European Journal of Pediatrics

, Volume 151, Issue 5, pp 353–356

Elastase α1 proteinase inhibitor complex, granulocyte count, ratio of immature to total granulocyte count, and C-reactive protein in neonatal septicaemiaproteinase inhibitor complex, granulocyte count, ratio of immature to total granulocyte count, and C-reactive protein in neonatal septicaemia

  • F. K. Tegtmeyer
  • C. Horn
  • A. Richter
  • J. van Wees
Neonatology

DOI: 10.1007/BF02113257

Cite this article as:
Tegtmeyer, F.K., Horn, C., Richter, A. et al. Eur J Pediatr (1992) 151: 353. doi:10.1007/BF02113257
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Abstract

In a prospective study elastase α1-proteinase inhibitor (Eα1PI), polymorphonuclear (PMN) count, the immature to total neutrophil count ratio (I/T ratio), and C-reactive protein (CRP) were analysed in 74 patients (76 cases) with neonatal septicaemia at the time of initial clinical symptoms. At that early stage of the disease, 94% of the patients had abnormal values for Eα1PI, 71% for I/T ratio, 61% for PMN count, and only 54% for CRP. PMN count was a poor indicator of septicaemia. Neutropenia, present in 26% of all patients, was related to normal Eα1PI in only 4 patients. The combined use of Eα1 and I/T ratio was the most sensitive indicator. In all patients irrespective of causative bacteria or disease onset at least one of these parameters was elevated. In early-onset septicaemia (n=31), normal CRP values occurred significantly more often (63%) than in late-onset sepsis (33%). Even in five of the seven fatal cases, initial CRP measurements were normal. The sensitivity of PMN count and I/T ratio did not differ significantly between early-and late-onset septicaemia. Laboratory changes observed in 18 newborns during the first 3 days of the septic episode show that the rate of pathological values for Eα1PI and I/T ratio was highest at the time of initial clinical symptoms and decreased on days 2 and 3. In contrast, CRP reached maximal values as late as day 2 (88% abnormal values), followed by a decrease on day 3. We conclude that the use of Eα1PI may improve the laboratory detection of neonatal septicaemia especially if used in combination with I/T ratio.

Key words

Neonatal septicaemiaElastase α1 proteinase inhibitorGranulocyteC-reactive protein

Abbreviations

CRP

C-reactive protein

1PI

α1-proteinase inhibitor complex

I/T-ratio

ratio of immature to total granulocytes

PMN

polymorphonuclear neutrophil granulocyte

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • F. K. Tegtmeyer
    • 1
  • C. Horn
    • 1
  • A. Richter
    • 2
  • J. van Wees
    • 1
  1. 1.Department of PaediatricsMedical University of LuebeckLübeckFederal Republic of Germany
  2. 2.Department of NeonatologyMedical University of LuebeckLübeckFederal Republic of Germany