Serum acute phase reactants in pediatric patients; especially in neonates

Area of Science:

• Biochemistry
• Surgical Pathology
• Pediatric Surgery

Background:

• Acute phase reactants (APRs) are proteins whose plasma concentrations increase or decrease by at least 25% during inflammatory states.
• Monitoring APRs can provide insights into the body's response to surgical stress and inflammation.

Purpose of the Study:

• To investigate the dynamic changes in serum APR levels in pediatric surgical patients postoperatively.
• To evaluate the utility of specific APRs, including alpha 1-acid glycoprotein (alpha 1-AG), alpha 1-antitrypsin (alpha 1-AT), haptoglobin (Hp), and C-reactive protein (CRP), as indicators of recovery and complications.

Main Methods:

• Serum samples were collected from 45 pediatric surgical patients at various time points after surgery.
• Levels of alpha 1-AG, alpha 1-AT, Hp, and CRP were measured.
• Correlations between APR levels and clinical recovery, as well as the presence of complications like infection and ileus, were analyzed.

Main Results:

• Alpha 1-acid glycoprotein (alpha 1-AG) and alpha 1-antitrypsin (alpha 1-AT) peaked on days 3-5 postoperatively (P.O.) and normalized by day 21 P.O.
• Haptoglobin (Hp) remained elevated until day 21 P.O.
• C-reactive protein (CRP) peaked on days 1-2 P.O. and normalized by day 14 P.O.; in infected patients, CRP normalized before clinical recovery.
• Persistent ileus correlated with increased APR levels due to intestinal mucosal barrier breakdown.

Conclusions:

• Alpha 1-acid glycoprotein (alpha 1-AG) is a valuable indicator of pathological conditions in pediatric surgical patients.
• Postoperative APR monitoring aids in the early detection of complications.
• Changes in APRs reflect the inflammatory response and recovery process following surgery.