Can neutrophil gelatinase-associated lipocalin be a novel and efficient marker to predict the clinical course of acute pancreatitis?

OBJECTIVE: This study aimed to determine the value of serum Neutrophil Gelatinase-Associated Lipocalin (NGAL) levels to predict the severity of the disease and to identify its correlation with White Blood Cell (WBC), C-reactive protein (CRP), and high-sensitivity C-reactive protein (hs-CRP) levels in acute pancreatitis (AP). PATIENTS AND METHODS: The study sample included 86 AP-diagnosed patients in the study group and 77 age- and gender-matched healthy volunteers with no comorbidity in the control group. The WBC, CRP, hs-CRP, and NGAL levels were examined at the time and 24 hours after diagnosis. RESULTS: Between the control group and the study group, a significant difference with and without necrosis in terms of NGAL averages (p=0.003) at the time of admission was observed. The mean level of the 24th-hour NGAL in the study group with necrosis (132.7±11.7 ng/ml) was found to be higher than the mean of the 24th-hour NGAL (117.5±22.6 ng/ml) in the study group without necrosis (p=0.032). Additionally, a significant difference was observed between the control group and the study group with and without necrosis in terms of CRP averages evaluated at admission. When the correlation of NGAL levels with WBC, CRP, and hs-CRP levels at the admission (r=0.224, p=0.038) and at the 24th h (r=0.389, p<0.001) are evaluated, weak correlations between NGAL and WBC levels were identified, but no correlation between NGAL and CRP and hs-CRP levels were observed. CONCLUSIONS: The usability of serum NGAL levels to predict the development of necrotizing pancreatitis in the early period was evaluated. Serum NGAL levels were found to be higher in the study group than in the control group, but there was no statistically significant difference between the mean values of 0th and 24th h NGAL values in any of the groups with/without pancreatic necrosis and the total study group was observed. More research is needed on the subject, with larger sampling sizes.

Spontaneous recovery of pancytopenia in an immunosuppres- sed patient infected with Parvovirus B19.

Abstract: Parvovirus B19 infection can be associated with a wide spec-trum of clinical manifestations that mainly depends on the clinical background of the patient. Infection causes severe aplastic effects on bone marrow in immunosuppressive patients. Our patient was using Azathioprine for Crohn Disease when she admitted with malaise and fatigue laboratory tests revealed pancytopenia due to Parvovirus B19 infection . But contrary to expectations patients pancytopenia improved spontaneously without any treatment. Although intravenous immuno-globulin treatment is a safe approach waiting spontaneous recovery of bone marrow may be risky but another option.

Wernicke-Korsakoff syndrome in a patient with tuberculous peritonitis.

Tuberculous peritonitis is an uncommon type of extrapulmonary tuberculosis and can be present in different and rare conditions. Wernicke-Korsakoff syndrome is a neuropsychiatric disorder due to thiamine deficiency which is caused by poor nutrition for any reason. The relationship between tuberculous peritonitis and the Wernicke-Korsakoff has not been declared yet. Therefore, we aim to report a case of tuberculous peritonitis which presented with Wernicke-Korsakoff syndrome.

Evaluation of pentraxin-3 in familial Mediterranean fever patients during attack and attack-free periods.

INTRODUCTION: Pentraxin-3 (PTX-3) is a prototype of pentraxin proteins that have been shown to be involved in acute phase response. In this study, we aimed to investigate the relationship between PTX-3 levels and familial Mediterranean fever (FMF) disease, and to evaluate PTX-3 as a novel diagnostic marker of FMF. METHOD: Forty-three male patients diagnosed with FMF and 42 healthy individuals were included in the study. Patients with other inflammatory diseases and patients who used drugs having anti-inflammatory properties were excluded from the research. Blood samples were obtained during both attack and attack-free periods. RESULTS: Patient attack periods were confirmed by combining physical examination and elevation of acute phase reactants. Acute phase reactants were significantly higher in attack versus attack-free periods (p < 0.01), however PTX-3 levels were not significantly different between the two periods. Additionally, PTX-3 levels in FMF patients were higher than in controls in both attack (917.29 ± 725.29 vs 451.83 ± 291.95, p < 0.01) and attack-free periods (748.23 ± 487.53 vs 451.83 ± 291.95, p < 0.01). CONCLUSION: In this study, we showed that PTX-3 levels, in both FMF attack and attack-free periods, were significantly higher than in the control group. Finally, PTX-3 may be a promising biomarker for FMF diagnosis and may predict FMF attacks (Tab. 2, Fig. 2, Ref. 18).