ROLE OF PROADRENOMEDULLIN AS A BIOMARKER OF PEDIATRIC PNEUMONIA | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 10, Volume 21, Issue 1, January 2018, Page 1990-2002 PDF (241.01 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2018.70335 | ||||
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| Authors | ||||
| . Fahima Mohammed Hassan; Rania Salah EL Zayat; Al Zahraa Ahmed Abdel Aziz Mostafa | ||||
| Abstract | ||||
| Background: Community acquired pneumonia (CAP), is an important cause of childhood mortality. Proadrenomedullin (ProADM), is a new regulatory peptide extracted from pheochromocytoma and is a precursor of adrenomedullin but a more stable form. Adult studies found that ProADM is elevated in patients with pneumonia and it is found to be correlated with severity and complications. Also other studies investigated ProADM as prognostic marker for many diseases as sepsis,dengue shock and heart failure. Objective: The aim of this study was to measure the levels of ProADM in children with CAP and to correlate its levels with the severity and complications. Methods: This study was done on 90 children (60 children were diagnosed as having CAP and 30 age & sex matched healthy controls). All children were subjected to history taking, clinical examination and investigations ( chest x ray, Complete Blood Count, C-reactive protein, serum levels of ProADM by enzyme-linked immuno-sorbent assay ELIZA). Modified Respiratory Distress Assessment Instrument (RDAI) score was used to classify out cases into mild, moderate and severe. Results: Serum level of ProADM was found to be higher in CAP cases than in controls and the difference was statistically significant (Mean ± SD = 1.52±0.62 and 0.05±0.04 respectively). Also ProADM was found to be higher in complicated cases, (4 pleural effusion, 1 collapse, 1 pneumothorax ) than uncomplicated cases and the difference was statistically significant (2.50±0.24 and 1.41±0.05) respectively. ProADM was increasing with increasing severity of pneumonia. Cutoff point>2.2 nmol/l was the best level to distinguish between complicated and uncomplicated cases (P=0.01 , sensitivity100%, specificity 81.5% , positive predictive value 37.5% , negative predictive value 100% ). Conclusion: level of ProADM was elevated in CAP patients than in controls and higher levels were found in severe and complicated cases. | ||||
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