The diagnostic and prognostic value of angiopoietins compared with C-reactive protein and procalcitonin in children with febrile neutropenia

Abstract

Mimaroğlu E, Çıtak EÇ, Kuyucu N, Eskendari G. The diagnostic and prognostic value of angiopoietins compared with C-reactive protein and procalcitonin in children with febrile neutropenia. Turk J Pediatr 2017; 59: 418-425. In this study, we aimed to determine serum angiopoetin (Ang) levels and compare them with levels of C-reactive protein (CRP) and procalcitonin (PCT). Cancer patients (aged 0-18 years) who experienced febrile neutropenia attacks were included in the study. Ang-1, Ang-2, CRP, and PCT were analyzed at admission and 2nd day. Ninety-four episodes of febrile neutropenia that developed in 62 patients were analyzed in this study. The mean age of the patients was 7.56 ± 4.8 (0.5-17) years. The patients had lymphoma (33.9%), solid tumors (48.4%), and other cancer (17.7%). The percentages of the patients with fever of unknown origin (FUO), clinically documented infection (CDI), and microbiologically documented infection (MDI) categories were 45.7%, 22.3%, and 31.9%, respectively. During the study period 11 patients were lost to follow-up. The levels of CRP, PCT and Ang-2 were significantly higher; and that of Ang-1 was significantly lower, compared to the controls. The differentiation cannot be made between the groups by CRP and PCT levels. The level of Ang-1 was the lowest in MDI group; the level of Ang-2 and the ratio of Ang-2/Ang-1 were high in each group. Ang-1, Ang-2 and the ratio of Ang-2/Ang-1 were significantly associated with mortality. Angs correlated with the severity of infection.

One Hundred Consecutive Neutropenic Febrile Episodes Demonstrate That CXCR3 Ligands Have Predictive Value in Discriminating the Severity of Infection in Children with Cancer

“…This can be followed by antibiotic therapy in the case of infection; however, microbiological tests are first necessary to establish the etiology of the infection. It should be strictly performed before starting antibiotic therapy; however, a relatively long waiting time for the results means that they can only confirm the etiology of infection and indicate the optimal treatment based on the culture result [2][3][4].…”

“…Unfortunately, the biomarkers currently used in the diagnosis of neutropenic infection, such as C-reactive protein (CRP) and procalcitonin (PCT) are not satisfactory, and the Children 2023, 10, 39 2 of 9 diagnosis of FN hence presents a great challenge for clinicians [4]. Optimal inflammatory markers would allow low-risk patients to be differentiated from those at high risk of severe systemic infection.…”

“…Optimal inflammatory markers would allow low-risk patients to be differentiated from those at high risk of severe systemic infection. Although many potential biomarkers of infection have been studied, for example interleukin-6 (IL-6), interleukin-8 (IL-8), interferon gamma (TNF-α) and tumor necrosis factor alpha (TNF-β), satisfactory results have still not been obtained [4][5][6].…”

“…The CXCR3 receptor and its ligands represent a complex chemokine system whereby one receptor has three interferon (IFN)-infection. It should be strictly performed before starting antibiotic therapy; however, a relatively long waiting time for the results means that they can only confirm the etiology of infection and indicate the optimal treatment based on the culture result [2][3][4].…”