[Levels of fibrinogen compared to crp in plasma as new marker in diagnosis of pulmonary edema of non septic origin].
BACKGROUND
Community-acquired pneumonia, that requires hospitalization, is a severe illness with high mortality rates, especially in cases of delay of appropriate treatment. At times, the correct diagnosis of the disease is difficult due to equivocal clinical picture or chest film, accompanying diseases that could mask or simulate the pneumonia.


OBJECTIVE
1. follow-up levels of fibrinogen throughout hospitalization in the group of patients admitted to the hospital due to pneumonia and pulmonary edema of non-infectious origin; 2. an estimation opportunity using them as possible new markers for diagnosis of pneumonia and for following response to treatment.


METHODS
Three groups of patients were studied: a group of 15 patients admitted due to pneumonia, a group of 15 patients admitted due to pulmonary edema, and a control group 15 healthy subjects. The blood samples for white blood cells count, erythrocyte sedimentation rates, levels of fibrinogen, C-reactive protein, albumin, were taken for each patient on admission, 48 and 72 hours following admission and on discharge day. The received dates were compared using Student t-test.


RESULTS
The levels of fibrinogen were higher on admission, in the patients with pneumonia, maximally after 48 and 72 hours (P<0.001) in comparison to the control group. In pulmonary edema the fibrinogen levels were also high but less than those with pneumonia (P=0.0044), with gradual declining throughout hospitalization period (P> 0.027 for both groups in discharge day). The comparison of fibrinogen levels between groups of patients with pneumonia and pulmonary edema reveal statistically significant results at time of admission, after 48 and 72 hours but not on discharge day.


CONCLUSIONS
Fibrinogens can be used as reliable markers for primary diagnosing of pneumonia or differential diagnosis from pulmonary edema, on admission and until 72 hours but not for patient follow-up throughout hospitalization period. Additional studies are needed for discovering other new markers for patient follow-up throughout hospitalization period.
Farah
Raymond
R
Internal Medicine F, Western Galilee Hospital-Nahariya. Raymond.Farah@naharia.health.gov.il
Makhoul
Nicola
N
D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D011654:Pulmonary Edema / Q000097:blood* / Q000175:diagnosis*; D012016:Reference Values; D012709:Serum Albumin / Q000378:metabolism
D015415:Biomarkers; D012709:Serum Albumin; D005340:Fibrinogen; D002097:C-Reactive Protein