title: Association of in vitro oxidative stress, serum ferritin concentration and C-reactive protein in febrile emergency room patients.
abstract: BACKGROUND
  Both C-reactive protein (CRP) and ferritin have been reported to reflect the extent of oxidative stress and inflammation in individual patients and may be useful markers of disease activity and mortality risk. Exposure to oxidative stress has been reported to increase ferritin synthesis. We investigated the relationship between oxidative stress with CRP and ferritin concentrations in febrile emergency room patients to test the hypothesis whether the intensity of oxidative stress correlated with serum ferritin concentration.
  
  
  METHODS
  Six normal healthy volunteers and 59 emergency room, febrile patients with body temperature >38.3 we enrolled before receiving medical treatment. Baseline measurements included complete blood count, blood biochemistry, CRP and serum ferritin concentrations, and transferring saturation (TSAT). The intensity of lucigenin-enhanced chemiluminescence (LucCL), corresponding to the level of superoxide, was detected by luminometer.
  
  
  RESULTS
  In febrile patients, plasma LucCL intensity was higher than in normal healthy volunteers (P<0.05). The group with bacterial infection had higher serum ferritin (319.4+/-53.7 vs 102.0+/-21.2 ng/dL, P<0.05) and CRP concentrations (7.2+/-1.2 vs 2.2+/-0.6 mg/dL; P<0.05) than the group without bacterial infection. There were no differences in leukocytes (9790+/-606 vs 9577+/-656 /mm3) or plasma LucCL intensity (423.7+/-10.8 vs 409.5+/-6.9 relative light unit?RLU?;) between the two groups. LucCL intensity showed no correlation with serum ferritin concentration (r= -0.0599, P>0.05), TSAT(r= -0.0592, P>0.05), CRP(r= 0.1027, P>0.05) and absolute neutrophil counts (r= 0.1059; P >0.05).
  
  
  CONCLUSIONS
  In this sample of emergency room febrile patients, plasma LucCL intensity was higher than in normal healthy control volunteers. A single point measurement of oxidative stress, particularly plasma LucCL intensity, may not be sufficient to differentiate the origin of fever in febrile patients. These data demonstrate that patients with bacterial infection had increased levels of CRP and ferritin, but this was not associated with LucCL intensity.
authors.affiliation: Department of Emergency Medicine, Taipei-Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hsien-Hao
authors.initials: HH
authors.lastname: Huang
authors.forename: Horng-Chin
authors.initials: HC
authors.lastname: Yan
authors.forename: Chih-Lu
authors.initials: CL
authors.lastname: Han
authors.forename: Fu-Chiu
authors.initials: FC
authors.lastname: Yu
authors.forename: Woei-Yau
authors.initials: WY
authors.lastname: Kao
authors.forename: Wei-Teing
authors.initials: WT
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D004630:Emergencies; D004636:Emergency Service, Hospital; D005260:Female; D005293:Ferritins / Q000097:blood*; D005334:Fever / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007239:Infections; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D013624:Taiwan
chemical_list: D002097:C-Reactive Protein; D005293:Ferritins