Subject(s)
Arteriovenous Malformations/complications , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Intestinal Mucosa/blood supply , Jejunum/pathology , Arteriovenous Malformations/pathology , Female , Gastrointestinal Hemorrhage/pathology , Humans , Intestinal Mucosa/pathology , Young AdultABSTRACT
Familial Mediterranean Fever (FMF) is an autosomal recessive disease characterized by periodic attacks of fever and polyserositis. The effects of the MEFV genotype differences on clinical picture and inflammatory activity have not been well documented. The aim of this study was to investigate levels of conventional inflammation markers, procalcitonin, interleukin levels, TNF-alpha, and C5a levels in patients with FMF who had different MEFV genotypes and compare them with those of healthy subjects. The study consisted of 41 patients with FMF (F/M: 23/18), and 31 healthy subjects (F/M: 18/13). Tests were performed during the attack-free period. White-blood cell count, CRP and IL-8 levels were higher in patients with FMF than in healthy subjects (p < 0.05) and also higher in M680I carriers than in the patients with M694V allele carriers. However, ESR, fibrinogen, procalcitonin, IL-6, C5a, TNF-alpha, and IgD levels were not significantly different between patients and healthy subjects (p > 0.05). Arthralgia or arthritis was significantly higher in M694V carriers than in non-M694V carriers (p < 0.05). It is concluded that the clinical features and inflammatory-cytokine activities were higher in patients with FMF during the attack-free period than in healthy subjects, and the different genotype might be related to different clinical pictures.
Subject(s)
Cytoskeletal Proteins/genetics , Familial Mediterranean Fever/genetics , Inflammation Mediators/analysis , Adult , Blood Sedimentation , C-Reactive Protein/analysis , C-Reactive Protein/metabolism , Case-Control Studies , Disease Progression , Familial Mediterranean Fever/physiopathology , Female , Fibrinogen/analysis , Fibrinogen/metabolism , Follow-Up Studies , Genotype , Humans , Male , Probability , Pyrin , RNA, Messenger/analysis , Reference Values , Risk Assessment , Sensitivity and Specificity , Severity of Illness Index , Statistics, NonparametricABSTRACT
Lactococcus lactis is a gram-positive bacterium, commonly used in the dairy industry. Although Lactococcus lactis is known to be non-pathogenic for humans, it can cause infection in immunocompromised patients. We report a case of peritonitis due to L. lactis in a continuous ambulatory peritoneal dialysis patient, which is the second reported case in the literature.
Subject(s)
Lactococcus lactis/isolation & purification , Peritoneal Dialysis, Continuous Ambulatory , Peritonitis/microbiology , Female , Humans , Middle AgedABSTRACT
OBJECTIVES: To determine the significance of a newly described marker of inflammation procalcitonin (PCT), and to investigate its relationship to conventional markers of inflammation, such as C-reactive protein (CRP), fibrinogen, and erythrocyte sedimentation rate (ESR), in patients on peritoneal dialysis (PD) and with peritonitis. DESIGN: A prospective, observational clinical study. SETTING: The Nephrology Division of a University-affiliated teaching hospital. PATIENTS AND METHODS: 51 consecutive patients on PD were included in the study. Of this number, 16 developed peritonitis during the observational period. Baseline PCT, CRP, and fibrinogen concentrations and ESR of 51 PD patients were determined at a time point (TB) prior to any evidence of infection. These results were compared with laboratory values from 74 hemodialysis patients and 34 nonuremic control subjects. All PD patients then were followed prospectively for evidence of peritonitis. In addition to routine blood tests, including hemoglobin and leukocyte count, and routine biochemical tests, blood samples were taken to measure PCT, CRP, and fibrinogen concentrations and ESR at the time (T0) when patients first were diagnosed with PD peritonitis and also on the 4th (T4) and the 14th (T14) days after treatment for peritonitis was initiated. PCT was assayed by immunoluminometry. RESULTS: No significant difference was observed between baseline median serum PCT concentrations in PD and hemodialysis patients; however, in both groups, baseline median PCT concentrations were significantly higher than those of nonuremic controls (p < 0.05). The 16 patients on PD who developed peritonitis had 21 PD peritonitis episodes during the study period. The increased PCT concentration observed at T0 in PD peritonitis episodes decreased with therapy, and this change was statistically significant (p < 0.05). In a receiver operating characteristic curve analysis for peritonitis, the area under the curve (AUC) for PCT was 0.80, which was significantly lower than the AUC for CRP and greater than the AUCs for fibrinogen and ESR. The sensitivity of PCT for peritonitis was lower than the sensitivity of conventional markers of inflammation; however, the specificity of PCT was higher. CONCLUSIONS: Median serum PCT concentration in PD patients was significantly higher than in nonuremic controls but not hemodialysis patients. Serum PCT concentrations may serve as a useful adjunct to traditional markers of inflammation in detecting and monitoring inflammation and peritonitis in PD patients.
