International Orthopaedics

, Volume 18, Issue 6, pp 352–355 | Cite as

PMN elastase in bone and joint infections

  • K. M. Peters
  • K. Koberg
  • T. Rosendahl
  • H. D. Haubeck
Article

Summary

PMN (polymorphonuclear neutrophil) elastase is a proteolytic enzyme which is a biochemical marker for abnormal granulocyte stimulation. In inflammation and sepsis, excessive neutrophil stimulation results in significant amounts of PMN elastase being released into the plasma which indicates the severity of the disease and its prognosis. In 62 patients with osteomyelitis or suppurative arthritis, PMN elastase had a diagnostic sensitivity of 81%, which is comparable to the nonspecific erythrocyte sedimentation rate. Sensitivity of C-reactive protein (CRP) was 71%, fibrinogen 54% and leucocyte count 26%. PMN elastase was also useful in the follow up of patients with bone and joint infections; in the early post-operative period it became normal more quickly than the other findings unless the patients developed complications. Ten days after operation, PMN elastase was normal in 75% of the patients compared to the CRP which became normal in only 25%. Later both results were similar: on discharge from hospital, PMN elastase was normal in 77% and CRP in 71%.

Résumé

La PMN élastase, enzyme protéolytique, est un marqueur biochimique de la stimulation granulocytaire pathologique. En cas d'inflammation ou d'infection il se produit une stimulation neutrophile excessive. La PMN élatase est libérée dans le plasma en quantités significativement importantes susceptibles de renseigner sur la sévérité de la maladie et sur le pronostic. Chez 62 patients atteints d'ostéomyélite ou d'arthrite septique, le taux de PMN élastase a atteint une sensibilité diagnostique de 81%, n'étant dépassé que par la vitesse de sédimentation érythrocytaire non spécifique (sensibilité de 90%). Les sensibilités des autres paramétres d'inflammation étaient plus basses: C-réactive protéine (CRP) 71%, fibrinogène 54% et numération leucocytaire 26%. Dans le cadre de la surveillance post-opératoire, chez les patients présentant des infections osseuses et articulaires, la mesure du taux de PMN élastase revient plus vite à la normale que ceux des autres paramètres, sauf en cas de complications. Au 10è jour post-opératoire, la PMN élastase était normale dans 75% des cas, la CRP dans 25%. Ultérieurement les deux paramétres évoluent de façon similaire: à la sortie des malades les taux de PMN élastase étaient normaux dans 77% des cas, ceux de CRP dans 71% des cas.

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Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • K. M. Peters
    • 1
  • K. Koberg
    • 1
  • T. Rosendahl
    • 1
  • H. D. Haubeck
    • 2
  1. 1.Department of Orthopaedic SurgeryRWTHAachenGermany
  2. 2.Institute of Clinical Chemistry and PathobiochemistryRWTHAachenGermany
  3. 3.Orthopädische Klinik, Klinikum IngolstadtIngolstadtGermany

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