Gastric fluid fibronectin, transferring and prealbumin in children with bacterial pneumonia

ABSTRACT

The study included 103 patients with bacterial pneumonia as well as 20 controls. Their ages ranged from 2-36 months. Patients with any disease that could affect plasma proteins were excluded from the patients and controls. Patients were classified according to Downe's score for respiratory distress into mild, moderate and severe. The patients were subjected to full clinical examination chest x-ray, full blood picture, tuberculin test and early morning fasting gastric aspirate for bacteriological studies as well as for determination of fibronectin [Fn] transferrin [Tn] and prealbumin [PA] initial and on follow up after 10 days. Similarly gastric aspirate to plasma ratio [G/P] of Fn, Tn and PA were done initially and on follow up. Controls were subjected to the same gastric aspirate studies. Patients with bacterial pneumonia showed significantly higher values of gastric fluid as well as G/P ratio of Fn and Tn and significantly lower gastric aspirate and G/P ratio of PA than controls. Cases with both severe and moderate bacterial pneumonia showed significantly lower values of gastric fluid and G/P ratio of Fn and PA and significantly higher values of gastric fluid and G/P ratio of Tn than mild ones. Mild cases that became worse showed significantly lower values of gastric fluid and G/P ratio of Fn and PA and significantly higher values of gastric fluid and G/P ratio of Tn than mild cases that became better, cases who died from bacterial pneumonia showed significantly lower values of gastric fluid Fn initially than cases that improved either within or after 10 days treatment. There was a marked and significant decline of gastric fluid Fn in cases that died at deterioration of their state than cases that improved. These data suggest that gastric fluid Fn, Tn and PA may have a prognostic value during the management of bacterial pneumonia. The addition of I.V. fibronectin during the treatment of bacterial pneumonia in the cases that show either significant initial low or significant decline in gastric fluid Fn during the course of the disease may be worthy trial