Sequential changes of inflammatory and nutritional markers in patients with community-acquired pneumonia
- 1 January 1997
- journal article
- research article
- Published by Taylor & Francis in Scandinavian Journal of Clinical and Laboratory Investigation
- Vol. 57 (2) , 111-118
- https://doi.org/10.1080/00365519709056378
Abstract
Hansson L-O, Hedlund JU, Örtqvist ÅB. Sequential changes of inflammatory and nutritional markers in patients with community-acquired pneumonia. Scand J Clin Lab Invest 1997; 57: 111-118. The aim of the present study was to describe the long-term sequential changes of the acute phase proteins and of commonly used so-called nutritional markers in patients with community-acquired pneumonia (CAP), and to calculate the normalization rate of serum C-reactive protein (CRP), defined as the time for a 50% decrease, during the initial treatment of these patients. The long-term sequential changes of inflammatory and nutritional markers in patients with CAP have not been previously well-documented. However, in the diagnostic work-up of patients with suspected infectious diseases CRP levels are often used nowadays. Serum albumin, transthyretin (prealbumin), and transferrin together with serum iron, have often been used as “nutritional markers” in patients. We therefore studied the long-term changes of these parameters in patients with CAP, as these markers also are influenced by inflammatory reactions, in pneumonia for example. All the patients within the age range 50-85 years, with the exception of immunocompromised patients, who were admitted with CAP to the Department of Infectious Diseases at Danderyd Hospital during a 12-month period (January 1992-January 1993), were reviewed for inclusion in a prospective study of the long-term sequential changes of inflammatory and nutritional markers in CAP patients. A total of 97 patients (50 men) with a mean age of 69.6 years were included in the study. Blood samples were drawn on admission, during the hospitalization period, and at the follow-up visits. Serum CRP, α1antitrypsin, haptoglobin and orosomucoid (α1acid glycoprotein) were used as acute phase proteins. However, albumin, transthyretin, and transferrin together with serum iron and percentage transferrin saturation were also included. Of all the parameters studied, CRP showed the greatest variation, already having the highest values at admission. CRP also showed, together with iron, the earliest response to recovery in the patients. The median time for a 50% decrease of CRP was 3.3 days for the patients (n=73) with more than two CRP values measured during the first nine days. Transthyretin responded faster to patient recovery than did albumin. CRP showed the greatest amplitude of changes and together with iron and percentage saturation of transferrin it also showed the earliest response to recovery in patients with CAP. This indicates that CRP is the best of the parameters studied for use in diagnostic work-up and in follow up.Keywords
This publication has 25 references indexed in Scilit:
- Interleukin‐6 is the major regulator of acute phase protein synthesis in adult human hepatocytesPublished by Wiley ,2001
- Linkage of cell-mediated immunity to iron metabolismImmunology Today, 1995
- Factors of importance for the long term prognosis after hospital treated pneumonia.Thorax, 1993
- Comparison of two automated nephelometersJournal of Clinical Laboratory Analysis, 1992
- Laboratory Tests for Pneumonia in General Practice: The Diagnostic Values Depend on the Duration of IllnessScandinavian Journal of Primary Health Care, 1992
- The prognostic inflammatory and nutritional index in traumatized patients receiving enteral nutrition support.Journal of the American College of Nutrition, 1991
- Interleukin-6 in clinical medicineAnnals of Hematology, 1991
- The Value of C-reactive Protein as a Marker of Bacterial Infection in Patients with Septicaemia/Endocarditis and InfluenzaScandinavian Journal of Infectious Diseases, 1989
- Quantitative C‐reactive Protein (CRP) Determined by an Immunoturbidimetric Method in Rapid Differential Diagnosis of Acute Bacterial and Viral Diseases of ChildrenActa Paediatrica, 1984
- Use of serum C-reactive protein in differentiating septicfrom aseptic meningitis in childrenThe Journal of Pediatrics, 1983