Probable role of Brain Natriuretic Peptide (BNP) in lung hypertension secondary to scleroderma

BACKGROUND Scleroderma, when complicated with pulmonary hypertension (PHT), presents a worse prognosis; recently treatment with new drugs seems to offer good perspectives, especially in early diagnosis and treatment. The standard approach for diagnosing PHT consists in measurement of the pulmonary artery pressure (PAP) by means of echodoppler. AIM OF INVESTIGATION Aim of this work is evaluating the significance of the NT-proBNP parameter, matched to echodoppler, in diagnosing scleroderma PHT. MATERIALS AND METHODS Sixty (60) patients, who came to observation for progressive systemic sclerosis underwent echodoppler in order to measure the PAP (normal values up to 30 mmHg). NT-proBNP was determined on serum sample using ECLIA method by Modular E170 (Roche Diagnostics); manufacturer reference values for age and gender were used. Forty-three (43) patients underwent a further NT-proBNP sampling 5 days later in order to assess parameter stability. RESULTS PHT and non- PHT patients showed statistically different (p < 0,001) medians (126 vs 69 pg/ml). No pathologic values of NT-proBNP were measured in the group with PAP < 30 mmHg, while 27% of cases who had PAP between 30 and 40 showed pathologic concentrations. The positivity ratio increases to 57% in patients showing PAP > 40 mmHg. No relevant correlation (r = 0,2) was found between PAP and NT-proBNP. Mean average between the two sampling groups was 31%. CONCLUSIONS In scleroderma patients, combination of NT-proBNP and PAP seems to improve the diagnosis of pulmonary hypertension, especially in presence of borderline pulmonary pressure values. We therefore propose the biochemical observation of NT-proBNP when PAP is > 30 mmHg and in monitoring the evolution of the pathology

Fecal calprotectin levels in patients with colonic polyposis

Context: The usefulness of stool calprotectin determination in diagnosis of inflammatory disease of the colon has been reported; information about its usefulness for patients with polyposis are scarce, however. Objective: To evaluate the significance of stool calprotectin concentrations for patients affected by colonic polyposis. Patients: Sixty-three consecutive patients (35 males, 28 females, mean age 60.3 years, range 39-78 years) were enrolled: 26 patients (41.3%) with polyps, 17 patients (27.0%) with asymptomatic diverticular disease, and 20 subjects (31.7%) with normal endoscopic appearance of the colon. Results: Stool calprotectin concentrations were 17.4 \ub1 24.5 \u3bcg g-1 for patients with colonic polyposis, significantly higher than concentrations for patients with diverticulosis (7.1 \ub1 5.7 \u3bcg g -1; P = 0.026) or for patients with normal appearance of the colon (calprotectin 6.0 \ub1 5.8 \u3bcg g-1; P = 0.003). For patients with a single polyp, stool calprotectin concentrations were similar to those for patients with multiple polyps. Calprotectin fecal concentrations for patients with sessile polyps and those with flat polyps were not significantly different. Calprotectin concentrations were not significantly related to the size of the polyps. Conclusion: Our data show that colonic polyposis may cause an increase in stool calprotectin values and that these colonic lesions should be suspected when elevated stool calprotectin concentrations are found

Fecal Calprotectin Levels in Patients with Colonic Polyposis

Context: The usefulness of stool calprotectin determination in diagnosis of inflammatory disease of the colon has been reported; information about its usefulness for patients with polyposis are scarce, however. Objective: To evaluate the significance of stool calprotectin concentrations for patients affected by colonic polyposis. Patients: Sixty-three consecutive patients (35 males, 28 females, mean age 60.3 years, range 39-78 years) were enrolled: 26 patients (41.3%) with polyps, 17 patients (27.0%) with asymptomatic diverticular disease, and 20 subjects (31.7%) with normal endoscopic appearance of the colon. Results: Stool calprotectin concentrations were 17.4 ± 24.5 μg g-1 for patients with colonic polyposis, significantly higher than concentrations for patients with diverticulosis (7.1 ± 5.7 μg g -1; P = 0.026) or for patients with normal appearance of the colon (calprotectin 6.0 ± 5.8 μg g-1; P = 0.003). For patients with a single polyp, stool calprotectin concentrations were similar to those for patients with multiple polyps. Calprotectin fecal concentrations for patients with sessile polyps and those with flat polyps were not significantly different. Calprotectin concentrations were not significantly related to the size of the polyps. Conclusion: Our data show that colonic polyposis may cause an increase in stool calprotectin values and that these colonic lesions should be suspected when elevated stool calprotectin concentrations are found

CA-125 in benign and malignant diseases involving coelomic epithelium

The presence of CA-125 (cut-off 35 U/ml) was assessed in serum from 263 neoplastic and 65 non neoplastic patients and in the pleural or ascitic fluid from 84 of them (49 neoplastic and 35 non neoplastic). Tumors (including mesotheliomas, mucinous and non-mucinous ovarian carcinomas, primitive and metastatic cancers of lung and liver and of the digestive tract) were staged according to TNM and FIGO classification and the tumors with peritoneal or pleural effusion considered apart. Non malignant patients had liver cirrhosis, lung inflammation and effusions due to heart failure. CA-125 was positive in most of the sera from patients with ovarian cancer and benign and malignant serous involvement; high concentrations were found in all examined effusions. The relationship between development of serous effusion and the increasing level of serum CA-125 could explain the abnormal serum concentrations found in diseases with peritoneal or pleural involvement. This could also explain the increased levels of CA-125 and ovarian carcinoma (including mucinous) progression which may extend resulting in peritoneal localization. Elevation of serum CA-125 may be expected in patients with all types of diseases affecting peritoneum and pleura and this marker may be used in the follow-up of epithelial ovarian carcinomas as well as of tumors involving coelomic epithelium

Tumour associated antigens CA 15.3 and CA 125 in ovarian cancer.

CA 125 and CA 15.3 antigens were determined by enzyme immunoassay in 78 patients with ovarian cancer for a total of 540 determinations. The antigens were also investigated in sera from 100 women with other gynaecological diseases, 82 lung cancer patients and in 39 pleural fluids of varying origin. CA 15.3 reference values were evaluated in 91 healthy women (cut-off: 25 U/ml). CA 15.3 sensitivity at diagnosis (60%) and for detecting relapse (44%) was lower than that of CA 125 (90% and 64.7%, respectively). However, CA 15.3 does not increase with aspecific mesothelial cell reaction and thus it is more specific than CA 125. Combined use of the markers during follow-up improves early detection of relapse (at least one of the two was positive in 79% of cases). Therefore both CA 15.3 and CA 125 should be routinely determined for the detection and monitoring of ovarian cancer

Fatal Ceftriaxone-induced hemolysis in a child with congenital cytomegalovirus infection

A 7-year-old girl with congenital Cytomegalovirus infection had a massive, fatal intravascular hemolysis after intravenous administration of ceftriaxone. Laboratory studies confirmed the presence of antibodies against ceftriaxone in the serum and on the patient's red blood cells. No evidence of sepsis or anaphylaxis was found

Utilit\ue0 e limiti dei markers CA 125, CA 15-3, CA 50 nei carcinomi epiteliali dell\u2019ovaio.

Utilit\ue0 e limiti dei markers CA 125, CA 15-3, CA 50 nei carcinomi epiteliali dell\u2019ovaio