Background The diagnosis of Behçet disease (BD) is challenging in many cases. The purpose of this study was to describe the clinical characteristics of patients at a referral BD clinic. Methods In a retrospective study, we collected data from patients at a national referral Behçet clinic from November 2018–August 2019. A BD diagnosis was confirmed (BD group) or ruled out (Non-BD group), and the two groups were compared for differences. Results A total of 238 patients satisfied the inclusion criteria. Forty patients (16.8%) were finally diagnosed with BD. Ocular and genital lesions were significantly more prevalent in the BD group. A positive pathergy test and HLA-B51 were also significantly more common in BD. However, oral lesions, articular involvement, and gastrointestinal manifestations were similar between groups. Also, patients with BD were significantly more likely to have multi-organ (≥2 organ systems) involvement. Conclusions Being the first study to evaluate the clinical characteristics of patients who are visited at a referral BD clinic and are believed to have a high probability of Behçet, the results of this study are important from an epidemiological standpoint. Also, the findings of this study could be used by referral Behçet clinics, which evaluate and diagnose patients with a high pretest probability and atypical presentations of BD on a daily basis. The alternative diagnoses established in this study could be used as the list of the most common differential diagnoses for Behçet’s disease.
Introduction: Graft function early after kidney transplantation is an important parameter in determining the outcome of operation. Urinary and plasma neutrophil gelatinase-associated lipocalin (NGAL), a member of the lipocalin protein family, has been advocated as a sensitive, early biomarker for predicting early renal graft after transplantation. The functions of NGAL appears to be expressed in stress conditions and in tissues undergoing involution. It rapidly accumulates in the kidney tubules and urine after nephrotoxic and ischemic insults. Objectives: This study aimed to examine the prognostic role of NGAL early after renal transplantation. Patients and Methods: A total of 37 kidney recipients were enrolled from a teaching centre in Tabriz within a 6-month period of time. Plasma NGAL was measured immediately before and at 6 and 12 hours post-transplantation. Changes of serum creatinine were documented daily within the first week post-operation. Acute kidney injury (AKI)/graft rejection during the first week after transplantation was the outcome variable. Results: There were 22 males (59.5%) and 15 females (40.5%) with the mean age of 34.93 ± 14.97 years (range: 12-59) in the study group. AKI/graft rejection developed in 12 patients (32.4%). The mean post-transplantation plasma NGAL levels and serum creatinine at all time points were significantly higher in patients with AKI/graft rejection. The best prognostic role was found for plasma NGAL at 12 hours (sensitivity = 100%, specificity = 92%; cut-off value = 309 ng/ml), far better than the prognostic accuracy of corresponding serum creatinine (sensitivity = 66.7%, specificity = 61.9%). Conclusion: Plasma NGAL, particularly 12 hours after transplantation, is a very sensitive and specific biomarker for predicting acute renal injury.
In the presented study, the diagnostic advantage of neutrophil gelatinase-associated lipocalin (NGAL) was illustrated in AKI. On the other hand, it is concluded that the NGAL is very useful biomarker particularly at the early stages of low blood pressure status in comparison with the routine serum creatinine. Please cite this paper as: PezeshgiA, Ghodrati S, Kiafar M, Kamali K, Asadi-Khiavi M. Study of neutrophil gelatinase-associated lipocalin in patients with cardiovascular shock.Introduction: Acute kidney injury (AKI) makes a reversible accumulation of nitrogen products. This waste product is partly determined by serum creatinine level but it is not reliable during hypotension. However, neutrophil gelatinase-associated lipocalin (NGAL), as a new biomarker, shows an obvious increase even at hypotensive status. Objectives: The presented study was designed to evaluate NGAL as a right biomarker for AKI early diagnosis and consequent appropriate therapies. Patients and Methods: In this study, 25 healthy individuals and 47 cases out of 60 primarily admitted patients with low blood pressure were evaluated for NGAL level using blood samplings, health documents as well as analysis of questionnaires data. The group's sizes were determined based on AKI and hypotension risk rates. Exclusion and inclusion criteria were firmly considered to avoid major confounding factors. Results: AKI was found in 20 cases out of 47 hypotensive patients. NGAL levels were about 243.35 ± 105.74 ng/dL (Mean ± SD) in AKI and 192.32 ± 64.31 ng/dL (Mean ± SD) in non-AKI hypotensive patients that showed a significant difference (P = 0.037) at the first 6 hours. There was no significant difference between hospitalization duration and NGAL level (P = 0.616). Conclusion: NGAL is important diagnostic protein in the early stages of AKI while there was no creatinine increasing. On the other hand, NGAL level during early 6 hours of hypotension introduces it as an indicative biomarker of AKI based on provided literature and our presented results.
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