title: Long pentraxin PTX3 is associated with mortality and disease severity in severe Leptospirosis.
abstract: OBJECTIVE
  To evaluate the long pentraxin PTX3 in patients with severe leptospirosis and to compare the results with the widely used short pentraxin C-reactive protein and the pro-inflammatory cytokines IL-6 and IL-8.
  
  
  METHODS
  This observational cohort study was carried out in Semarang, Indonesia, where leptospirosis is endemic and mortality is high. Consecutive patients with severe leptospirosis were sampled on admission and during follow-up.
  
  
  RESULTS
  A total number of 52 patients entered the study, the mortality was 27%. Severe leptospirosis patient yielded elevated plasma PTX3 levels. PTX3 correlated with IL-8 and to a lesser extent with CRP and IL-6 levels. High levels of PTX3, IL-6 and IL-8 were associated with mortality (OR 5.6, 95%CI: 1.2-26; OR 3.2, 95%CI: 1.2-8.1; OR 6.5, 95%CI: 1.5-28). Moreover, PTX3 levels were associated with disease severity (OR 9.5; 95%CI: 2.9-45). This association was unique, since none of the other markers showed this relation. C-reactive protein was not able to differentiate the severe from the severest cases.
  
  
  CONCLUSIONS
  The long pentraxin PTX3 is elevated in patients with severe leptospirosis and is associated with fatal disease and disease severity. PTX3 may be used as a marker to monitor disease severity in severe leptospirosis or predict outcome.
authors.affiliation: Slotervaart Hospital, Department of Internal Medicine (9B), Louwesweg 6, 1066 EC, Amsterdam, The Netherlands. jfpwagenaar@hotmail.com
authors.forename: Jiri F P
authors.initials: JF
authors.lastname: Wagenaar
authors.forename: Marga G A
authors.initials: MG
authors.lastname: Goris
authors.forename: M Hussein
authors.initials: MH
authors.lastname: Gasem
authors.forename: Bambang
authors.initials: B
authors.lastname: Isbandrio
authors.forename: Federica
authors.initials: F
authors.lastname: Moalli
authors.forename: Alberto
authors.initials: A
authors.lastname: Mantovani
authors.forename: Kimberly R
authors.initials: KR
authors.lastname: Boer
authors.forename: Rudy A
authors.initials: RA
authors.lastname: Hartskeerl
authors.forename: Cecilia
authors.initials: C
authors.lastname: Garlanda
authors.forename: Eric C M
authors.initials: EC
authors.lastname: van Gorp
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D007214:Indonesia; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007922:Leptospirosis / Q000097:blood* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D018805:Sepsis / Q000097:blood / Q000401:mortality; D000683:Serum Amyloid P-Component / Q000378:metabolism*; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood / Q000401:mortality; D000099153:Pentraxins
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D015850:Interleukin-6; D016209:Interleukin-8; D000683:Serum Amyloid P-Component; D000099153:Pentraxins