INVESTIGATION OF THE DIAGNOSTIC AND PROGNOSTIC VALUE OF SERUM SOLUBLE INTERLEKIN-2 RECEPTOR LEVEL IN THE DIAGNOSIS OF HEMOPHAGOSITIC SYNDROME IN PATIENTS WITH SYSTEMIC INFLAMMATORY RESPONSE SYNDROME
Project no. 20436 · Status: Kapanmış · 2019
Summary
Introduction: Hemophagocytic syndrome (HPS) is a highly nonspecific clinical picture with clinical and laboratory findings that should be considered when fever and accompanying cytopenias are present, especially in intensive care patients. Patients followed up with the diagnosis of systemic inflammatory syndrome (SIRS) are patients who may develop HPS and it is important to distinguish them from this patient group. Aim and Method: Blood sample was drawn for sIL-2r level during diagnosis in patients who met the diagnostic criteria for HPS and SIRS. In the HPS group, resampling was taken at the time of endpoint (death or discharge). Clinical and demographic data were recorded. Routine hemogram and biochemical parameters were recorded. At the end of the study, sIL-2r level was studied in all patients at the same time. Regression analysis was applied for descriptive statistics and mortality indicator. Spearman correlation test was applied for parameters that correlated with sIL-2r level. Results: 33 patients diagnosed with HPS and 46 patients diagnosed with SIRS were included. NLR, CRP, fibrinogen levels and platelets were significantly higher in the SIRS group; The HPS group had higher ferritin, LDH, sIL-2r levels and OAB. Mortality was higher in the HPS group (p < 0.001). The optimal cut-off value of sIL-2r to distinguish between the two groups among our patients was 5888 U/mL, with a sensitivity of 45.5% (28.1 to 63.6) and a specificity of 89.1% (76.4 to 96.4). sIL-2r level did not differ significantly between subtypes of HPS; however, sIL-2r levels were significantly higher in malignancy-associated HPS than in non-malignant causes. During his stay in intensive care; NTproBNP, LDH, ferritin, platelets, temporal changes in mean arterial pressure were found to be predictors of mortality (p < 0.005 for all). Age, baseline NTproBNP, urea, creatinine and triglyceride levels were positively correlated with sIL-2r level. Conclusion: When sIL-2r level is evaluated as a diagnostic criterion in adult HPS patients, there is no clear cutoff value in current studies. In our study, it was found to be 5888 U/mL in distinguishing HPS from SIRS, and it was not found as a mortality indicator. Studies with more patients are needed.