title: Acute phase proteins as markers of systemic illness in acute diarrhoea.
abstract: Fifty-seven Tanzanian children, 6-25 months, hospitalized with acute diarrhoea were grouped according to whether there was clinical evidence of systemic infection (SI) (n = 35) or not (n = 22). Serum acute phase proteins were measured in samples taken within 48 h of admission. Means for C-reactive protein (CRP) and serum amyloid A (SAA) were significantly higher in children with SI compared to those without (geometric means (95% CI); CRP, mg/l: 22.1 (13.6-35.5) vs. 7.4 (4.4-12.4); SAA, mg/l: 12.2 (6.8-22.1) vs. 4.9 (2.5-9.7)). Levels of alpha1-acid glycoprotein were similar in both groups (1.16 g/l (0.95-1.43) vs. 1.04 (0.83-1.29), respectively). CRP > or =30 mg/l had a positive predictive value of 95%, and specificity of 96% for correctly identifying SI, but a low sensitivity (51%) and negative predictive value (55%). Clinical outcome of diarrhoea was worse in children with SI: more needed intravenous fluids (23% vs. 5%), the duration of diarrhoea was longer (59.4 vs. 34.2 h) and mortality was higher (6% vs. 0%). APPs were not found to be useful markers of systemic illness in acute diarrhoea in this population.
authors.affiliation: Centre for International Child Health, Institute of Child Health, London, UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Darling
authors.forename: S M
authors.initials: SM
authors.lastname: Filteau
authors.forename: J A
authors.initials: JA
authors.lastname: Kitundu
authors.forename: R R
authors.initials: RR
authors.lastname: Kingamkono
authors.forename: A E
authors.initials: AE
authors.lastname: Msengi
authors.forename: A M
authors.initials: AM
authors.lastname: Tomkins
mesh_terms: D000208:Acute Disease; D000209:Acute-Phase Proteins / Q000032:analysis*; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002675:Child, Preschool; D003967:Diarrhea / Q000097:blood* / Q000150:complications* / Q000276:immunology; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood* / Q000150:complications* / Q000276:immunology; D013636:Tanzania; D013997:Time Factors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers