Soluble CD40 ligand in prediction of acute severe pancreatitis.
OBJECTIVE
To assess the early predictability of the soluble CD40L (sCD40L) in pancreatitis severity.


METHODS
Between February 2000 and February 2003, 279 consecutive patients with acute pancreatitis were prospectively enrolled in our study. In this report, 40 patients with mild and 40 patients with severe pancreatitis were randomly studied. sCD40L concentrations were measured 48 hours after admission.


RESULTS
sCD40L levels were significantly higher 48 hours after admission in severe pancreatitis than in mild pancreatitis. Using a cutoff of 1000 pg/L, the sensitivity and specificity of sCD40L to detect a severe course of the disease were 78% and 62% respectively compared to 72% and 81% for CRP. Logistic regression analysis found that CRP was the only statistically significant marker able to detect a severe course of the disease.


CONCLUSIONS
These findings indicate that CRP remains a valuable marker to determine the severity and prognosis of acute pancreatitis whereas sCD40L levels should be assessed in further studies.
Division of Gastroenterology, Geneva University Hospital, 1211 Genève 14, Switzerland. jean-louis.frossard@hcuge.ch
Jean Louis
JL
Frossard
Philippe
P
Morel
Brenda
B
Kwak
Catherine
C
Pastor
Thierry
T
Berney
Léo
L
Buhler
Alain
A
Von Laufen
Sandrine
S
Demulder
François
F
Mach
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D019013:CD40 Antigens / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D019013:CD40 Antigens; D002097:C-Reactive Protein