×
Home Current Archive Editorial board
News Contact
Research paper

Efficiency of Fetuin-A and Procalcitonin in the Diagnosis of Infection in Patients with Febrile Seizure

By
Hussein Kadhem Al-Hakeim ,
Hussein Kadhem Al-Hakeim
Azhar Mohammed Al-Ankoshy ,
Azhar Mohammed Al-Ankoshy
Mohammed-R. Alsharifi
Mohammed-R. Alsharifi

Abstract

Summary Fetuin-A is a negative acute phase reactant, while procalcitonin is an indicator of severe bacterial infection. Diagnosis of bacterial infection in febrile seizure (FS) is important for choosing the most suitable treatment. In this study, serum fetuin-A was estimated, for the first time, in the inpatients with FS and compared with procalcitonin and blood culture tests. A total of 60 children (28 male and 32 female) with FS in addition to 30 sex- and age-matched children participated in the study. Patients were classified according to sex, age, PCT level (high PCT>0.5ng/mL), C-reactive protein (CRP, positive >6mg/L), and according to the results of the blood culture. Fetuin-A level decreased and PCT level increased in FS patients in comparison to those in the control group. These changes are significantly increased (p<0.05) in the positive CRP group compared with that of the negative CRP group. Kernel density estimation showed that procalcitonin is a better indicator of the infection in FS children than fetuin-A . Procalcitonin is more sensitive and specific than fetuin-A and when used together they produce 100% sensitivity and specificity for the diagnosis of bacterial infection in FS patients. Fetuin-A is low in FS patients and can be used with procalcitonin in the diagnosis of bacterial infection in FS.

References

1.
Oncu K, Yazgan Y, Tanoglu A, Kaplan M, Ermis F, Ipcioglu OM, et al. Can Serum Fetuin-A Be Regarded as an Inflammatory Marker Among Patients with Familial Mediterranean Fever? Digestive Diseases and Sciences. 2013;58(11):3212–7.
2.
Wang H, Zhang M, Soda K, Sama A, Tracey KJ. Fetuin protects the fetus from TNF. The Lancet. 1997;350(9081):861–2.
3.
Phillips RS, Wade R, Lehrnbecher T, Stewart LA, Sutton AJ. Systematic review and meta-analysis of the value of initial biomarkers in predicting adverse outcome in febrile neutropenic episodes in children and young people with cancer. BMC Medicine. 2012;10(1).
4.
Chen R, Wang Z. Curve Fitting of the Corporate Recovery Rates: The Comparison of Beta Distribution Estimation and Kernel Density Estimation. PLoS ONE. 8(7):e68238.
5.
Wigger M, Schaible J, Muscheites J, Kundt G, Haffner D, Fischer DC. Fetuin-A serum concentrations in healthy children. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine. 2009;46(6):511–3.
6.
Abiodun PhO, Olomu IN. Alpha2 HS-Glycoprotein Levels in Children with Protein-Energy Malnutrition and Infections. Journal of Pediatric Gastroenterology and Nutrition. 1987;6(2):271–5.
7.
Hessel EVS, Wit M, Wolterink‐Donselaar IG, Karst H, Graaff E, Lith HA, et al. Identification ofSrp9as a febrile seizure susceptibility gene. Annals of Clinical and Translational Neurology. 2014;1(4):239–50.
8.
Arai T, Kumasaka K, Nagata K, Okita T, Oomura T, Hoshiai A, et al. Prediction of blood culture results by measuring procalcitonin levels and other inflammatory biomarkers. The American Journal of Emergency Medicine. 2014;32(4):330–3.
9.
Hattori T, Nishiyama H, Kato H, Ikegami S, Nagayama M, Asami S, et al. Clinical Value of Procalcitonin for Patients With Suspected Bloodstream Infection. American Journal of Clinical Pathology. 2014;141(1):43–51.
10.
Moreira VG, Prieto B, Rodríguez JSM, Álvarez FV. Usefulness of cell-free plasma DNA, procalcitonin and C-reactive protein as markers of infection in febrile patients. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine. 2010;47(3):253–8.
11.
Brylka L, Jahnen-Dechent W. The Role of Fetuin-A in Physiological and Pathological Mineralization. Calcified Tissue International. 2013;93(4):355–64.
12.
Smith ER, Cai MM, McMahon LP, Pedagogos E, Toussaint ND, Brumby C, et al. Serum fetuin‐<scp>A</scp> concentration and fetuin‐<scp>A</scp>‐containing calciprotein particles in patients with chronic inflammatory disease and renal failure. Nephrology. 2013;18(3):215–21.
13.
Luaces-Cubells C, Mintegi S, García-García JJ, Astobiza E, Garrido-Romero R, Velasco-Rodríguez J, et al. Procalcitonin to Detect Invasive Bacterial Infection in Non–Toxic-appearing Infants With Fever Without Apparent Source in the Emergency Department. Pediatric Infectious Disease Journal. 2012;31(6):645–7.
14.
Al-Hakeim H, Al-Hillawi Z, Al-Kindi M. Procalcitonin, Calcium, and Magnesium in Patients with Febrile Seizure during One-Hour Attack. British Journal of Medicine and Medical Research. 6(6):617–24.
15.
TEACH SJ, GEIL PA. Incidence of bacteremia, urinary tract infections, and unsuspected bacterial meningitis in children with febrile seizures. Pediatric Emergency Care. 1999;15(1):9–12.
16.
Heiss A, Eckert T, Aretz A, Richtering W, van Dorp W, Schäfer C, et al. Hierarchical Role of Fetuin-A and Acidic Serum Proteins in the Formation and Stabilization of Calcium Phosphate Particles. Journal of Biological Chemistry. 2008;283(21):14815–25.
17.
Xu RY, Liu HW, Liu JL, Dong JH. Procalcitonin and C-reactive protein in urinary tract infection diagnosis. BMC Urology. 2014;14(1).
18.
Moe SM, Chen NX. Inflammation and Vascular Calcification. Blood Purification. 2005;23(1):64–71.
19.
Kasem AJ, Bulloch B, Henry M, Shah K, Dalton H. Procalcitonin as a Marker of Bacteremia in Children With Fever and a Central Venous Catheter Presenting to the Emergency Department. Pediatric Emergency Care. 2012;28(10):1017–21.
20.
Kitanovski L, Jazbec J, Hojker S, Derganc M. Diagnostic accuracy of lipopolysaccharide-binding protein for predicting bacteremia/clinical sepsis in children with febrile neutropenia: comparison with interleukin-6, procalcitonin, and C-reactive protein. Supportive Care in Cancer. 2014;22(1):269–77.
21.
Ohnishi T, Nakamura O, Ozawa M, Arakaki N, Muramatsu T, Daikuhara Y. Molecular cloning and sequence analysis of cDNA for a 59 kD bone sialoprotein of the rat: Demonstration that it is a counterpart of human α2-HS glycoprotein and bovine fetuin. Journal of Bone and Mineral Research. 1993;8(3):367–77.
22.
Markic J, Jeroncic A, Polancec D, Bosnjak N, Markotic A, Mestrovic J, et al. CD15s is a potential biomarker of serious bacterial infection in infants admitted to hospital. European Journal of Pediatrics. 2013;172(10):1363–9.
23.
Tsalkidou EA, Roilides E, Gardikis S, Trypsianis G, Kortsaris A, Chatzimichael A, et al. Lipopolysaccharide-binding protein: a potential marker of febrile urinary tract infection in childhood. Pediatric Nephrology. 2013;28(7):1091–7.
24.
Haeusler GM, Carlesse F, Phillips RS. An Updated Systematic Review and Meta-analysis of the Predictive Value of Serum Biomarkers in the Assessment of Fever During Neutropenia in Children With Cancer. Pediatric Infectious Disease Journal. 2013;32(10):e390–6.
25.
Bell CW, Jiang W, Reich CF, Pisetsky DS. The extracellular release of HMGB1 during apoptotic cell death. American Journal of Physiology-Cell Physiology. 2006;291(6):C1318–25.
26.
Stöcklin B, Fouzas S, Schillinger P, Cayir S, Skendaj R, Ramser M, et al. Copeptin as a Serum Biomarker of Febrile Seizures. PLOS ONE. 10(4):e0124663.
27.
Patterson JL, Carapetian SA, Hageman JR, Kelley KR. Febrile Seizures. Pediatric Annals. 2013;42(12).
28.
Dubreuil JD, Giudice GD, Rappuoli R. Helicobacter pylori            Interactions with Host Serum and Extracellular Matrix Proteins: Potential Role in the Infectious Process. Microbiology and Molecular Biology Reviews. 2002;66(4):617–29.
29.
Becker KL, Snider R, Nylen ES. Procalcitonin assay in systemic inflammation, infection, and sepsis: Clinical utility and limitations. Critical Care Medicine. 2008;36(3):941–52.
30.
Shah SS, Alpern ER, Zwerling L, Reid JR, McGowan KL, Bell LM. Low Risk of Bacteremia in Children With Febrile Seizures. Archives of Pediatrics &amp; Adolescent Medicine. 2002;156(5):469.
31.
Wang H, E. Sama A. Anti-Inflammatory Role of Fetuin-A in Injury and Infection. Current Molecular Medicine. 2012;12(5):625–33.
32.
Yo CH, Hsieh PS, Lee SH, Wu JY, Chang SS, Tasi KC, et al. Comparison of the Test Characteristics of Procalcitonin to C-Reactive Protein and Leukocytosis for the Detection of Serious Bacterial Infections in Children Presenting With Fever Without Source: A Systematic Review and Meta-analysis. Annals of Emergency Medicine. 2012;60(5):591–600.
33.
Lü X, Liu Y, Wang X, Qu J. Evaluation of procalcitonin, C-reactive protein, interleukin-6 &amp; serum amyloid A as diagnostic biomarkers of bacterial infection in febrile patients. Indian Journal of Medical Research. 2015;141(3):315.
34.
Haberlandt E, Rauchenzauner M, Morass M, Wondrak P, Bürgi SS, Rostásy K, et al. Matrix-metalloproteinases and proinflammatory cytokines in children with febrile convulsions and epilepsy—Cause or consequence? Epilepsy Research. 2013;105(1–2):225–8.
35.
Daveau M, Christian-Davrinche, Julen N, Hiron M, Amaud P, Lebreton JP. The synthesis of human α‐2‐HS glycoprotein is down‐regulated by cytokines in hepatoma HepG2 cells. FEBS Letters. 1988;241(1–2):191–4.
36.
Yang H, Ochani M, Li J, Qiang X, Tanovic M, Harris HE, et al. Reversing established sepsis with antagonists of endogenous high-mobility group box 1. Proceedings of the National Academy of Sciences. 2004;101(1):296–301.

Citation

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.