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Alexopoulos A, Chouliaras G, Kakourou T, Dakoutrou M, Petrocheilou A, Nasi L, Thanopoulou I, Siahanidou S, Kanaka-Gantenbein C, Kontara L, Michos A, Loukou I. Aquagenic wrinkling of the palms in a cohort of Greek children diagnosed with cystic fibrosis: Associated clinical parameters. J Eur Acad Dermatol Venereol 2023; 37:2362-2369. [PMID: 37415513 DOI: 10.1111/jdv.19308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Aquagenic wrinkling of the palms (AWP) is an excessive and early palmar wrinkling occurring after brief immersion to water (BIW), and has been reported as a frequent finding among Cystic Fibrosis (CF) patients. OBJECTIVES To investigate any associations of CF patients presenting AWP with other disease characteristics and explore the pathomechanism of AWP phenomenon. METHODS We evaluated AWP in CF patients and assessed the AWP parameters of palmar wrinkling, oedema, papules, pruritus and pain at 3, 7 and 11 min after a BIW test with other disease characteristics. Statistical analyses explored the associations of AWP with genotype, lung function, pancreatic insufficiency, hyperhidrosis, personal and family history of atopy and sweat chloride levels. RESULTS One hundred CF patients (mean age 10.4 years) were included in the analysis. The genotypic distribution was ΔF508/ΔF508: 47%, ΔF508/other: 41% and other/other: 12%. Statistically significant associations of Kaplan-Meier curves of the AWP parameters with various disease characteristics and personal/family history were detected. Wrinkling was associated with history of atopy, hyperhidrosis and levels of sweat chloride test. The time to presentation of oedema and the appearance of papules were associated with history of hyperhidrosis and age at diagnosis. Finally, time to appearance of pruritus was related to history of atopy and of hyperhidrosis. Regarding TEWL regression analysis showed significant associations with age at diagnosis (p = 0.024), sweat chloride test levels (p = 0.005), history of hyperhidrosis (p = 0.033), history of atopy (p = 0.002) and hepatic-pancreatic involvement (p = 0.027). CONCLUSIONS The existence of a statistically significant association between AWP and the history of hyperhidrosis, atopy, sweat chloride levels and hepatic-pancreatic function in CF patients was detected. A strong association between AWP and CF was detected. AWP after BIW could be elicited easily and possibly can be used as an initial screening tool to diagnose an individual with symptoms and signs that raise the likelihood of CF.
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Affiliation(s)
- A Alexopoulos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sofia" Children's Hospital, Athens, Greece
| | - G Chouliaras
- Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aglaia Kiriakou" Children's Hospital, Athens, Greece
| | - T Kakourou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sofia" Children's Hospital, Athens, Greece
| | - M Dakoutrou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sofia" Children's Hospital, Athens, Greece
| | - A Petrocheilou
- Department of Cystic Fibrosis, "Aghia Sofia", Children's Hospital, Athens, Greece
| | - L Nasi
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sofia" Children's Hospital, Athens, Greece
| | - I Thanopoulou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sofia" Children's Hospital, Athens, Greece
| | - S Siahanidou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sofia" Children's Hospital, Athens, Greece
| | - C Kanaka-Gantenbein
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sofia" Children's Hospital, Athens, Greece
| | - L Kontara
- West Middlesex University Hospital, London, UK
| | - A Michos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sofia" Children's Hospital, Athens, Greece
| | - I Loukou
- Department of Cystic Fibrosis, "Aghia Sofia", Children's Hospital, Athens, Greece
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Toutouzas K, Antonopoulos AS, Koutagiar I, Skoumas I, Benetos G, Kafouris P, Miliou A, Petrocheilou A, Georgakopoulos A, Oikonomou G, Drakopoulou M, Siores I, Pitsavos C, Antoniades C, Anagnostopoulos CD, Tousoulis D. Visceral adipose tissue phenotype and hypoadiponectinemia are associated with aortic Fluorine-18 fluorodeoxyglucose uptake in patients with familial dyslipidemias. J Nucl Cardiol 2022; 29:1405-1414. [PMID: 33501546 DOI: 10.1007/s12350-020-02472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 11/12/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The role of adipose tissue (AT) in arterial inflammation in familial dyslipidaemias is poorly studied. We investigated the relationship between AT and arterial inflammation in patients with heterozygous familial hypercholesterolemia (heFH) and familial combined hyperlipidemia (FCH). METHODS AND RESULTS A total of 40 patients (20 heFH/20 FCH) and a subgroup of 20 of non-heFH/FCH patients were enrolled. Participants underwent blood sampling for serum adipokine measurements and Fluorine-18 fluorodeoxyglucose (18F-FDG) PET/CT imaging. Abdominal visceral (VAT) and subcutaneous (SAT) AT volumes and AT and abdominal aorta 18F-FDG uptake were quantified. FCH patients had increased VAT (pANOVA = 0.004) and SAT volumes (pANOVA = 0.003), lower VAT metabolic activity (pANOVA = 0.0047), and lower adiponectin levels (pANOVA = 0.007) compared to heFH or the control group. Log(Serum adiponectin) levels were correlated with aortic TBR (b = - 0.118, P = 0.038). In mediation analysis, VAT volume was the major determinant of circulating adiponectin, an effect partly mediated via VAT TBR. Clustering of the population of heFH/FCH by VAT volume/TBR and serum adiponectin identified two distinct patient clusters with significant differences in aortic TBR levels (2.11 ± 0.06 vs 1.89 ± 0.05, P= 0.012). CONCLUSIONS VAT phenotype (increased VAT volume and/or high VAT TBR) and hypoadiponectinemia may account for the observed differences in arterial inflammation levels between heFH and FCH patients.
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Affiliation(s)
- Konstantinos Toutouzas
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
| | - Alexios S Antonopoulos
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece.
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
| | - Iosif Koutagiar
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
- Fifth Department of Cardiology, Hygheia Hospital, Athens, Greece
| | - Ioannis Skoumas
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
| | - Georgios Benetos
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
| | - Pavlos Kafouris
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou St., 11527, Athens, Greece
- Department of Informatics and Telecommunications, National and Kapodistrian University of Athens, Athens, Greece
| | - Antigoni Miliou
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
| | - Aikaterini Petrocheilou
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
| | - Alexandros Georgakopoulos
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou St., 11527, Athens, Greece
| | - Georgios Oikonomou
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
| | - Maria Drakopoulou
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
| | - Ilias Siores
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
| | - Christos Pitsavos
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Constantinos D Anagnostopoulos
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou St., 11527, Athens, Greece.
| | - Dimitris Tousoulis
- First Department of Cardiology, Hippokration Hospital, Vasilissis Sofias 114, PO 11528, Athens, Greece
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Alexopoulos A, Chouliaras G, Kakourou T, Dakoutrou M, Nasi L, Petrocheilou A, Siahanidou S, Kanaka-Gantenbein C, Chrousos G, Loukou I, Michos A. Aquagenic wrinkling of the palms after brief immersion to water test as a screening tool for cystic fibrosis diagnosis. J Eur Acad Dermatol Venereol 2021; 35:1717-1724. [PMID: 33914973 DOI: 10.1111/jdv.17312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Aquagenic wrinkling of the palms (AWP) is an excessive and early palmar wrinkling occurring after Brief Immersion to Water (BIW), and has been reported as a frequent finding among cystic fibrosis (CF) patients. OBJECTIVES To evaluate and assess the diagnostic performance of BIW test as an initial screening tool for CF diagnosis. METHODS We measured AWP in CF patients, CF-heterozygotes (CF-het) and normal controls. The AWP parameters of palmar wrinkling, oedema, papules, pruritus and pain were assessed at 3, 7 and 11 min after a BIW test was performed for all the participants. Statistical analyses explored the progression of AWP in time for the three groups and assessed the diagnostic performance of BIW test as a diagnostic screening tool for CF. RESULTS A total of 250 individuals (100 CF patients, their 50 CF-het parents, 100 healthy controls) were included in the analysis. The average age in years (mean ± SD) was 10.4 ± 4.0 for CF, 35.9 ± 6.1 for CF-het and 10.5 ± 4.0 for controls. The rate of positives for AWP at 3 min among CF patients, CF-het and controls was 68%, 8% and 0%, respectively (P < 0.01). Kaplan-Meier analysis showed a clear trend towards earlier appearance of all five parameters in the direction controls < hetCF < CF (P values <0.01). The best diagnostic performance in detecting between CF patients and non-CF was achieved by the presence of papules and wrinkling at 7 min (sensitivity/specificity: 94.0%/98.3% and 100.0%/92.0%, respectively). CONCLUSIONS A strong association between AWP and CF was detected. AWP after BIW could be elicited easily and possibly can be used as an initial screening tool to assess if an individual with symptoms and signs that raise the likelihood of CF is a CF patient.
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Affiliation(s)
- A Alexopoulos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - G Chouliaras
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - T Kakourou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - M Dakoutrou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - L Nasi
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - A Petrocheilou
- Department of Cystic Fibrosis, 'Aghia Sofia', Children's Hospital, Athens, Greece
| | - S Siahanidou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - C Kanaka-Gantenbein
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - G Chrousos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - I Loukou
- Department of Cystic Fibrosis, 'Aghia Sofia', Children's Hospital, Athens, Greece
| | - A Michos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
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Vlachopoulos CV, Koutagiar IP, Georgakopoulos AT, Pouli AG, Sioni AΚ, Giannouli SΕ, Chondropoulos SD, Stergiou IΕ, Solomou EG, Terentes-Printzios DG, Karakitsios IG, Kafouris PP, Gaitanis A, Pianou NK, Petrocheilou A, Aggeli CI, Stroumpouli E, Marinakis TP, Voulgarelis M, Tousoulis DM, Anagnostopoulos CD. Lymphoma Severity and Type Are Associated With Aortic FDG Uptake by 18F-FDG PET/CT Imaging. JACC CardioOncol 2020; 2:758-770. [PMID: 34396292 PMCID: PMC8352324 DOI: 10.1016/j.jaccao.2020.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/27/2022]
Abstract
Background There is evidence that metabolic disease burden in lymphoma influences patient outcome. However, the impact of disease severity on the cardiovascular system is unknown. Objectives The aim of this study was to examine whether lymphoma is associated with arterial inflammation by investigating the relationship between disease metabolic burden and arterial fluorodeoxyglucose (FDG) uptake. Methods Sixty-two chemotherapy-naïve patients with active Hodgkin’s or non-Hodgkin’s lymphoma were matched (2:1) to individual control groups of lymphoma patients previously treated and free of active disease. All groups underwent 18F-FDG position emission tomography–computed tomography imaging. Disease severity was quantified by metabolic tumor volume (MTV) and total lesion glycolysis corresponding to standardized uptake values (SUVs) ≥41% or ≥2.5 of the maximum SUV within lymphoma regions, and aortic FDG uptake was quantified through the target-to-background ratio (TBR). Inflammatory and disease severity biomarkers were also measured. Results MTV and total lesion glycolysis measurements were significantly correlated with inflammatory and disease biomarkers. Aortic TBR was higher in patients with active non-Hodgkin’s lymphoma compared with control subjects (median difference 0.51; 95% confidence interval [CI]: 0.28 to 0.78; p < 0.001). Similarly, patients with active Hodgkin’s lymphoma had higher values of aortic TBR compared with control subjects (median difference 0.31; 95% CI: 0.15 to 0.49; p < 0.001). In addition, aortic TBR was modestly increased in patients with stage III to IV disease compared with those with stage I to II disease (median aortic TBR: 2.23 [interquartile range: 2.01 to 2.54] vs. 2.06 [interquartile range: 1.83 to 2.27; p = 0.050). In multivariable analysis, aortic FDG uptake and MTV≥2.5 values were independently associated (β = 0.425; 95% CI: 0.189 to 0.662; p = 0.001; R2 = 0.208), as were aortic FDG uptake and MTV≥41% (β = 0.407; 95% CI: 0.167 to 0.649, p = 0.001; R2 = 0.191). Conclusions Aortic wall FDG uptake is related with disease severity indicative of a possible vascular effect of lymphoma. This work highlights a new potential role of molecular imaging in cardio-oncology for evaluating disease severity and its consequences on the vasculature.
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Key Words
- 18F-FDG, 18F-fluorodeoxyglucose
- BMI, body mass index
- CI, confidence interval
- CT, computed tomography
- CVD, cardiovascular disease
- LDH, lactate dehydrogenase
- MTV, metabolic tumor burden
- PET, positron emission tomography
- SUV, standardized uptake value
- SUVmax, maximum standardized uptake value
- SUVmean, mean standardized uptake value
- TBR, target-to-background ratio
- TLG, total lesion glycolysis
- WBC, white blood cell count
- arterial inflammation
- hsCRP, high-sensitivity C-reactive protein
- lymphoma
- metabolic burden
- positron emission tomography
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Affiliation(s)
- Charalambos V Vlachopoulos
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Iosif P Koutagiar
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros T Georgakopoulos
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | | | | | - Stavroula Ε Giannouli
- 2nd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Ioanna Ε Stergiou
- Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece
| | - Eirini G Solomou
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios G Terentes-Printzios
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis G Karakitsios
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Pavlos P Kafouris
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece.,Department of Informatics and Telecommunications, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Gaitanis
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Nikoletta K Pianou
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Aikaterini Petrocheilou
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantina I Aggeli
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Euaggelia Stroumpouli
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Michael Voulgarelis
- Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece
| | - Dimitrios M Tousoulis
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantinos D Anagnostopoulos
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Katsagoni C, Yannakoulia M, Tokou I, Moustaki M, Petrocheilou A, Loukou I. S10.4 Association of energy intake, physical activity and sedentary behaviour with growth and pulmonary function in children with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30219-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Delicou S, Petrocheilou A, Pougiouka M, Maragkos K. Systematic Yersinia enterocolitica in an iron overloaded and immunocompromised thalassemic patient. Microbiol Med 2017. [DOI: 10.4081/mm.2017.6873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We report the case of a 43-year-old woman who presented with lower abdominal pain, maculopapular rash, arthritis of the left knee and left ankle joints, with a history of thalassemia and heavy iron overload. She was also on haemodialysis therapy three times a week for end stage renal therapy. <em>Yersinia enterocolitica</em> and <em>Yersinia pseudotuberculosis</em> cause yersiniosis, a diarrhoeal illness. Members of the genus <em>Yersinia</em> are gram-negative coccobacilli; they are facultative anaerobes in the family <em>Enterobacteriaceae</em>. Serological examinations revealed positive IgA and IgG antibodies against <em>Yersinia</em> <em>enterocolitica</em> outer membrane proteins (Yops) for YopD(4a) and Yop M(2a) and IgG for LorV (V antigen). Enteritis an reactive arthritis presented as the primary manifestation of <em>Y. enterocolitica</em> infection. Important risk factors include iron overload, cirrhosis, and immune suppression. The patient was successfully treated with oral ciprofloxacin.
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Kaditis A, Petrocheilou A, Kalampouka E, Tanou K, Troupi E, Sfingos K, Loukou I. 236 Efficacy of intravenous pulse methylprednisolone treatment versus continuous systemic corticosteroids for ABPA in children with cystic fibrosis. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30580-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Noni M, Katelari A, Petrocheilou A, Papakonstantinou E, Loukas I, Doudounakis SE. 13 Cases of false negative cystic fibrosis newborn screening in Greece. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30253-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kaditis A, Doulgeraki A, Petrocheilou A, Katelari A, Noni M, Doudounakis SE. 230 History of meconium ileus is associated with low fat tissue mass in children and adolescents with cystic fibrosis. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30405-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Elefsiniotis IS, Petrocheilou A, Scarmeas N, Ketikoglou I, Pantazis KD, Toutouza M, Tsianos EV. Serum procalcitonin levels in chronic hepatitis C patients under pegylated interferon-alpha plus ribavirin treatment. J Clin Virol 2006; 37:329-31. [PMID: 16996792 DOI: 10.1016/j.jcv.2006.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Accepted: 08/18/2006] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the alterations of serum procalcitonin (PCT) levels in patients with chronic hepatitis C during pegylated interferon-alpha (PEG-IFNa) plus ribavirin (RIB) treatment and to correlate them with clinical and virological outcomes. STUDY DESIGN Fifty-two consecutive patients (29 males, age=41.2+/-14.7 years) with chronic HCV-related liver disease (six cirrhotics) were evaluated for PCT levels at baseline and during the treatment course (at week 12, 24, 48 and 72) with PEG-IFNa plus RIB. Sustained virological response (SVR) was confirmed by undetectable serum HCV-RNA at the end of treatment and again 6 months after completion of treatment. RESULTS Two patients exhibited culture-proved bacterial infections during the treatment course. Thirty-six patients (69.2%) exhibit SVR and 16 (30.8%) were non-responders. Serum PCT levels remained within normal limits (0.1-0.5 ng/mL) in all treated patients throughout the follow-up period except those two who exhibited bacterial infections during the treatment course. Virological responders exhibited significant decline of serum PCT levels over time compared to non-responders (p<0.001), even when adjusted for multiple baseline parameters (p=0.037). CONCLUSION Serum PCT levels decline in chronic hepatitis C patients during PEG-IFNa plus RIB treatment, especially in the sustained virological responder group, while they elevate only when bacterial infections complicate the treatment course.
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Elefsiniotis IS, Skounakis M, Vezali E, Pantazis KD, Petrocheilou A, Pirounaki M, Papatsibas G, Kontou-Kastellanou C, Moulakakis A. Clinical significance of serum procalcitonin levels in patients with acute or chronic liver disease. Eur J Gastroenterol Hepatol 2006; 18:525-30. [PMID: 16607149 DOI: 10.1097/00042737-200605000-00012] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the diagnostic value of serum procalcitonin levels in patients with acute or chronic liver disease, with or without bacterial infections and to correlate the results with the clinical outcome and the laboratory findings for these patients. METHODS One hundred and six consecutive hospitalized patients with liver disease were evaluated for procalcitonin levels on admission. Fifteen of them (14.2%) had acute alcoholic hepatitis on cirrhotic background (group A), 20 (18.9%) had alcoholic cirrhosis without hepatitis and/or bacterial infection (group B), 16 (15.1%) had decompensated cirrhosis with proved bacterial infection (group C), 42 (39.6%) had uncomplicated viral hepatitis-related cirrhosis (group D) and 13 (12.3%) had acute icteric viral hepatitis (group E). Serum procalcitonin levels were measured using an immunoluminometric assay. Statistical analysis was based on Student's t-test and the non-parametric Kruskall-Wallis test (P<0.05). RESULTS Serum procalcitonin levels were significantly higher in cirrhotic patients with bacterial infection (9.80+/-16.80 ng/ml) than in those without bacterial infection (0.21+/-0.13 ng/ml, P=0.001), whereas they were within normal range (<0.5 ng/ml) in all patients with uncomplicated cirrhosis, irrespective of the cause of cirrhosis. Seven of 15 group A patients (46.2%) and 4/13 group E patients (30.8%), all of them cirrhotics, had procalcitonin levels higher than 0.5 ng/ml on admission, without established bacterial infection. CONCLUSION Serum procalcitonin levels remain below the threshold of 0.5 ng/ml in all patients with uncomplicated cirrhosis, irrespective of the cause of the disease, while they are significantly elevated when bacterial infection complicates the course of the disease. A significant proportion of patients with acute alcoholic hepatitis on a cirrhotic background as well as of patients with acute on chronic viral hepatitis, without bacterial infection, exhibit serum procalcitonin levels above 0.5 ng/ml, suggesting that this cut-off value is probably not enough to discriminate between patients with or without bacterial infection within these subgroups of patients with liver disease.
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Affiliation(s)
- Ioannis S Elefsiniotis
- Department of Internal Medicine, Hippokration Hospital of Athens, Carchidonos 9, A. Glyfada, GR-16562 Greece.
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