Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Kaufmann, P; Demel, U; Tilz, GP; Krejs, GJ.
Time course of plasma soluble intercellular adhesion molecule-1 (sICAM-1) is related to severity of acute pancreatitis.
Hepatogastroenterology. 1999; 46(28):2565-2571
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Demel Ulrike
- Krejs Günter Josef
- Tilz Gernot
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- Abstract:
- BACKGROUND/AIMS: In severe acute pancreatitis the release of cytokines indicates a key step from local to systemic inflammation. Increased plasma concentrations of circulating soluble intercellular adhesion molecule-1 (sICAM-1), a marker of leukocyte activation, were detected in necrotizing pancreatitis at the time of diagnosis, however, the exact role of sICAM-1 in the development of complications such as shock or organ dysfunction is unclear. Therefore, we investigated in what manner the time course of plasma sICAM-1 is associated with the development of severe pancreatitis and whether these results are of any predictive value for the further course of the disease. METHODOLOGY: In a medical intensive care unit we studied 29 consecutive patients admitted for acute pancreatitis. Plasma levels of sICAM-1 were measured serially over a period of 6 days and the time courses were assigned either to a group of patients with uncomplicated, mild disease or to patients who developed complications including multiple organ failure. RESULTS: In mild pancreatitis, decreasing and peak sICAM-1 concentrations were found in 88% of the patients with a mean maximal level of 574 +/- 59ng/ml (SE) (upper limit of normal: 400ng/ml) on day 1. Partial pancreatic necrosis was present in 24% and no deaths were observed. In severe pancreatitis an increase of sICAM-1 levels or an initial fall followed by an increase (relapsing response) was the predominant pattern (92%). Maximal values of 1453 +/- 136ng/ml occurred on day 6, significantly different when compared to mild disease (p<0.0001). Necrotizing pancreatitis was diagnosed in 75% and the mortality rate was 58%. The sensitivity in predicting severe pancreatitis using sICAM-1 plasma levels with an increasing or relapsing pattern was much higher (92%) when compared with serial C-reactive protein measurements (42%). CONCLUSIONS: In acute pancreatitis, increasing or relapsing plasma levels of sICAM-1 over 6 days after admission to hospital are associated with a high rate of pancreatic necrosis and a high mortality. Daily measurements of sICAM-1 would allow early recognition of patients prone to develop complications and follow a severe course.
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Biological Markers - blood
- C-Reactive Protein - analysis
- Female -
- Humans -
- Intercellular Adhesion Molecule-1 - blood
- Male -
- Middle Aged -
- Pancreatitis - blood Pancreatitis - complications Pancreatitis - diagnosis
- Pancreatitis, Acute Necrotizing - blood Pancreatitis, Acute Necrotizing - diagnosis
- Prospective Studies -
- Sensitivity and Specificity -
- Find related publications in this database (Keywords)
- Sicam-1
- Acute Pancreatitis
- Severity of Disease