title: KL-6, a Human MUC1 Mucin, as a prognostic marker for diffuse alveolar hemorrhage syndrome.
abstract: BACKGROUND
  Diffuse alveolar hemorrhage syndrome is a life threatening condition with diverse etiologies. Sensitive prognostic markers for diffuse alveolar hemorrhage have not been well investigated. Serum KL-6 is a biomarker for various interstitial lung disease associated with disease activity and prognosis. The purpose of the present study was to evaluate the clinical utility of serum KL-6 level as a prognostic marker for diffuse alveolar hemorrhage.
  
  
  METHODS
  We retrospectively collected 41 consecutive patients clinically diagnosed as having diffuse alveolar hemorrhage who were admitted to the Intensive Care Unit of Hiroshima University Hospital between 2004 and 2011. Correlation between prognosis and age, sex, laboratory findings including serum KL-6, radiological findings, ventilatory modes or therapeutic regimens were evaluated.
  
  
  RESULTS
  Baseline and peak serum KL-6 levels were significantly higher in non-survivors compared with survivors. An increase in KL-6 levels during the initial week was associated with a subsequent deterioration of the oxygenation index. Higher baseline KL-6 levels and higher peak KL-6 levels were strongly correlated with death. With a cut-off level of 700 U/mL for peak KL-6, the sensitivity, specificity and accuracy for non-survival were 75%, 85% and 78%, respectively. In the multivariate analysis, only the peak KL-6 level ≥ 700 U/ml was an independent poor prognostic factor for diffuse alveolar hemorrhage.
  
  
  CONCLUSIONS
  Peak serum KL-6 level ≥ 700 U/ml may become a clinically useful marker of poor prognosis for diffuse alveolar hemorrhage.
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Kida
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ohshimo
authors.forename: Kohei
authors.initials: K
authors.lastname: Ota
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tamura
authors.forename: Tadatsugu
authors.initials: T
authors.lastname: Otani
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Une
authors.forename: Takuma
authors.initials: T
authors.lastname: Sadamori
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Francesco
authors.initials: F
authors.lastname: Bonella
authors.forename: Noboru
authors.initials: N
authors.lastname: Hattori
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hirohashi
authors.forename: Josune
authors.initials: J
authors.lastname: Guzman
authors.forename: Ulrich
authors.initials: U
authors.lastname: Costabel
authors.forename: Nobuoki
authors.initials: N
authors.lastname: Kohno
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanigawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000097:blood; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood*; D016016:Proportional Hazards Models; D011650:Pulmonary Alveoli / Q000473:pathology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1