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  • Letter to the Editor
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Response to ‘Haptoglobin in diagnosis of sepsis’

Journal of Perinatology volume 32, page 313 (2012)Cite this article

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We appreciate the interest and the insightful comments that Dr Philip made about our article. We regret the omission of reference to his studies in our manuscript; his work on the subject done several decades ago has made a significant contribution to the knowledge of the kinetics and the role of haptoglobin (Hp) in newborns. Our results are in accordance with his findings and contribute with new information particularly concerning the early preterm group, as 14 patients in our study were born at <32 weeks gestational age. However, other researchers have been unable to detect Hp consistently in newborns, regardless of gestational age.1, 2, 3 The establishment of normal Hp values for premature and term newborns continues to be controversial. We hope that our work will contribute to improve the accuracy of neonatal Hp values provided by many clinical laboratories and various reference texts that generally report them at zero or do not provide them at all.4, 5, 6

The clinical applicability of Hp levels in newborns is uncertain. With regard to neonatal sepsis, we share Dr Philip's concerns for relaying on Hp levels to make an early diagnosis of neonatal sepsis. Hp or other acute-phase reactants may not always show abnormalities despite the presence of infection. A blunted host response is a well-recognized phenomenon that was illustrated in our study by the three neonates who died of fulminant sepsis and showed no elevation of Hp or C-reactive protein levels. We agree that diagnostic methods aimed not only at evaluating the neonatal response to sepsis but also with improved sensitivity for pathogen detection than those currently available are needed.

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  1. Section of Pediatric Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    S Chavez-Bueno

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  1. S Chavez-Bueno
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Correspondence to S Chavez-Bueno.

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Chavez-Bueno, S. Response to ‘Haptoglobin in diagnosis of sepsis’. J Perinatol 32, 313 (2012). https://doi.org/10.1038/jp.2011.160

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