Objective Brain natriuretic peptide (BNP) is synthesized in the cardiac ventricles and released in response to volume or pressure load. The aim of the study was to determine whether plasma level of N-terminal pro BNP (NT-pro BNP) can distinguish between cardiac and pulmonary disease (PD) among neonates with respiratory distress (RD). Patients and methods The study included 48 term neonates in the first month of life with signs of RD. They were recruited from Neonatal Intensive Care Unit of Al-Galaa Teaching Hospital. Twenty-six healthy neonates were included as a control group. The degree of RD was assessed using Silverman–Anderson score. Chest X-ray, echocardiography, and laboratory measurement of NT-pro BNP were performed. Results According to the underlying disease, neonates with RD were divided into 28 neonates with PD and 20 neonates with congenital heart disease (CHD). Regardless the etiology of RD, NT-pro BNP was significantly higher in the RD group than in the control ( p = 0.001). There was a significant difference between and within the three groups regarding NT-pro BNP ( p = 0.001). NT-pro BNP was significantly higher in the CHD group than in the PD group ( p = 0.001). There was a significant difference between and within RD subgroups. The NT-pro BNP is a very useful test for identification of CHD in neonates with RD. Area under the receiver operating characteristic curve for CHD was 0.857 ( p = 0.01), sensitivity 66%, specificity 85%, and cutoff point was 24.5 pg/mL. The area under the curve for PD was 0.646 ( p = 0.1) with poor sensitivity and specificity, indicating that NT-pro BNP is a poor test for identification of PD in neonates with RD. Conclusion Term neonates with RD have increased plasma levels of NT-pro BNP. NT-pro BNP is a very good test for identification of CHD in neonates with RD, in comparison with PD. Therefore, plasma NT-pro BNP can be used to differentiate between cardiac and pulmonary cause of RD.

The objective of this study was to evaluate the role of serum eosinophil cationic protein in relation to diagnosis and assessment of disease severity in asthmatic children. Patients and methods:This study included 50 patients suffering from bronchial asthma of those attending the pediatrics clinic of National Research Center (NRC). Patients were diagnosed as asthmatic up on the classification of asthma severity according to GINA Guidelines. Twenty four healthy age and sex matched children were included as a control group. The study was approved by the Ethics Committee of the NRC. The exclusion criteria were history of allergic rhinitis, conjunctivitis, atopic eczema, infectious exacerbation, and parasitic infestation. All children included in the study were subjected to complete history taking, thorough clinical examination, pulmonary function tests and measurement of serum eosinophil cationic protein.Results: There was a significant increase of serum ECP levels in patients compared with controls. (p=0.001), and significant positive correlation between ECP levels and severity of asthma. (r=0.91, p=0.001). There was a significant decrease in forced expiratory volume in one second (FEV 1 %) (p=0.001), peak expiratory flow rate (PEFR %) (p=0.001) and forced expiratory flow 25-75% (FEF 25-75%) (p=0.001) in patients compared with controls. There was a significant negative correlation between ECP compared to FEV 1 % and PEFR% (r=-0.78, p=0.001). Conclusion:Serum eosinophil cationic protein is raised significantly in asthmatic children. It has a significant positive correlation with the severity of asthma. So measurement of serum ECP can be used as a marker for assessing disease severity of asthma.

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