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Pentraxin 3: a novel biomarker in pediatric central nervous system infections
Huda El-Kady1, Mona Gamal Mostafa2, Shaimaa Madkour3
1Department of Pediatrics, Faculty of Medicine, Fayoum University, Fayoum, Egypt. hay01@fayoum.edu.eg.
Insights
Cerebrospinal fluid (CSF) Pentraxin 3 (PTX3) levels can indicate the severity and prognosis of pediatric central nervous system (CNS) infections. Elevated PTX3 levels are linked to worse outcomes and bacterial infections.
Area of Science:
- Neurology
- Infectious Diseases
- Biomarker Research
Background:
- Pediatric central nervous system (CNS) infections pose a significant global health challenge, leading to high mortality and severe consequences.
- Pentraxin 3 (PTX3) is an acute-phase reactant that elevates during inflammation and is found in bodily fluids and plasma.
Purpose of the Study:
- To evaluate the diagnostic and prognostic capabilities of cerebrospinal fluid (CSF) PTX3 levels in children with various CNS infections.
Main Methods:
- 100 children with suspected CNS infections were enrolled.
- Medical history, examination data, C-reactive protein (CRP) levels, complete blood count (CBC), CSF analysis, and cultures were assessed upon admission.
Main Results:
- CSF PTX3 levels correlated significantly with symptom duration, hospital stay, patient outcomes, CRP levels, and CSF findings (P < 0.001).
- Higher PTX3 levels were observed in patients with mechanical ventilation, adverse outcomes, and bacterial CNS infections (P < 0.05).
Conclusions:
- PTX3 serves as an indicator of disease severity and prognosis in pediatric CNS infections.
- PTX3 demonstrated significant sensitivity in differentiating bacterial from aseptic CNS infections and controls, outperforming serum CRP but with lower sensitivity/specificity than other CSF biomarkers.
Background:
Pediatric CNS infections have been identified as a global health problem, associated with an increased death rate and fatal consequences. Pentraxin 3 (PTX3) is an acute-phase mediator that increases in body fluids and plasma throughout inflammation. Our study was designed to assess the diagnostic and prognostic value of cerebrospinal fluid (CSF) PTX3 levels in pediatric patients with different central nervous system (CNS) infections.
Methods:
We enrolled 100 children hospitalized at Fayoum University Children's Hospital with suspected CNS infections fulfilling the case criteria for CNS infections. We recorded their medical history and examination data upon admission. The C-reactive protein (CRP) level, complete blood count (CBC), CSF PTX3 level, CSF analysis and culture, and blood culture were assessed in all patients at the time of admission.
Results:
Levels of PTX3 were significantly correlated with the duration of symptoms before admission, length of hospital stay, patient outcomes, CRP levels, CSF findings, and CSF cultures (P value < 0.001). Patients who needed mechanical ventilation or experienced adverse outcomes had greater levels of PTX3, which were more prevalent in those with a bacterial etiology (P value < 0.05).
Conclusion:
PTX3 indicates disease severity and prognosis. PTX3 showed statistically significant sensitivity when discriminating between bacterial and aseptic CNS infections, as well as between bacterial CNS infections and controls. However, it has lower sensitivity and specificity than other CSF biomarkers, though it is higher than serum CRP.
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