Severity markers in patients with acute pancreatitis

• Authors: Abdullah Kisaoglu , Bulent Aydinli , Gurkan Ozturk , Sabri Atamanalp , Bunyami Ozogul , Mehmet Yildirgan , Kamil Polat
• Languages of publication: EN

Abstracts

EN

To evaluate the effectiveness of serum levels of resistin and CD14 expression in monocytes, and high-sensitivity C-reactive protein (hsCRP) in early stages of acute pancreatitis and correct prediction of the severity of acute pancreatitis (AP) using scoring systems. The study involved 10 (29.41%) male and 24 (70.59%) female patients (total n=34) followed for AP diagnosis at the Department of General Surgery, Ataturk University Medical School between July 2008 and September 2009. In all the patients, Ranson and APACHE II scores, serum resistin, hsCRP, and monocyte CD14 expression levels were determined. The patients were divided into two groups as mild and severe AP groups. A control group was formed and the intergroup comparisons were made. Values ≥ 3 based on the Ranson scoring scale and values ≥ 8 in APACHE II scoring scale were considered to indicate severe AP. Evaluations were based on the values obtained on the 1st and 7th days for serum resistin and hsCRP levels and monocyte CD 14 expression. In 17 (50%) patients, severe AP was determined. No statistically significant differences were found between the mean serum resistin levels of AP groups, while the difference for the same parameter between the mild and severe AP groups and the control group was statistically significant. In the severe AP group, the mean 1st day and 7th day serum hsCRP levels were statistically significantly higher. The CD14 expression in monocytes was similar in all the groups. Serum hsCRP concentrations and Ranson and APACHE II scores and serum resistin and hsCRP concentrations on the 1st day were positively correlated. Serum hsCRP measurement is effective in determining the severity of acute pancreatitis. Serum resistin measurement may be a useful early marker in determining the inflammatory response in AP. However, CD14 expression in monocytes was not found to be a useful marker in the diagnosis and prediction of the disease severity in AP patients.

Keywords

EN

Acute pancreatitis; Severity

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2014
• Volume: 9
• Issue: 4
• Pages: 556-564

Dates

published

1 - 8 - 2014

online

19 - 7 - 2014

Contributors

author

Abdullah Kisaoglu

• Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey

author

Bulent Aydinli

• Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey

author

Gurkan Ozturk

• Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey

author

Sabri Atamanalp

• Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey

author

Bunyami Ozogul

• Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey

author

Mehmet Yildirgan

• Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey

author

Kamil Polat

• Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey

References

• [1] Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al. Classification of acute pancreatitis - 2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013; 62: 102–111 http://dx.doi.org/10.1136/gutjnl-2012-302779[WoS][Crossref]
• [2] Reber HA. (Çeviri: Baykal A) Pankreas. Schwartz SI, Shires GT, Spencer FC, Daly JM, Fischer JE, Galloway AC (eds). Principles of Surgery. Seventh Edition. Çeviri: Geçim IE (ed). Cerrahinin İlkeleri. Ankara: Antıp A.Ş. 2005: 1489–1522
• [3] Sayek İ. Pankreatit. İçinde Sayek I (yazar). Temel Cerrahi 3. baskı, Ankara: Güneş Kitabevi 2004: 1409–1416
• [4] Emre A. Akut Pankreatit. İçinde Kalaycı G (yazar). Genel Cerrahi. İstanbul: Nobel Tıp Kitabevleri 2002: 1247–1258
• [5] Slavin J, Ghaneh P, Sutton R, Hartley M, Rowlands P, Garvey C, et al. Management of Necrotizing Pancreatitis. World J Gastroenterol 2001; 7: 476–481 [PubMed]
• [6] Arbuckle J, Isla A. Acute Pancreatitis-Update 2006 In Neugebauer EAM, Sauerland S, Fingerhut A et al (eds). EAES Guidelines for Endoscopic Surgery. Berlin: Springer 2006: 377–386 http://dx.doi.org/10.1007/978-3-540-32784-4_20[Crossref]
• [7] Clancy TE, Ashley SW. (Çeviri: Kalafat H) Akut Pankreatit Tedavisi. Zinner MJ, Ashley SW (eds). Maingot’s Abdominal Operations. Çeviri: Andican AA (ed). Maingot Abdominal Operasyonlar. İstanbul: Nobel Tıp Kitabevleri Ltd. Şti. 2008: 939–960
• [8] Mitchell RMS, Byrne MF, Baillie J. Pancreatitis. Lancet 2003; 361: 1447–55 http://dx.doi.org/10.1016/S0140-6736(03)13139-X[Crossref]
• [9] Chatzicostas C, Roussomoustakaki M, Vardas E, Romanos J, Kouroumalis EA. Balthazar Computed Tomography Severity Index is Superior to Ranson Criteria and APACHE II and III Scoring Systems in Predicting Acute Pancreatitis Outcome. J Clin Gastroenterol 2003; 36: 253–260 http://dx.doi.org/10.1097/00004836-200303000-00013[Crossref]
• [10] Cappell MS. Acute Pancreatitis: Etiology, Clinical Presentation, Diagnosis, and Therapy. Med Clin North Am 2008; 92: 889–923 http://dx.doi.org/10.1016/j.mcna.2008.04.013[Crossref][WoS]
• [11] Buğdaycı G, Düzgün AP, Koca Y, Sezer S, Turhan T. Metabolik Sendromu Olan ve Olmayan Yaşlı Bireylerde Hs-CRP’nin Önemi. Türk Geriatri Dergisi 2005; 8: 57–60
• [12] Altekin E, Önvural B. Kardiyovasküler Hastalıklarda Bir Risk Faktörü Olarak C-Reaktif Proteinden Yararlanım. T Klin Tıp Bilimleri 2004; 24: 57–61
• [13] Kosova F, Arı Z. Adipositokinler ve Meme Kanseri. Fırat Üniversitesi Sağ. Bil. Derg. 2008; 22: 377–384
• [14] Papachristou GI, Clermont G, Sharma A, Yadav D, Whitcomb DC. Risk and Markers of Severe Acute Pancreatitis. Gastroenterol Clin North Am 2007; 36: 277–296 http://dx.doi.org/10.1016/j.gtc.2007.03.003[Crossref]
• [15] Russell JA. Management of Sepsis. N Engl J Med 2006; 355: 1699–1713 http://dx.doi.org/10.1056/NEJMra043632[Crossref]
• [16] Cinel I, Opal SM. Molecular Biology of Inflammation and Sepsis. Crit Care Med 2009; 37: 291–304 http://dx.doi.org/10.1097/CCM.0b013e31819267fb[Crossref][WoS]
• [17] Rahman SH, Menon KV, Holmfield JH, McMahon MJ, Guillou JP. Serum Macrophage Migration Inhibitory Factor Is an Early Marker of Pancreatic Necrosis in Acute Pancreatitis. Ann Surg 2007; 245: 282–289 http://dx.doi.org/10.1097/01.sla.0000245471.33987.4b[WoS][Crossref]
• [18] Bhatnagar A, Wig JD, Majumdar S. Immunological Findings in Acute and Chronic Pancreatitis. ANZ J. Surg 2003; 73: 59–64 http://dx.doi.org/10.1046/j.1445-2197.2003.02621.x[Crossref]
• [19] Ranson JHC. Etiological and Prognostic Factors in Human Acute Pancreatitis: A Review. Am J Gastroenterol 1982; 77: 633–638
• [20] Delrue LJ, De Waele JJ, Duyck PO. Acute Pancreatitis: Radiologic Scores in Predicting Severity and Outcome. Abdom Imaging (2009). DOI: 10.1007/s00261-009-9522-y [Crossref][WoS]
• [21] Bradley III EL. A Clinically Based Classification System for Acute Pancreatitis. Arch. Surg. 1993; 128: 586–590 http://dx.doi.org/10.1001/archsurg.1993.01420170122019[Crossref]
• [22] Balthazar EJ, Freeny PC, van Sonnenberg E. Imaging and Intervention in Acute Pancreatitis. Radiology 1994; 193: 297–306 http://dx.doi.org/10.1148/radiology.193.2.7972730[Crossref]
• [23] Robert JH, Frossard JL, Mermillod B, Soravia C, Mensi N, Roth M, et al. Early Prediction of Acute Pancreatitis: Prospective Study Comparing Computed Tomography Scans, Ranson, Glascow, Acute Physiology and Chronic Health Evaluation II Scores, and Various Serum Markers. World J Surg 2002; 26: 612–619 http://dx.doi.org/10.1007/s00268-001-0278-y[Crossref]
• [24] Triester SL, Kowdley KV. Prognostic Factors in Acute Pancreatitis. J Clin Gastroenterol 2002; 34: 167–176 http://dx.doi.org/10.1097/00004836-200202000-00014[Crossref]
• [25] Yousaf M, McCallion K, Diamond T. Management of Severe Acute Pancreatitis. Br J Surg 2003; 90: 407–420 http://dx.doi.org/10.1002/bjs.4179[Crossref]
• [26] Windsor JA, Schweder P. (Çeviri: Kalafat H) Akut Pankreatit Komplikasyonları (Psödokistler Dahil). Zinner MJ, Ashley SW (eds). Maingot’s Abdominal Operations. Çeviri: Andican AA (ed). Maingot Abdominal Operasyonlar. İstanbul: Nobel Tıp Kitabevleri Ltd. Şti. 2008: 961–982
• [27] Beger HG, Rau B, Isenmann R. Natural History of Necrotizing Pancreatitis. Pancreatology 2003; 3: 93–101 http://dx.doi.org/10.1159/000070076[Crossref]
• [28] Frossard JL, Ster ML, Pastor CM. Acute pancreatitis. Lancet 2008; 371: 143–152 http://dx.doi.org/10.1016/S0140-6736(08)60107-5[Crossref][WoS]
• [29] Pekmezci S. Akut Pankreatitte Yaklaşım ve Tedavi. İ.Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri Hepato-Bilier Sistem ve Pankreas Hastalıkları Sempozyum Dizisi No: 28 Ocak 2002; 239–262
• [30] Dedeli Ö, Özütemiz AÖ. Akut Pankreatit ve Akut Akciğer Hasarı. Genel Tıp Dergisi 2007; 17: 59–66
• [31] Clancy TE, Benoit EP, Ashley SW. Current Management of Acute Pancreatitis. Journal of Gastrointestinal Surgery. 2005; 9: 440–452 http://dx.doi.org/10.1016/j.gassur.2004.09.027[Crossref]
• [32] Keşkek M, Hamaloğlu E. Akut Pankreatit. Yoğun Bakım Dergisi 2002; 2: 185–917
• [33] Gürleyik G, Çırpıcı OZ, Aktekin A, Sağlam A. Akut Pankreatit Şiddetinin Erken Tanısında Ranson ve APACHE II Skorlarının, Serum İnterlökin-6 ve C-Reaktif Protein Düzeylerinin Rolü. Ulus Travma Derg 2004; 10: 83–88
• [34] Hazinedaroğlu S, Kayaoğlu HA, Karayalçın K. Akut Pankreatit Tanısı Almış 47 Hastanın Analizi: Gelişen Tanı ve Tedavi Olanakları Prognozu Etkiliyor mu? Türkiye Klinikleri J Med Sci 2005; 25: 383–386
• [35] Schütte K, Malfertheiner P. Markers for Predicting Severity and Progression of Acute Pancreatitis. Best Practice & Research Clinical Gastroenterology 2008; 22: 75–90 http://dx.doi.org/10.1016/j.bpg.2007.10.013[Crossref]
• [36] Emral R. Adiponektin ve Diğer Sitokinler. Turkiye Klinikleri J Med Sci 2006; 26: 409–420
• [37] Berköz M, Yalın S. Yağ Dokusunun İmmünolojik ve İnflamatuvar Fonksiyonları. Mersin Üniversitesi Sağlık Bilim Derg 2008; 1: 1–9
• [38] Schäffler A, Landfried K, Völk M, Fürst A, Büchler C, Schölmerich J, et al. Potential of Adipocytokines in Predicting Peripancreatic Necrosis and Severity in Acute Pancreatitis: Pilot Study. Journal of Gastroenterology and Hepatology 2007; 22: 326–34 http://dx.doi.org/10.1111/j.1440-1746.2006.04364.x[Crossref][WoS]
• [39] Lesniowski B, Kumor A, Daniel P, Jasinska A, Pietruczuk M, Panas EM. Adiponectin, Resistin and Acute Inflammatory Phase Factors Concentration in Serum in Patients with Acute Pancreatitis (AP). 39th European Pancreatic Club (EPC) Meeting. Pancreatology 2007; 7: 209–99
• [40] Frey EA, Miller DS, Jahr TG, Sundan A, Bazil V, Espevik T, et al. Soluble CD14 Participates in the Response of Cells to Lipopolysaccharide. J. Exp. Med 1992; 176: 1665–1671 http://dx.doi.org/10.1084/jem.176.6.1665[Crossref]
• [41] Yaegashi Y, Shirakawa K, Sato N, Suzuki Y, Kojika M, Imai S, et al. Evaluation of a Newly Identified Soluble CD14 Subtype as a Marker for Sepsis. J Infect Chemother 2005; 11: 234–238 http://dx.doi.org/10.1007/s10156-005-0400-4[Crossref]
• [42] Li HG, Zhou ZG, Li Y, Zheng XL, Lei S, Zhu L, et al. Alterations of Toll-like Receptor 4 Expression on Peripheral Blood Monocytes During the Early Stage of Human Acute Pancreatitis. Dig Dis Sci 2007; 52: 1973–1978 http://dx.doi.org/10.1007/s10620-006-9211-4[WoS][Crossref]
• [43] Rahman SH, Salter G, Holmfield JH, Larvin M, McMahon MJ. Soluble CD14 Receptor Expression and Monocyte Heterogeneity but not the C-260T CD14 Genotype are Associated with Severe Acute Pancreatitis. Crit Care Med 2004; 32: 2457–2463 http://dx.doi.org/10.1097/01.CCM.0000148008.99716.9C[Crossref]

Identifiers

DOI

10.2478/s11536-014-0501-5