive study was conducted at the department of general surgery Unit-IV, Liaquat University Hospital Hyderabad from March 2016 to February 2017. All cases above 12 years of age with severe appendicitis based on presenting signs and symptoms were included. The patient underwent routine laboratory investigations including abdominal plain x-ray in an erect position and ultrasound abdomen. The blood sample was taken from each patient for C-reactive protein and was send to Hospital diagnostic laboratory. During surgery, a specimen of each patient was sent to a diagnostic laboratory for histopathology. All the data were record on Performa. Results: A total of 305 patients were studied; their mean age was 35.7+9.7 years. Males were found in the majority (73%). 75.41% of patients had leukocytosis. C-reactive protein was raised among 26.22% of patients. On histopathological findings, 04.91% of patients had a normal appendix, while 69.83% had gross inflammation of the appendix, 19.67% patients had gangrenous appendix, and 05.57% patients had perforation and peritonitis. Elevated C reactive protein (CRP) and leukocytosis were significantly associated with the severity of appendicitis, p value 0.001. Conclusion: C-reactive protein is a non-invasive and reliable indicator for surgical treatment of appendicitis. C-reactive protein and white blood cells (WBCs) were significantly associated with the severity of appendicitis.


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