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Toplum kökenli pnömonili çocuklarda hastalık aktivitesinin değerlendirilmesinde yeni bir biyobelirteç olarak C-reaktif protein (CRP)/ortalama trombosit hacmi (OTH) oranı

Year 2017, Volume: 42 Issue: 3, 451 - 458, 30.09.2017
https://doi.org/10.17826/cutf.323816

Abstract

Amaç: Son yıllarda inflamasyon göstergesi olarak değerlendirilen C-reaktif proteinin (CRP)/ortalama trombosit hacmi (OTH) oranı ve beyaz küre sayısı (BKS)/ortalama trombosit hacmi (OTH) oranının toplum kökenli pnömonili (TKP) çocuklarda tanı ve hastalık şiddeti ile ilişkisini araştırmaktır.

Gereç ve Yöntem: Çalışma TKP tanısı alan 3 ay ile 18 yaş arasında 60 hasta ve 30 sağlıklı çocuktan oluşturuldu. Hasta ve kontrol grubunda CRP, BKS, OTH, nötrofil/lenfosit oranı (NLO) değerleri ile birlikte CRP/OTH ve BKS/OTH değerleri incelendi. 

Bulgular: Hasta ve kontrol grubu arasında OTH düzeyleri açısından anlamlı fark saptanmazken, CRP/OTH, BKS/OTH, NLO ve plateletkrit düzeyleri hasta grubunda anlamlı olarak yüksek bulundu. Ciddi pnömonili hasta grubunda (n=27) BKS, NLO, BKS/OTH, CRP/OTH ve CRP düzeyleri hafif-ılımlı pnömonili gruba (n=33) göre anlamlı olarak yüksek saptandı. CRP/OTH ve BKS/OTH oranlarının hastalık belirtilerinin süresiyle arasında pozitif korelasyon gösterildi. Receiver Operating Characteric (ROC) analizinde CRP (Eğri altındaki alan (EAA)=0.801), BKS (EAA=0.761) ve BKS/OTH (EAA=0.731) düzeylerinin TKP’nin tanısında yeterliliği anlamlı bulundu. Ciddi TKP’li hastaların ayrımında ise CRP/OTH (EAA=0.733) ve CRP (EAA=0.708) düzeyleri anlamlı bulundu.

Sonuç: CRP/OTH ve BKS/OTH oranları TKP tanısının değerlendirilmesinde ve CRP/OTH oranı hastalık aktivitesinin belirlenmesinde iyi bir belirteç olabileceğini göstermektedir.


References

  • 1. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44: 27-72.
  • 2. Garau J, Baquero F, Pérez-Trallero E, Pérez JL, Martín-Sánchez AM, García-Rey C et al. Factors impacting on length of stay and mortality of community-acquired pneumonia. Clin Microbiol Infect. 2008;14:322–29.
  • 3. Polverino E, Torres Marti A. Community-acquired pneumonia. Minerva Anestesiol. 2011;77:196-211.
  • 4. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095-128.
  • 5. Juvén T, Mertsola J, Waris M, Leinonen M, Meurman O, Roivainen M et al. Etiology of community-acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J. 2000;19:293-8.
  • 6. Michelow IC, Olsen K, Lozano J, Rollins NK, Duffy LB, Ziegler T et al. Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children. Pediatrics. 2004;113:701-7.
  • 7. Bekdas M, Goksugur SB, Sarac EG, Erkocoglu M, Demircioglu F. Neutrophil/lymphocyte and C-reactive protein/mean platelet volume ratios in differentiating between viral and bacterial pneumonias and diagnosing early complications in children. Saudi Med J. 2014;35:442-7.
  • 8. Long SS, Pickering LK, Prober CG. Principles and Practice of Pediatric Infectious Diseases. 2nd ed, Philadelphia, Churchill Livingstone, 2003. . 9. Tan TQ, Mason EO Jr, Barson WJ, Wald ER, Schutze GE, Bradley JS et al. Clinical characteristics and outcome of children with pneumonia attributable to penicillin-susceptible and penicillin-nonsusceptible Streptococcus pneumoniae. Pediatrics. 1998;102:1369-75.
  • 10. Yavuzcan A, Cağlar M, Ustün Y, Dilbaz S, Ozdemir I, Yıldız E, et al. Evaluation of mean platelet volume, neutrophil/lymphocyte ratio and platelet/ lymphocyte ratio in advanced stage endometriosis with endometrioma. J Turk Ger Gynecol Assoc. 2013;14:210-5.
  • 11. Briggs C. Quality counts: new parameters in blood cell counting. Int J Lab Hematol. 2009;31:277-97.
  • 12. Karadag-Oncel E, Ozsurekci Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumonia in children. Ital J Pediatr. 2013;39:16.
  • 13. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis. 1996;7:157-61.
  • 14. Cicek G, Açıkgöz SK, Yayla Ç, Kundi H, İleri M. White blood cell count to mean platelet volume ratio: A novel and promising prognostic marker for st-segment elevation myocardial ınfarction. Cardiology J. 2016;23:225-35.
  • 15. Bradley JS1, Byington CL, Shah SS, Alverson B, Carter ER, Harrison et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53:25-76.
  • 16. Menéndez R, Martínez R, Reyes S, Mensa J, Filella X, Marcos MA et al. Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia. Thorax. 2009;64:587-91.
  • 17. Virkki R1, Juven T, Rikalainen H, Svedström E, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children. Thorax. 2002;57:438-41.
  • 18. Ayata A, Genç H, Sütçü R. The role of procalcitonin, neopterin and C-reactive protein for diagnosis and monitoring in infectious diseases of childhood. Tıp Araştırmaları Dergisi. 2004;2:11-7.
  • 19. Uysal P, Tuncel T, Olmez, Babayiğit A, Karaman O, Uzuner N. The role of mean platelet volume predicting acute exacerbations of cystic fibrosis in children. Ann Thorac Med. 2011;6:227-30.
  • 20. Yazici S, Yazici M, Erer B, Calik Y, Ozhan H, Ataoglu S. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets. 2010;21:122–5.
  • 21. Öztürk ZA, Dag MS, Kuyumcu ME, Cam H, Yesil Y, Yilmaz N et al. Could platelet indices be new biomarkers for inflammatory bowel diseases. Eur Rev Med Pharmacol Sci. 2013;17:334-41.
  • 22. Şahin F, Yazar E, Yıldız P. Prominent features of platelet count, plateletcrit, mean platelet volume and platelet distribution width in pulmonary tuberculosis. Multidiscip Respir Med. 2012;7:38.
  • 23. Safak S, Uslu AU, Korkmaz S, Turker T, Soner S, Lutfi A. Association between mean platelet volume levels and inflammation in SLE patients presented with arthritis. Afr Health Sci. 2014;14.4:919-24.
  • 24. Eser İ, Günay Ş, Sak ZHA, Yalçın F , Kürkçüoğlu İC. Pnömoni hastalığında bir tanı indikatörü olarak ortalama trombosit hacmi. Tıp Araştırmaları Dergisi. 2014;12:12-4.
  • 25. Hlatky MA, Greenland P, Arnett DK, Ballantyne CM, Criqui MH, Elkind MS et al. Criteria for evaluation of novel markers of cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009;119:2408-16.
  • 26. Morrow DA, de Lemos JA. Benchmarks for the assessment of novel cardiovascular biomarkers. Circulation. 2007;115:949-52.
  • 27. Dehghani MR, Rezaei Y, Taghipour-Sani L. White blood cell count to mean platelet volume ratio as a novel non-invasive marker predicting long-term outcomes in patients with non-ST elevation acute coronary syndrome.Cardiol J. 2015;22.4:437-45.
  • 28. Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M et al. British Thoracic Society Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011;66(Suppl 2):ii1-23.
  • 29. Mani CS, Murray DL. Acute pneumonia and its complications. In Principles and Practice of Pediatric Infectious Diseases, 3rd ed (Eds SS Long, LK Pickering, CG Prober):245-57. Philadelphia, Elsevier, 2008.

C-reactive protein (CRP)/mean platelet volume (MPV) ratio as a new biomarker for community-acquired pneumonia in children

Year 2017, Volume: 42 Issue: 3, 451 - 458, 30.09.2017
https://doi.org/10.17826/cutf.323816

Abstract

Purpose: Our aim is to evaluate the relationship between C-reactive protein (CRP)/mean platelet volume (MPV) ratio and white blood cell (WBC)/mean platelet volume (MPV) ratio  and diagnosis and disease severity in children with community-acquired pneumonia (CAP).

Material and Methods: 60 patients with CAP including 33 mild-moderate (Group 1) and 27 severe pneumonia (Group 2) and 30 healthy children were examined for routine blood test. WBC, MPV, neuotrophile/lymhocyte ratio (NLR), CRP, WBC/MPV, CRP/MPV values were recorded on each patient and healthy groups.

Result: CRP/MPV, WBC/MPV, NLR and plateletcrit values were significantly higher in patients group than controls, while MPV value is not correlated between patient and control groups. WBC, NLR, WBC/MPV, CRP/MPV and CRP values were higher in the Group 2 compared to Group 1. CRP/MPV and WBC/MPV were positively correlated with duration of symptoms in the CAP. The area under ROC curve of CRP, WBC and WBC/MPV in diagnosing CAP was significant (0.801, 0.761 and 0.731). Also the area under ROC curve of Group 2 in CRP/MPV and CRP in diagnosing CAP was significant (0.733, 0.708).

Conclusion: CRP/MPV and WBC/MPV ratio may be used a marker in the evaluation of CAP diagnosis and CRP/MPV ratio can be good marker prediction of disease activity.


References

  • 1. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44: 27-72.
  • 2. Garau J, Baquero F, Pérez-Trallero E, Pérez JL, Martín-Sánchez AM, García-Rey C et al. Factors impacting on length of stay and mortality of community-acquired pneumonia. Clin Microbiol Infect. 2008;14:322–29.
  • 3. Polverino E, Torres Marti A. Community-acquired pneumonia. Minerva Anestesiol. 2011;77:196-211.
  • 4. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095-128.
  • 5. Juvén T, Mertsola J, Waris M, Leinonen M, Meurman O, Roivainen M et al. Etiology of community-acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J. 2000;19:293-8.
  • 6. Michelow IC, Olsen K, Lozano J, Rollins NK, Duffy LB, Ziegler T et al. Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children. Pediatrics. 2004;113:701-7.
  • 7. Bekdas M, Goksugur SB, Sarac EG, Erkocoglu M, Demircioglu F. Neutrophil/lymphocyte and C-reactive protein/mean platelet volume ratios in differentiating between viral and bacterial pneumonias and diagnosing early complications in children. Saudi Med J. 2014;35:442-7.
  • 8. Long SS, Pickering LK, Prober CG. Principles and Practice of Pediatric Infectious Diseases. 2nd ed, Philadelphia, Churchill Livingstone, 2003. . 9. Tan TQ, Mason EO Jr, Barson WJ, Wald ER, Schutze GE, Bradley JS et al. Clinical characteristics and outcome of children with pneumonia attributable to penicillin-susceptible and penicillin-nonsusceptible Streptococcus pneumoniae. Pediatrics. 1998;102:1369-75.
  • 10. Yavuzcan A, Cağlar M, Ustün Y, Dilbaz S, Ozdemir I, Yıldız E, et al. Evaluation of mean platelet volume, neutrophil/lymphocyte ratio and platelet/ lymphocyte ratio in advanced stage endometriosis with endometrioma. J Turk Ger Gynecol Assoc. 2013;14:210-5.
  • 11. Briggs C. Quality counts: new parameters in blood cell counting. Int J Lab Hematol. 2009;31:277-97.
  • 12. Karadag-Oncel E, Ozsurekci Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumonia in children. Ital J Pediatr. 2013;39:16.
  • 13. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis. 1996;7:157-61.
  • 14. Cicek G, Açıkgöz SK, Yayla Ç, Kundi H, İleri M. White blood cell count to mean platelet volume ratio: A novel and promising prognostic marker for st-segment elevation myocardial ınfarction. Cardiology J. 2016;23:225-35.
  • 15. Bradley JS1, Byington CL, Shah SS, Alverson B, Carter ER, Harrison et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53:25-76.
  • 16. Menéndez R, Martínez R, Reyes S, Mensa J, Filella X, Marcos MA et al. Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia. Thorax. 2009;64:587-91.
  • 17. Virkki R1, Juven T, Rikalainen H, Svedström E, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children. Thorax. 2002;57:438-41.
  • 18. Ayata A, Genç H, Sütçü R. The role of procalcitonin, neopterin and C-reactive protein for diagnosis and monitoring in infectious diseases of childhood. Tıp Araştırmaları Dergisi. 2004;2:11-7.
  • 19. Uysal P, Tuncel T, Olmez, Babayiğit A, Karaman O, Uzuner N. The role of mean platelet volume predicting acute exacerbations of cystic fibrosis in children. Ann Thorac Med. 2011;6:227-30.
  • 20. Yazici S, Yazici M, Erer B, Calik Y, Ozhan H, Ataoglu S. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets. 2010;21:122–5.
  • 21. Öztürk ZA, Dag MS, Kuyumcu ME, Cam H, Yesil Y, Yilmaz N et al. Could platelet indices be new biomarkers for inflammatory bowel diseases. Eur Rev Med Pharmacol Sci. 2013;17:334-41.
  • 22. Şahin F, Yazar E, Yıldız P. Prominent features of platelet count, plateletcrit, mean platelet volume and platelet distribution width in pulmonary tuberculosis. Multidiscip Respir Med. 2012;7:38.
  • 23. Safak S, Uslu AU, Korkmaz S, Turker T, Soner S, Lutfi A. Association between mean platelet volume levels and inflammation in SLE patients presented with arthritis. Afr Health Sci. 2014;14.4:919-24.
  • 24. Eser İ, Günay Ş, Sak ZHA, Yalçın F , Kürkçüoğlu İC. Pnömoni hastalığında bir tanı indikatörü olarak ortalama trombosit hacmi. Tıp Araştırmaları Dergisi. 2014;12:12-4.
  • 25. Hlatky MA, Greenland P, Arnett DK, Ballantyne CM, Criqui MH, Elkind MS et al. Criteria for evaluation of novel markers of cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009;119:2408-16.
  • 26. Morrow DA, de Lemos JA. Benchmarks for the assessment of novel cardiovascular biomarkers. Circulation. 2007;115:949-52.
  • 27. Dehghani MR, Rezaei Y, Taghipour-Sani L. White blood cell count to mean platelet volume ratio as a novel non-invasive marker predicting long-term outcomes in patients with non-ST elevation acute coronary syndrome.Cardiol J. 2015;22.4:437-45.
  • 28. Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M et al. British Thoracic Society Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011;66(Suppl 2):ii1-23.
  • 29. Mani CS, Murray DL. Acute pneumonia and its complications. In Principles and Practice of Pediatric Infectious Diseases, 3rd ed (Eds SS Long, LK Pickering, CG Prober):245-57. Philadelphia, Elsevier, 2008.
There are 28 citations in total.

Details

Subjects Health Care Administration
Journal Section Research
Authors

Eda Çelik Güzel

Çiğdem Fidan This is me

Savaş Güzel This is me

Cem Paketçi This is me

Publication Date September 30, 2017
Acceptance Date November 30, 2016
Published in Issue Year 2017 Volume: 42 Issue: 3

Cite

MLA Çelik Güzel, Eda et al. “C-Reactive Protein (CRP)/Mean Platelet Volume (MPV) Ratio As a New Biomarker for Community-Acquired Pneumonia in Children”. Cukurova Medical Journal, vol. 42, no. 3, 2017, pp. 451-8, doi:10.17826/cutf.323816.