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Serum acute phase reactants in pediatric patients; especially in neonates
Insights
Serum acute phase reactant (APR) levels were studied in pediatric surgical patients. Alpha 1-acid glycoprotein (alpha 1-AG) emerged as a valuable indicator for detecting postoperative complications and pathological conditions.
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.
Abstract:
We studied serum acute phase reactant (APR) levels in 45 pediatric surgical patients. Alpha 1-acid glycoprotein (alpha 1-AG) showed a peak value on day 3 postoperatively (P.O.) and alpha 1-antitrypsin (alpha 1-AT) showed a high value on days 3-5 P.O. These glycoproteins returned to normal levels by day 21 P.O., but the level of haptoglobin (Hp) remained high until day 21 P.O. The postoperative changes of alpha 1-AG and alpha 1-AT correlated with the process of recovery from inflammatory conditions, but C-reactive protein (CRP) reached a peak on days 1-2 P.O. and returned to normal limits by day 14 P.O. In patients with infection, CRP returned to the normal level rapidly before recovery from infection. Of the 3 glycoproteins, alpha 1-AG seemed to be a valuable indicator of the pathological conditions. Postoperative changes in APR levels should be useful for early detection of postoperative complications. Persistent ileus led to an increase in APR levels, as a consequence of an inflammatory reaction due to breakdown of the intestinal mucosal barrier.