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[Elastase-alpha 1-proteinase inhibitor complex (E alpha 1 PI) and lactoferrin plasma concentrations in viral and
F K Tegtmeyer1, S Maacks, J van Wees
1Klinik für Pädiatrie, Medizinischen Universität zu Lübeck.
Abstract:
Typical alterations of the white blood cell count are often missed during the acute course of infectious diseases. Activiation and degranulation of granulocytes are followed by elevation of E alpha 1 PI and lactoferrin plasma concentrations under these conditions. The aim of our study was the evaluation of the diagnostic significance of these granulocyte parameters in relation with the absolute granulocyte count in infected pediatric patients. A total number of 106 patients at the age of 1 day to 16 years were studied. 25 children suffered from viral, 26 from localized and 23 from systemic bacterial infections, 32 children exhibiting no signs of infection served as controls. Results of the study are given as medians and ranges. Total granulocyte count was elevated above controls (4.8; 2.2-12.7/nl) only in patients with localized bacterial infections (13.3; 5.5-36.5/nl). E alpha 1 PI and lactoferrin plasma concentrations correlated well (r = 0.72) and were found to be significantly elevated in patients with localized bacterial infections (856; 363-4820 micrograms/l and 748; 206-2078 micrograms/l) and septicemia respectively (661; 256-2078 micrograms/l and 871; 160-9550 micrograms/l). A clearcut differentiation of septic and locally infected patients was given by the ratio of E alpha 1 PI and total granulocyte counts. Significantly elevated E alpha 1 PI concentrations of patients exhibiting viral infections (295; 86-690 micrograms/l) may suggest effective granulocyte activation under this condition. Finally we conclude that E alpha 1 PI and lactoferin plasma concentration related to total granulocyte counts in infected patients may serve as a helpful indicator of granulocyte activation during the acute course of the disease.
Insights
Elevated E alpha 1 PI and lactoferrin plasma levels, alongside granulocyte counts, help diagnose infections in children. These markers indicate granulocyte activation during acute illness, aiding in differentiating infection types.
Area of Science:
- Pediatric Infectious Diseases
- Hematology
- Clinical Immunology
Context:
- White blood cell count alterations are often overlooked in acute infectious diseases.
- Granulocyte activation and degranulation lead to increased plasma E alpha 1 PI and lactoferrin.
Purpose:
- To evaluate the diagnostic significance of granulocyte parameters (E alpha 1 PI, lactoferrin) relative to absolute granulocyte count in pediatric infections.
Summary:
- The study analyzed 106 pediatric patients (viral, bacterial infections, controls). Absolute granulocyte count was elevated only in localized bacterial infections.
- Plasma E alpha 1 PI and lactoferrin concentrations correlated well and were significantly elevated in localized bacterial infections and septicemia.
- The ratio of E alpha 1 PI to total granulocyte counts differentiated septic from locally infected patients. Elevated E alpha 1 PI in viral infections suggests granulocyte activation.
Impact:
- E alpha 1 PI and lactoferrin plasma concentrations, when related to total granulocyte counts, serve as valuable indicators of granulocyte activation in acute pediatric infections.
- These markers can aid in the early and accurate diagnosis of various infectious conditions in children.
- Findings contribute to improved diagnostic strategies for pediatric infectious diseases.