Sodium and Copeptin Levels in Children with Community Acquired Pneumonia

Wrotek, August; Jackowska, Teresa; Pawlik, Katarzyna

doi:10.1007/5584_2014_41

Cited by 17 publications

(18 citation statements)

References 17 publications

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“…However, it turns out that it is also essentially a measure of all kinds of stresses and adverse events (714–719), including those caused by infection (720–729). …”

Section: Proteomic and Similar Biomarkers – Circulating And Placentalmentioning

confidence: 99%

A Dormant Microbial Component in the Development of Preeclampsia

Kell

Kenny

2016

Front. Med.

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Preeclampsia (PE) is a complex, multisystem disorder that remains a leading cause of morbidity and mortality in pregnancy. Four main classes of dysregulation accompany PE and are widely considered to contribute to its severity. These are abnormal trophoblast invasion of the placenta, anti-angiogenic responses, oxidative stress, and inflammation. What is lacking, however, is an explanation of how these themselves are caused. We here develop the unifying idea, and the considerable evidence for it, that the originating cause of PE (and of the four classes of dysregulation) is, in fact, microbial infection, that most such microbes are dormant and hence resist detection by conventional (replication-dependent) microbiology, and that by occasional resuscitation and growth it is they that are responsible for all the observable sequelae, including the continuing, chronic inflammation. In particular, bacterial products such as lipopolysaccharide (LPS), also known as endotoxin, are well known as highly inflammagenic and stimulate an innate (and possibly trained) immune response that exacerbates the inflammation further. The known need of microbes for free iron can explain the iron dysregulation that accompanies PE. We describe the main routes of infection (gut, oral, and urinary tract infection) and the regularly observed presence of microbes in placental and other tissues in PE. Every known proteomic biomarker of “preeclampsia” that we assessed has, in fact, also been shown to be raised in response to infection. An infectious component to PE fulfills the Bradford Hill criteria for ascribing a disease to an environmental cause and suggests a number of treatments, some of which have, in fact, been shown to be successful. PE was classically referred to as endotoxemia or toxemia of pregnancy, and it is ironic that it seems that LPS and other microbial endotoxins really are involved. Overall, the recognition of an infectious component in the etiology of PE mirrors that for ulcers and other diseases that were previously considered to lack one.

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“…However, it turns out that it is also essentially a measure of all kinds of stresses and adverse events (714–719), including those caused by infection (720–729). …”

Section: Proteomic and Similar Biomarkers – Circulating And Placentalmentioning

confidence: 99%

A Dormant Microbial Component in the Development of Preeclampsia

Kell

Kenny

2016

Front. Med.

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“…Furthermore, under normal circumstances, it is well correlated with total extracellular fluid volume. Hence, regulation of circulating Na + and extracelluar fluid volume largely involves different hormonal mechanisms, although there is partial overlap between the natremic and the volemic stimulus to the release of anti‐diuretic hormone …”

Section: Pathophysiologymentioning

confidence: 99%

“…Levels of anti‐diuretic hormone or copeptin, a stable surrogate marker of anti‐diuretic hormone secretion, are elevated in virtually all hyponatremic children affected with acute respiratory infections . In this condition, three possible mechanisms may underlay the release of anti‐diuretic hormone: (i) true extracellular fluid volume depletion; (ii) decreased effective arterial blood volume; and (iii) volume‐independent (i.e., inappropriate) anti‐diuresis.…”

Section: Pathophysiologymentioning

confidence: 99%

Hyponatremia in children with acute respiratory infections: A reappraisal

Lavagno

Milani

Uestuener

et al. 2017

Pediatric Pulmonology

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Hyponatremia (<135 mmol/L), typically associated with an elevated anti-diuretic hormone level, is common among children admitted with bronchiolitis, pneumonia, or pulmonary exacerbation of cystic fibrosis. The main consequences of acute hyponatremia include cerebral edema and Ayus-Arieff pulmonary edema. A widespread belief is that, in children with pneumonia or bronchiolitis, hyponatremia results from inappropriate anti-diuresis. By contrast, the pathogenic role of extracellular fluid volume depletion or decreased effective circulating blood volume is underscored. Considering the prevalence of hyponatremia, sodium determination is advised on admission in children diagnosed with bronchiolitis, pneumonia, or pulmonary exacerbation of cystic fibrosis. There is no necessity to do anything beyond reassessing the appropriateness of fluid therapy in cases with mild (130-134 mmol/L) hyponatremia. In children with sodium <130 mmol/L, the underlying etiology is sometimes evident from history and physical findings. Given that clinical assessment of fluid volume status is difficult in hyponatremia, further laboratory evaluation is often required in these patients. An increase in sodium level ≤6 mmol/L per day is currently considered the therapeutic goal in all cases. Emergency correction with a 2 mL/kg body weight bolus of 3.0% saline over 10-15 min intravenously is advised in cases with severe symptoms due to hyponatremia and in cases with symptoms, even if mild, due to a rapid-onset (<48 h) of hyponatremia (two additional doses are administered if the patient's condition does not improve).

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“…Di samping itu, mereka memperlihatkan ada nya perbedaan yang bermakna antara kadar copeptin pada subjek kelompok CAP dengan kelompok sehat. 8 Peningkatan kadar copeptin pada pneumonia diduga disebabkan oleh gangguan oksigenasi jaringan, Faktor-faktor tersebut akan meningkatkan respon stres, selanjutnya mengaktivasi sistem saraf otonom, yaitu HPA axis. Copeptin bersama dengan neurophysin II dan AVP akan disekresi dari neuron magnoselular di nukleus supraoptik dan paraventrikular hipotalamus sebagai prohormon dalam bentuk granul.…”

Section: Pembahasanunclassified

“…5,6 Penelitian tentang hubungan kadar copeptin serum dengan pneumonia pada balita sangat sedikit dan hasilnya masih kontroversi. 7,8 Penilaian prognosis yang tepat mendorong klinisi untuk melakukan pemantauan yang lebih ketat, terapi yang akurat dan bisa menjadi dasar pertimbangan etik konseling untuk memberikan informasi mengenai keadaan penderita kepada orangtua. Tujuan penelitian ini untuk mengetahui hubungan antara kadar copeptin serum dengan derajat pneumonia pada anak balita. )…”

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Hubungan Kadar Copeptin Serum dengan Derajat Pneumonia pada anak balita

Rianasyah

Wahani

Sondakh

2016

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Latar belakang. Peran copeptin pada pneumonia masih merupakan kontroversi. Tujuan. Mengetahui hubungan antara kadar copeptin serum dengan derajat pneumonia pada anak balita. Metode. Kami melakukan penelitian secara cross sectional pada anak dengan kriteria pneumonia menurut kriteria WHO dan radiologis. Sampel diambil secara consecutive sampling dan dilakukan pemeriksaan kadar copeptin serum. Orang tua atau wali subjek penelitian diminta menandatangani inform consent. Penelitian ini dilaksanakan dibawah persetujuan Komite Etik. Hasil. Didapatkan hasil 38 anak yang terdiri dari 25 laki-laki dan 13 perempuan dengan rerata umur 14,26 (SD 13,544) bulan. Rerata kadar copeptin serum 13.868 ng/mL. Didapatkan hubungan positf antara kadar copeptin serum dengan derajat pneumonia. Background. There has been controversy in the role of serum copeptin level in pneumonia. Objective. To assess a correlation between serum copeptin with severity of pneumonia in children under five years old. Method. We conducted a cross-sectional study in children with pneumonia. Diagnosis was based on WHO criteria plus chest x ray findings. We recruited sample consecutively and examined serum copeptin level in children who met the criteria as sudy participants. Informed consents were obtained from parents or guardians. This study was approved by ethical comitte. Results. Subjects were 38 children, consist of 25 boys and 13 girls with an average age 14.26 (SD 13.544) months. Mean serum copeptin levelwas 13,868 ng/mL. We found a positive correlation between serum copeptin levelwith the severity of pneumonia. (r=0.781 and p<0.0001) Conclusion. There is a significant and strong correlation between levels of serum copeptin with the degree of pneumonia. Sari Pediatri 2015;17(4):292-6.

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Sodium and Copeptin Levels in Children with Community Acquired Pneumonia

Cited by 17 publications

References 17 publications

A Dormant Microbial Component in the Development of Preeclampsia

A Dormant Microbial Component in the Development of Preeclampsia

Hyponatremia in children with acute respiratory infections: A reappraisal

Hubungan Kadar Copeptin Serum dengan Derajat Pneumonia pada anak balita

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