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C-reactive protein and prealbumin in suspected sudden infant death syndrome
1Department of Laboratories, Children's Hospital and Medical Center, Seattle, Washington.
Insights
Sudden Infant Death Syndrome (SIDS) infants show no signs of acute inflammation or nutritional deficiency. Elevated C-reactive protein (CRP) in SIDS cases warrants further investigation for infection.
Area of Science:
- Biochemistry
- Pediatric Pathology
- Neonatology
Background:
- C-reactive protein (CRP) and prealbumin are biomarkers for acute phase response and nutritional status.
- Sudden Infant Death Syndrome (SIDS) is a leading cause of post-neonatal infant mortality.
- Investigating inflammatory markers may elucidate underlying causes of SIDS.
Purpose of the Study:
- To determine if acute inflammatory response or nutritional deficits are present in infants suspected of SIDS.
- To analyze C-reactive protein (CRP) and prealbumin levels in SIDS cases.
Main Methods:
- Serum CRP and prealbumin levels were measured in 87 infants with suspected SIDS.
- Patients were categorized based on CRP levels and clinical findings.
- Nutritional status was assessed indirectly via prealbumin levels.
Main Results:
- Eighty infants were classified with typical SIDS; only four showed minimal CRP elevation (<2 mg/dl) without clear cause.
- Seven infants had significant infections, with four exhibiting prominent CRP elevations.
- Prealbumin levels were not reduced in the SIDS population, indicating no recent nutritional deficit.
Conclusions:
- The study found no evidence of an activated acute inflammatory response in infants dying from SIDS.
- Elevated CRP levels (>2 mg/dl) in SIDS cases should prompt further investigation into potential infections.
- There is no indication of recent significant nutritional compromise in infants diagnosed with SIDS.
Abstract:
This study investigated the levels of C-reactive protein (CRP) and prealbumin in 87 infants suspected of dying from sudden infant death syndrome (SIDS). These proteins change rapidly, within 24 hr, in patients who have an acute phase response, especially a response resulting from bacterial infection. In addition, prealbumin is sensitive to a recent reduction of protein or calorie intake. Eighty patients were determined to have typical SIDS. Only four of these had a minimal increase in CRP (0.8-2 mg/dl), and in none could an explanation be found. Seven patients were uncovered who had a significant infection, four of whom had prominent CRP elevations. Prealbumin was not decreased in the SIDS population. We conclude that there is no evidence that the acute inflammatory response is activated in infants dying of SIDS. An elevation of CRP above 2 mg/dl should prompt additional studies to find the cause. There is also no evidence of a recent, significant decrease in nutrition in these patients.