Coagulation and inflammation biomarkers may help predict the severity of community‐acquired pneumonia

Agapakis, D.; Tsantilas, D.; Psarris, Panagiotis; Massa, E.; Kotsaftis, Panagiotis; Τζιόμαλος, Κωνσταντίνος; Hatzitolios, Apostolos

doi:10.1111/j.1440-1843.2010.01773.x

Cited by 37 publications

(38 citation statements)

References 28 publications

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“…It could be argued that infections of airways may trigger abnormalities in inflammation and thrombosis markers, such as mean platelet volume, a link between inflammation and thrombosis. 23 Along these lines, it has been found that children with cystic fibrosis have decreased levels of mean platelet volume during the exacerbation period compared with the stable phase. 24 Similarly, mean platelet volume levels in subjects with asthma with exacerbations were lower compared with those in subjects with stable asthma.…”

Section: Discussionmentioning

confidence: 97%

The Role of Mean Platelet Volume in Chronic Obstructive Pulmonary Disease Exacerbation

Agapakis¹,

Massa

Hantzis³

et al. 2015

Respir Care

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BACKGROUND: Studies have supported the correlation between mean platelet volume and COPD. However, there are limited data on the relationship between COPD exacerbation and mean platelet volume. We aimed to evaluate the mean platelet volume trend in patients with COPD exacerbation. METHODS: A total of 81 subjects, 62 men and 19 women, who were admitted to the hospital because of exacerbation of COPD during 9 months, were enrolled in this prospective observational study. The levels of mean platelet volume, C-reactive protein, complete blood count, and percentof-predicted FEV 1 were measured in subjects at admission (exacerbation period) and after 3 months (stable period). Thirty-seven age-and sex-matched healthy individuals constituted the control group. RESULTS: Subjects in the exacerbation period had significantly higher levels of C-reactive protein (P ‫؍‬ .001), white blood cell count (P ‫؍‬ .01), and percentage of neutrophils (P ‫؍‬ .01) and lower percent-of-predicted FEV 1 than in the stable period (P ‫؍‬ .02). Mean platelet volume levels were significantly decreased in the exacerbation period (P ‫؍‬ .001). Considering a cut-off point of mean platelet volume levels <8.2 fL for indicating COPD exacerbation showed a sensitivity of 80% and a specificity of 76%. Also, mean platelet volume levels correlated significantly with increase of C-reactive protein level, white blood cell count, and neutrophil percentage in the exacerbation period (P ‫؍‬ .01, P ‫؍‬ .01, and P ‫؍‬ .02, respectively). CONCLUSIONS: Mean platelet volume may be an inflammatory marker in exacerbation of COPD, and the measurement of mean platelet volume values may be useful for identifying patients who are at increased risk for exacerbations of illness.

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Section: Discussionmentioning

confidence: 97%

The Role of Mean Platelet Volume in Chronic Obstructive Pulmonary Disease Exacerbation

Agapakis¹,

Massa

Hantzis³

et al. 2015

Respir Care

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“…The authors found that DD elevation was a negative prognostic factor in CAP: DD 256-1000 ng/mL was combined with 2-3 fold higher mortality rate and DD > 1000 ng/mL -with 5 fold higher mortality rate [26]. Snijders et al and Agapakis et al found DD concentration significantly higher in patients with severe CAP (CURB-65 score 3-5) comparing to the others [27,28].…”

Section: Discussionmentioning

confidence: 96%

Non-High Risk PE in the Patients with Acute or Exacerbated Respiratory Disease: The Value of the Algorithm Based on D-Dimer Evaluation and Revised Geneva Score

Szturmowicz¹,

Kacprzak²,

Wyrostkiewicz³

et al. 2015

Advances in Respiratory Medicine

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Introduction: The diagnostic algorithm of non-high risk pulmonary embolism (PE) is based on probability scoring systems and plasma D-dimer (DD) assessment. The aim of the present study was to investigate the efficacy of Revised Geneva Scoring (RGS) and DD testing for the excluding of non-high risk PE, in the patients admitted to the hospital due to acute respiratory diseases. Material and methods:The consecutive patients, above 18 years of age, referred to the department of lung diseases, entered the study. The exclusion criteria were: the pregnancy and the suspicion of high risk PE. Plasma DD was measured with quick ELISA test, VIDAS D-dimer New, bioMerieux, France. Multislice computed tomography angiography was performed in all of the patients. Results: 153 patients, median age 65 (19−88) years entered the study. The probability of PE was: low -in 58 patients (38%), intermediate -in 90 (59%), high -in 5 (3%). DD < 500 ng/ml was found in 12% of patients with low and intermediate probability of PE. PE was recognized in 10 out of 153 patients (7%). None of the patients with DD < 500 ng/ml was diagnosed with PE (NPV 100%). Median DD value was significantly higher in PE patients comparing to non-PE (4500 ng/ml and 1356 ng/ml respectively, p = 0.006). Conclusion: In the group of the patients with acute respiratory symptoms, low or intermediate clinical probability scoring combined with normal DD had a high NPV in excluding PE. Nevertheless, such approach was not very effective, as the increased DD was noted in 88% of the examined population.

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“…Furthermore, anticoagulant therapy appears to be beneficial in the treatment of lung fibrosis (10)(11)(12)(13)(14). From the standpoint of systemic inflammation, it is reported that urokinase-type plasminogen activator (u-PA) and antithrombin III (AT-III) were decreased or plasminogen activator-inhibitor 1 (PAI-1) and α2-plasmin inhibitor (PI) levels were increased in severe pneumonia (15,16). In addition, it is possible that exertional dyspnea and hypoxia due to interstitial pneumonia causes decreased mobility, resulting in deep-vein thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Chronic Pulmonary Thromboembolism Pathologically Showing Homogeneous Cellular Alveolitis

et al. 2011

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A 60-year-old man was admitted to our hospital complaining of general malaise. Examination of arterial blood gases on room air revealed hypoxia. Pulmonary function test showed restrictive abnormality. Chest high-resolution CT showed diffuse mosaic attenuation without evident pulmonary artery abnormality on contrast chest CT. Based on these findings, interstitial pneumonia or chronic pulmonary thromboembolism was suspected. The findings of bronchoalveolar lavage revealed 4.4×10 5 cells/mL, including 89.6% macrophages, 9.4% lymphocytes, and 1.0% neutrophils. TBLB showed marked alveolitis. Moreover video-assisted thoracoscopic surgical biopsy was performed. Biopsies of the lung specimen showed focal infarct with surrounding mild mononuclear cell infiltrates (homogenous cellular alveolitis). 99mTc pulmonary perfusion and 81m Kr ventilation scintigraphy showed V/Q mismatch. Furthermore, pulmonary angiography also revealed inadequate artery flow corresponding to the mismatch area of scintigraphy. Collagen vascular diseases and abnormality of coagulation factors were not detected. Multiple perfusion defects persisted for more than 6 months. Thus, finally the patient was diagnosed with chronic pulmonary thromboembolism, pathologically showing homogenous cellular alveolitis.

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Coagulation and inflammation biomarkers may help predict the severity of community‐acquired pneumonia

Abstract: Serum levels of AT-III, D-D and CRP at admission appear to be useful biomarkers for assessing the severity of CAP.

Cited by 37 publications

References 28 publications

The Role of Mean Platelet Volume in Chronic Obstructive Pulmonary Disease Exacerbation

The Role of Mean Platelet Volume in Chronic Obstructive Pulmonary Disease Exacerbation

Non-High Risk PE in the Patients with Acute or Exacerbated Respiratory Disease: The Value of the Algorithm Based on D-Dimer Evaluation and Revised Geneva Score

Chronic Pulmonary Thromboembolism Pathologically Showing Homogeneous Cellular Alveolitis

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