Acute phase proteins in serum and cerebrospinal fluid in the course of bacterial meningitis.

We carried out estimations of the following acute phase proteins: C-reactive protein (CRP), alpha-1-antitrypsin (AAT), alpha-1-acid glycoprotein (AAG), alpha-2-ceruloplasmin (CER), and alpha-2-haptoglobin (HPT) in serum and in cerebrospinal fluid (CSF) in patients with bacterial meningitis (BM, n = 30) and viral meningitis (VM, n = 30). We have shown that determinations of concentrations of AAG and CRP in serum and CER in CSF are useful in differentiation between BM and VM. The diagnostic power of these three tests (the areas under their ROC curves equal 0.942, 0.929, and 0.931, respectively) is bigger, though statistically not significantly, than that of traditional parameters of BM in CSF, i.e., total protein concentration and white blood cell count. Determination of AAG, CRP, and AAT in serum is a valuable monitoring marker in the course of BM treatment. Convenience of serum sampling constitutes an advantage over traditional BM parameters in CSF.

[Usefulness of establishing chosen acute phase proteins concentrations in serum and cerebrospinal fluid for differential diagnosis and monitoring of purulent meningitis in adults. I]. / Przydatnosc oznaczania stezen wybranych bialek ostrej fazy w surowicy krwi i plynie mózgowo-rdzeniowym do diagnostyki róznicowej i monitorowania przebiegu ropnych zapalen opon mózgowo-rdzeniowych u doroslych. I. Stezenie bialek ostrej fazy w surowicy krwi.

40 adult patients were examined: 24 with purulent meningitis and 16 with lymphocytic meningitis. The control group consisted of 100 healthy people. In purulent meningitis patients in the 1st, 3rd, 5th, 7th, 14th and 28th day of the disease, concentrations of the following acute phase proteins were measured in serum: C-reactive protein, alpha 1-antitripsin, alpha 1-orosomucoid, alpha 2-ceruloplasmin, alpha 2-macroglobulin and alpha 2-haptoglobin. In lymphocytic meningitis patients concentrations of the above mentioned acute phase proteins were measured only in the 1st day of the disease. Usefulness of establishing alpha 2-haptoglobin, alpha 1-antitripsin, alpha 2-ceruloplasmin and particularly C-reactive protein concentrations for differential diagnosis of purulent and lymphatic meningitis was proved. Evaluation of C-reactive protein and alpha 1-antitripsin concentration kinetics proved to be fully useful for monitoring of seriousness of the course of purulent meningitis, and together with evaluation of the clinical condition of the patient it can constitute a valuable marker of effectiveness of the disease treatment.

[Usefulness of establishing chosen acute phase proteins concentrations in serum and cerebrospinal fluid for differential diagnosis and monitoring of purulent meningitis in adults. II]. / Przydatnosc oznaczania stezen wybranych bialek ostrej fazy w surowicy krwi i plynie mózgowo-rdzeniowym do diagnostyki róznicowej i monitorowania przebiegu ropnych zapalen opon mózgowo-rdzeniowych u doroslych. II. Stezenie bialek ostrej fazy w plynie mózgowo-rdzeniowym.

40 adult patients were examined: 24 with purulent meningitis and 16 with lymphocytic meningitis. In the course of purulent meningitis concentrations of the following acute phase proteins were measured in the cerebrospinal fluid: C-reactive protein, alpha 1-antitripsin, alpha 1-orosomucoid, alpha 2-ceruloplasmin, alpha 2-macroglobulin and alpha 2-haptoglobin in the 1st, 3rd, 5th, 7th, 14th and 28th day of the disease. In lymphocytic meningitis patients concentrations of the above mentioned acute phase proteins were measured only in the 1st day of the disease. Full usefulness of establishing concentrations of all the above mentioned acute phase proteins within the first five days of the purulent meningitis for differential diagnosis of purulent and lymphatic meningitis was proved. Evaluation of concentration kinetics of acute phase proteins in cerebrospinal fluid for monitoring of the course of purulent meningitis is of a limited value.

Hemodialysis and the acute-phase response in chronic uremic patients.

In comparison with healthy persons, chronic uremic patients on regular hemodialysis treatment had significantly higher blood serum concentrations of alpha 1-acid glycoprotein, ceruloplasmin and C4 complement component, while levels of haptoglobin, C3 and transferrin were lower. Serum alpha 2-macroglobulin and alpha 1-antitrypsin levels were similar in both groups. Hemodialysis with cuprophan membrane induced only slight changes in some of these glycoproteins during a 48-hour follow-up period. Seven hours after termination of hemodialysis slight, but significant, decreases in blood serum transferrin and alpha 1-antitrypsin concentrations were observed. Hemodialysis thus does not seem to induce a conspicuous acute-phase reaction.