Comparative Study of the Level of Inflammatory Factors of Erythrocyte Sedimentation Rate and Reactive Protein C in Benign and Malignant Thyroid Nodules

ABSTRACT Objective: To evaluate the level of inflammatory factors of erythrocyte sedimentation rate and reactive protein C in benign and malignant thyroid nodules. Material and Methods: In this case-control study, patients who were referred because of an enlarged thyroid gland were selected, patients who had undergone surgery for the thyroid nodule were included in the study. Erythrocyte sedimentation rate and reactive protein C were measured before surgery in patients who were candidates for thyroid surgery. The histopathological records of patients were retrospectively reviewed. Relevant cases had a cytological evaluation of thyroid nodules by fine-needle aspiration cytology (FNAC). The mean of ESR / CRP in both groups was compared using an independent t-test (p>0.05). Results: In malignant tumor type, in all patients, with Pill (PTC), analyzes in the malignant group showed a significant difference between the mean ESR / CRP in both groups with and without thyroid history. Sub-analyzes in the malignant group were significantly different between the mean ESR / CRP in both groups with and without thyroid histories (p=0.009) (40.16 ± 28.81). The association between ESR and CRP, ESR / CRP and tumor size, ESR / CRP and age in each group as well as in the whole patients were evaluated using Pearson correlation test, which showed a positive association between ESR age and ESR (p=0.024, r=0.375). In the malignant group, a negative correlation was found between the age and the CRP rate (p=0.027, r=-0.441), and in the total patients between the age and the rate (ES=0.043, r=-0.256). Conclusion: Factors such as ESR and CRP, which are considered acute phase reactors and their levels increase in acute inflammatory conditions, may not have a significant increase in chronic inflammatory conditions and malignancies.

Citocinas e proteínas de fase aguda do soro como marcadores de regressão da resposta inflamatória ao tratamento da tuberculose pulmonar / Cytokines and acute phase serum proteins as markers of inflammatory regression during the treatment of pulmonary tuberculosis

OBJETIVO: Analisar o padrão de citocinas pró- e antiinflamatórias e da resposta de fase aguda (RFA) como marcadores de resposta ao tratamento da tuberculose pulmonar. MÉTODOS: Determinação dos níveis de interferon-gama (IFN-γ), tumor necrosis factor-alpha (TNF-α, fator de necrose tumoral-alfa), interleucina-10 (IL-10) e transforming growth factor-beta (TGF-β, fator transformador de crescimento-beta), pelo método ELISA, em sobrenadante de cultura de células mononucleares do sangue periférico e monócitos, assim como dos níveis de proteínas totais, albumina, globulinas, alfa-1-glicoproteína ácida (AGA), proteína C reativa (PCR) e velocidade de hemossedimentação (VHS) em 28 doentes com tuberculose pulmonar, em três tempos: antes (T0), aos três meses (T3) e aos seis meses (T6) de tratamento, em relação aos controles saudáveis, em um único tempo. RESULTADOS: Os pacientes apresentaram valores maiores de citocinas e RFA que os controles em T0, com diminuição em T3 e diminuição (TNF-α, IL-10, TGF-β, AGA e VHS) ou normalização (IFN-γ e PCR) em T6. CONCLUSÕES: PCR, AGA e VHS são possíveis marcadores para auxiliar no diagnóstico de tuberculose pulmonar e na indicação de tratamento de indivíduos com baciloscopia negativa; PCR (T0 > T3 > T6 = referência) pode também ser marcador de resposta ao tratamento. Antes do tratamento, o perfil Th0 (IFN-γ, IL-10, TNF-α e TGF-β), indutor de e protetor contra inflamação, prevaleceu nos pacientes; em T6, prevaleceu o perfil Th2 (IL-10, TNF-α e TGF-β), protetor contra efeito nocivo pró-inflamatório do TNF-α ainda presente. O comportamento do IFN-γ (T0 > T3 > T6 = controle) sugere sua utilização como marcador de resposta ao tratamento.

OBJECTIVE: To evaluate the pattern of pro-inflammatory cytokines, anti-inflammatory cytokines and the acute phase response (APR) as markers of the response to treatment of pulmonary tuberculosis. METHODS: Twenty-eight patients with pulmonary tuberculosis were evaluated at three time points: pretreatment (T0), treatment month 3 (T3) and treatment month 6 (T6). Levels of interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukine-10 (IL-10) and transforming growth factor-beta (TGF-β) were determined using ELISA in the supernatant of peripheral blood mononuclear cell and monocyte culture. Levels of total protein, albumin, globulins, C-reactive protein (CRP), alpha-1-acid glycoprotein (AAG) and erythrocyte sedimentation rate (ESR) were also determined. All of these parameters were also evaluated, only once, in a group of healthy controls. RESULTS: In relation to controls, patients presented cytokine levels and APR that were higher at T0, lower at T3 and either lower (TNF-α, IL-10, TGF-β, AAG and ESR) or normal (IFN-γ and CRP) at T6. CONCLUSIONS: For individuals with negative smear sputum microscopy, CRP, AAG and ESR are potential markers of pulmonary tuberculosis and of the need for treatment; CRP (T0 > T3 > T6 = reference) can also be a marker of treatment response. In the patients, the Th0 profile (IFN-γ, IL-10, TNF-α and TGF-β), inducer of and protector against inflammation, predominated at T0, whereas the Th2 profile (IL-10, TNF-α and TGF-β), protecting against the harmful pro-inflammatory effect of the remaining TNF-α, predominated at T6. The behavior of IFN-γ (T0 > T3 > T6 = controls) suggests its use as a marker of treatment response.

pattern of fetal hemoglobin changes in patients with malignancy on chemotherapy

Production of fetal proteins by malignant tissue is a recognized phenomenon seen in many neoplastic disorders. Hence, the aim was to determine if there is a positive correlation between administration of chemotherapy and reduction in fetal hemoglobin [HbF] levels. In a prospective study at the University of Benin Teaching Hospital, Nigeria, 50 cancer patients at various stages of the disease and 50 controls for 10 months period [March to December, 2005], HbF was determined in pre- chemotherapy [n=23] and post-chemotherapy [n=27] cancer patients. Fetal hemoglobin was estimated by the modified Betke's method. A total of 20 patients [40%] comprising 10 pre-chemotherapy and 10 post-chemotherapy patients presented with increased HbF which was statistically significant [p<0.0001]. There was also a significant decrease in post- chemotherapy result when both pre and post-chemotherapy values were compared [p=0.0073]. The results presented indicate that during recovery of erythropoiesis some erythroblasts synthesized HbF and there was a reduction following administration of chemotherapy

[ comparative study on the effect of sodium citrate and EDTA in erythrocyte sedimentation rate after one and two hours in children and adults]

One of the most common tests performed in the hematology laboratories is erythrocyte sedimentation rate [ESR] test at the first and second hours for monitoring the course of infections, inflammatory diseases and some types of cancers. The recommended method by the international council for standardization in hematology [ICSH] and national committee for clinical laboratory standards [NCCLS] for ESR measurement is based on the traditional Westergren method, using EDTA anticoagulated sample without dilution. But selected method for routine works in laboratories is using sodium citrate while EDTA is used in most other hematological tests. Now if the same blood samples containing EDTA could be used for ESR measurement, it would lead to decrease in laboratory working load as well as the amount of required blood. Three hundred cases [125 males, 75 females, 79 of the total cases anemic] were included in this study. 150 cases were less than 14 years and 150 cases more than 14 years old. Two blood samples were taken from each patient with EDTA or sodium citrate anticoagulant. We used samples of CBC test as EDTA containing samples. The first and second hour ESR were measured simultaneously for both samples using Westergren method under completely identical conditions and the results were recorded, the ESR results obtained using sodium citrate in the first and second hour were compared with the ESR test results of the same patients with EDTA containing samples by paired t-test. It was observed that there was significant difference between the results of ESR test by using two anticoagulants in adults and anemic cases. But in children, statistical difference between first hour ESR test results using EDTA and sodium citrate was not significant. It can be concluded that if only first hour ESR in children is required, samples containing EDTA can be used which will decrease the amount of required blood to a half. It would also cause a decrease in working load of laboratories

Does pentoxifylline find a place in the armementarium of leprologists in type II reaction?

Alternative therapeutic interventions in Type II lepra reaction are being considered following serious problems associated with the use of steroids and thalidomide. Pentoxifylline (PTX) has been used in Type II reaction with varying degrees of success. The results of a study on the use of this drug in a dose of 1200 mg per day for a period of 2 months in patients with ENL reaction are discussed. Five patients, one of whom was HIV positive--all with severe Type II reaction, were regularly evaluated for regression of inflammatory symptoms and clinical involution of ENL lesions while on PTX therapy and thereafter. It was found that PTX led to a total elimination of systemic symptoms within a week. ENL lesions regressed in two weeks. However, in one patient, lesions recurred after one month of therapy. It appears that PTX is well tolerated and could be used as an additional drug in the armamentarium of leprologists in the management of Type II reaction, especially in HIV co-infection, where long-term steroids are contraindicated. However, further studies to compare the effects of PTX with currently, widely used drugs for the treatment of ENL reaction are necessary.

Effect of linear alkyl benzene sulphonate on erythrocyte sedimentation rate of teleost fish, Heteropneustes fossilis.

ESR increased at all concentrations and exposures to LAS. However, increases were more pronounced at LC50 for 24 h and minimum at the end of 96 h.

A study on osmotic resistance of RBC and ESR in stored blood.

The present work was undertaken to study the changes in osmotic resistance of stored blood, used for blood transfusion. Blood samples of 50 cases from Orissa Red Cross Blood Bank, Cuttack, were studied. The blood was collected in acid citrate dextrose solution and stored at 4 degrees C. Storage was done under usual condition followed in blood banks. Osmotic fragility was determined at 3 days interval up to 15 days. In each case ESR was determined and in 20 cases plasma fibrinogen level was determined. In this study there was gradual increase in fragility which was maximum on 9th day and then slowly declined, which was statistically significant. ESR decreased markedly after 6th day, which was also statistically significant.

Effect of alkaloidal extract from Clerodendron colebrookianum on hematological parameters and hepatorenal functions in mice.

Effects of multiple weekly (20, 40 and 80 mg/kg) and daily therapeutic (2, 4 and 8 mg/kg) ip doses of C. colebrookianum leaf extract on liver and kidney functions and hematological parameters in mice were studied. No alteration in hematological and biochemical parameters at low and moderate dose level of daily and low dose level of weekly treatment of alkaloidal extract was observed. However, alkaloidal extract at moderate dose in weekly treatment increased significantly serum alanine aminotransferase, alkaline phosphatase, nonprotein nitrogen, blood urea, plasma protein and erythrocyte sedimentation rate. High dose of alkaloidal extract increased all the above parameters of weekly treated mice including serum aspartate aminotransferase and plasma cholesterol and decreased significantly serum bilirubin and clotting time. Whereas, in high dose daily treatment erythrocyte count and hemoglobin content were increased and serum bilirubin was decreased. The present study reveals that the high dose (above 40 mg/kg body weight) of alkaloidal extract of C. colebrookianum affects liver and kidney functions and metabolism and also alters only clotting time and ESR whereas the therapeutic dose level (hypotensive action at 2 to 8 mg/kg, i.v., dose level) did not exhibit any toxic action on the above mentioned system; the toxic action may be due to overdose. Hepatorenal dysfunction and alteration of hematological parameters were noted at moderate and high dose in a dose dependent manner.

Methotrexate: clinical and immunological effects in refractory rheumatoid arthritis.

Thirty five patients with refractory rheumatoid arthritis were given 7.5 mg of methotrexate (Mtx) every week. Eleven patients had to discontinue treatment either because of adverse effects or unresponsiveness. Twenty four patients showed clinical response and significant improvement in ESR and they continued Mtx for a mean of 25.24 months. Seven patients achieved clinical remission as defined by ARA criteria. Immunological parameeters including IgG, IgM, IgA, lymphocyte subsets (CD3+, CD4+, CD8+ and B), C3 and C4 however, did not show any change during this treatment in any of the groups upto 6 months. There was a significant fall in the erythrocyte sedimentation rate (ESR), c-reactive protein (CRP) and rheumatoid factor (RF) levels in responders only.

Efectos de la terapéutica corticoidea sobre los leucocitos / Effects of corticoids therapeutic overleukocytes

Se estudiaron 60 pacientes de 18 meses a 70 años, en que la administración terapéutica de Corticoides provocó en el 63 por ciento leucocitosis neutrófila, lo cual está totalmente de acuerdo con la literatura internacional revisada