title: Novel biochemical marker for differential diagnosis of seizure: ischemia-modified albumin.
abstract: BACKGROUND
  Differential diagnosis of seizure is critical in patients presented to emergency department (ED) with altered mental status or loss of consciousness. Although electroencephalogram is important for the diagnosis of seizures, its use in EDs is limited. The level of ischemia-modified albumin (IMA) increases in conditions of ischemic distress such as acute coronary syndrome, pulmonary embolism, and mesenteric ischemia. No studies exist in literature regarding the increase of IMA levels parallel to increased seizure activity in adults. The aim of the study was to investigate the diagnostic value of IMA in adult patients presented to ED with seizures.
  
  
  METHODS
  Forty patients presented to ED with seizure, and 40 control patients of similar age and sex as the study group were enrolled in this study. Initial and fourth-hour levels of IMA and albumin were measured. Groups were compared in terms of sociodemographic data and details regarding their seizures as well as initial and fourth-hour levels of IMA.
  
  
  RESULTS
  Mean levels of IMA were 61.5 IU/mL and 18.5 IU/mL (P < .001) initially and 56.7 IU/mL and 15.4 IU/mL (P < .001) at the fourth hour; levels were higher in the study group compared with control group. Ischemia-modified albumin/albumin ratios in study and control groups were 1555.3 IU/g and 462.4 IU/g (P < .001) initially and 1431.4 IU/g and 383.6 IU/g (P < .001) at the fourth hour, respectively.
  
  
  CONCLUSIONS
  Blood IMA level and IMA/albumin ratio significantly increase in adult patients who experienced seizures. Ischemia-modified albumin may be considered as a useful biomarker in the differential diagnosis of seizure.
authors.affiliation: Dokuz Eylul University, School of Medicine, Department of Emergency Medicine, Balcova, 35340 Izmir, Turkey. Electronic address: doktor4735@hotmail.com.
authors.forename: Muzeyyen
authors.initials: M
authors.lastname: Uzel
authors.affiliation: Dokuz Eylul University, School of Medicine, Department of Emergency Medicine, Balcova, 35340 Izmir, Turkey. Electronic address: nese.oray@deu.edu.tr.
authors.forename: Nese Colak
authors.initials: NC
authors.lastname: Oray
authors.affiliation: Dokuz Eylul University, School of Medicine, Department of Emergency Medicine, Balcova, 35340 Izmir, Turkey. Electronic address: basakdr@yahoo.com.
authors.forename: Basak
authors.initials: B
authors.lastname: Bayram
authors.affiliation: Dokuz Eylul University, School of Medicine, Department of Medical Biochemistry, Balcova, 35340 Izmir, Turkey. Electronic address: tuncay.kume@deu.edu.tr.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Kume
authors.affiliation: Dokuz Eylul University, School of Medicine, Department of Emergency Medicine, Balcova, 35340 Izmir, Turkey. Electronic address: mcgirgin@gmail.com.
authors.forename: Mehmet Can
authors.initials: MC
authors.lastname: Girgin
authors.affiliation: Dokuz Eylul University, School of Medicine, Department of Emergency Medicine, Balcova, 35340 Izmir, Turkey. Electronic address: ozgurdoylan@yahoo.com.tr.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Doylan
authors.affiliation: Dokuz Eylul University, School of Medicine, Department of Emergency Medicine, Balcova, 35340 Izmir, Turkey. Electronic address: esaritabak@hotmail.com.
authors.forename: Ercument
authors.initials: E
authors.lastname: Saritabak
authors.affiliation: Dokuz Eylul University, School of Medicine, Department of Emergency Medicine, Balcova, 35340 Izmir, Turkey. Electronic address: sedat.yanturali@deu.edu.tr.
authors.forename: Sedat
authors.initials: S
authors.lastname: Yanturali
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012640:Seizures / Q000097:blood / Q000175:diagnosis*; D012709:Serum Albumin; D000075462:Serum Albumin, Human
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; C561522:ischemia-modified albumin; D000075462:Serum Albumin, Human