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PMN elastase in bone and joint infections

K M Peters1, K Koberg, T Rosendahl

  • 1Department of Orthopaedic Surgery, RWTH, Aachen, Germany.

International Orthopaedics
|January 1, 1994
PubMed
Summary
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Polymorphonuclear neutrophil (PMN) elastase is a valuable marker for inflammation and sepsis severity. Elevated PMN elastase levels in patients with bone and joint infections indicate disease severity and aid in post-operative monitoring.

Area of Science:

  • Biochemistry
  • Immunology
  • Clinical Diagnostics

Background:

  • Polymorphonuclear neutrophil (PMN) elastase is a proteolytic enzyme.
  • It serves as a biochemical marker for abnormal granulocyte stimulation.
  • Elevated PMN elastase in plasma indicates disease severity and prognosis in inflammation and sepsis.

Purpose of the Study:

  • To evaluate the diagnostic utility of PMN elastase in bone and joint infections.
  • To assess the role of PMN elastase in monitoring treatment response and complications.
  • To compare PMN elastase with other inflammatory markers like CRP, fibrinogen, and leucocyte count.

Main Methods:

  • Study included 62 patients diagnosed with osteomyelitis or suppurative arthritis.
  • Diagnostic sensitivity of PMN elastase was compared against erythrocyte sedimentation rate, C-reactive protein (CRP), fibrinogen, and leucocyte count.

Related Experiment Videos

  • PMN elastase levels were monitored during the post-operative period to assess recovery and detect complications.

    • Main Results:

    • PMN elastase demonstrated a diagnostic sensitivity of 81% in bone and joint infections, comparable to erythrocyte sedimentation rate.
    • Its sensitivity surpassed that of CRP (71%), fibrinogen (54%), and leucocyte count (26%).
    • Post-operatively, PMN elastase normalized faster than CRP, especially in uncomplicated cases, indicating its utility in early follow-up.

    Conclusions:

    • PMN elastase is a sensitive and useful marker for diagnosing bone and joint infections.
    • It provides valuable insights into disease severity and prognosis.
    • PMN elastase aids in effective post-operative monitoring, detecting complications earlier than other markers.