High Mortality Associated with Hyperglycemia, Neutrophilia, and Lymphopenia in Critically Ill Patients

Jiménez-Ibáñez, Enrique O.; Castillejos-López, Manuel; Hernández, Andrés; Gorocica, Patrícia; Alvarado-Vásquez, Noé

doi:10.1620/tjem.226.213

Cited by 17 publications

(12 citation statements)

References 32 publications

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“…The percentage of CD19+CD23+ B lymphocytes appears to be a biomarker for the prognosis of outcome of septic shock patients. These data support a role for the B-cell compartment in septic shock patients and are in agreement with those published in previous studies [24-26]. …”

Section: Discussionsupporting

confidence: 93%

Early alterations of B cells in patients with septic shock

et al. 2013

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IntroductionIt has recently been proposed that B lymphocytes are involved in sepsis pathogenesis. The goal of this study is to investigate potential abnormalities in a subset distribution and activation of circulating B lymphocytes in patients with septic shock.MethodsThis observational prospective study was conducted in a medical-surgical ICU. All patients with septic shock were eligible for inclusion. B-cell phenotypes (CD19+CD69+, CD19+CD23+, CD19+CD5+, CD19+CD80, CD19+CD86+, CD19+CD40 and CD19+CD95+) were assessed by quantitative flow cytometry upon admission to the ICU and 3, 7, 14 and 28 d later.ResultsFifty-two patients were included. Thirty-six healthy volunteers matched for age and sex were used as controls. The patients had lymphopenia that was maintained during 28 d of follow-up. In patients with septic shock who died, the percentage of CD19+CD23+ was lower during the 7 d of follow-up than it was in survival patients. Moreover, the percentage of CD80+ and CD95+ expression on B cells was higher in patients who died than in survivors. Receiver operating characteristic curve analysis showed that a CD19+CD23+ value of 64.6% at ICU admission enabled discrimination between survivors and nonsurvivors with a sensitivity of 90.9% and a specificity of 80.0% (P = 0.0001).ConclusionsPatients with septic shock who survive and those who don't have different patterns of abnormalities in circulating B lymphocytes. At ICU admission, a low percentage of CD23+ and a high of CD80+ and CD95+ on B cells were associated with increased mortality of patients with septic shock. Moreover, a drop in circulating B cells persisted during 28 d of ICU follow-up.

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Section: Discussionsupporting

confidence: 93%

Early alterations of B cells in patients with septic shock

et al. 2013

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“…The eSS rats had also a significantly lower number of white cells than in controls. Differential count also showed a pattern of lymphopenia and neutrophilia as was reported in critically ill hyperglycemic patients [25,26]. These white blood cell changes possibly contribute to the increased susceptibility to infection reported for the eSS rats [27].…”

Section: Discussionsupporting

confidence: 54%

Anemia in Spontaneously Type 2 Diabetic Rats With Renal Impairment

Danièle

2012

J Endocrinol Metab

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Background:The eSS rats display a mild non obese type 2 diabetic syndrome with an insulin resistant state characterized by hyperglycemia, dyslipidemia and hyperinsulinemia. During the first year, eSS male rats exhibit proteinuria as well as alterations in glomerular filtration. Methods:In this study, some hematological characteristics were evaluated in 12 month-old eSS males compared to eumetabolic Wistar rats, and the renal histology was also studied. Results:The diabetic rats were found to have fewer erythrocytes and lower values of hemoglobin. In eSS rats, peripheral blood smears showed immature erythrocytes with polychromatophilia and the presence of erythroblasts was also verified. Thickening of the glomerular basement membrane, areas of tubular dilatation and protein cylinders were observed in kidneys of diabetic animals. Conclusions:Our results suggest that eSS rats develop anemia because of complex influences of metabolic disturbances and diabetic renal damage and that it might provide new opportunities for studying the pathogenesis of this relevant complication of type 2 diabetics.

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“…In this last work, analyses of blood mtDNA levels in intensive care unit (ICU) patients showed an association between high mtDNA levels and the mortality rate in ICU patients. In a retrospective cohort study, Jiménez-Ibáñez et al (2012) showed that hyperglycemia is a common finding in patients admitted to the ICU. The levels of mtDNA have been evaluated and compared between patients with traumatic damage and those with severe sepsis, and the analysis revealed the importance of mtDNA in the clinical evolution of these patients.…”

Section: Mitochondrial Deoxyribonucleic Acid (Mtdna)mentioning

confidence: 99%

High Mortality Associated with Hyperglycemia, Neutrophilia, and Lymphopenia in Critically Ill Patients

Cited by 17 publications

References 32 publications

Early alterations of B cells in patients with septic shock

Early alterations of B cells in patients with septic shock

Anemia in Spontaneously Type 2 Diabetic Rats With Renal Impairment

Circulating cell-free mitochondrial DNA as the probable inducer of early endothelial dysfunction in the prediabetic patient

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