Abstract
Background and aims: The diagnosis of sepsis in children with febrile neutropenia (FN) remains difficult. The aim of the study was to evaluate the role of procalcitonin (PCT), interleukin-6 (IL- 6), lipopolysaccharide- binding protein (LBP) and C-reactive protein (CRP) in the diagnosis of bacteremia and sepsis of children with FN.
Methods: Chemiluminiscent immunometric assay was used for IL-6 (IL-6 Immulite, DPC) and LBP (Immulite LBP, DPC) determination, immunoluminometric assay for PCT (LUMItest PCT) and immunoturbidimetric for CRP (QuickRead CRP, Orion Diagnostica) determination. Diagnostic accuracy for each parameter was assesed by ROC curve analysis (AUC). Statistical analysis was performed using MedCalc for Windows, version 5.0.
Results: Forty patients (21 girls, 19 boys) with the median age of 5.6 years (range 0.5 - 19.9) experienced 82 episodes of FN. Underlying disease was hematologic in 55 and solid tumor in 27 episodes. Bacteremia was confirmed in 16 (19.5 %) episodes; Gram negative in 8, Gram positive in 7 and combined in 1 episode. The fever was due to local infection in 14 (17 %), viral in 9 (11 %), whereas in 41 episodes (50 %) the cause could not be identified (FUO).
On day 1 the best diagnostic accuracy (AUC) was seen for IL-6 (0.765) followed by CRP (0.738), LBP (0.696) and PCT (0.666). On day 2 CRP had the best diagnostic accuracy (0.824), followed by IL-6 (0.753), PCT (0.695) and LBP (0.685).
Conclusions: New inflammatory markers did not show advantage over CRP, except for IL-6 on the first day.
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Kitanovski, L., Gmeiner-Stopar, T. & Derganc, M. 1381 Procalcitonin, Interleukin-6, Lipopolysaccharide-Binding Protein and C-Reactive Protein in the Diagnosis of Sepsis of Febrile Neutropenic Children. Pediatr Res 68 (Suppl 1), 683–684 (2010). https://doi.org/10.1203/00006450-201011001-01381
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DOI: https://doi.org/10.1203/00006450-201011001-01381