title: Sodium and copeptin levels in children with community acquired pneumonia.
abstract: Copeptin has been associated with the severity of pneumonia and its complications. This study was designed to assess the usefulness of copeptin measurement in children with community-acquired pneumonia (CAP) and copeptin's relation with disease severity and sodium equilibrium. The study encompassed 311 patients (227 with pneumonia and 84 healthy controls) aged 8 days-18 years. Clinical findings and inflammatory markers were used to predict the disease severity. We found that the level of copeptin was significantly higher in patients with CAP (median 0.88 ng/mL) vs. healthy children (0.33 ng/mL; p < 0.01). ROC analysis showed a high AUC value (0.87) and the cut-off point for plasma copeptin level was 0.44 ng/mL, with a high sensitivity (89 %) and specificity (73 %) in recognizing pneumonia. Patients with higher copeptin concentrations were at higher risk of hyponatremia (OR 2.43). Yet there was only a weak reverse correlation between the sodium and the copeptin concentrations (Spearmann's rank coefficient = -0.19). The levels of copeptin were higher in hyponatremic patients (0.83 ng/mL) vs. normonatremic patients (0.69 ng/mL; p = 0.02). Copeptin elevation did not reflect the CAP severity measured with traditionally used methods. In conclusion, copeptin elevation is a promising marker of pneumonia, but it reflects neither the disease severity nor sodium concentration.
authors.affiliation: Department of Pediatrics, Medical Center of Postgraduate Education, 99/103 Marymoncka St., Warsaw, 01-813, Poland.
authors.forename: August
authors.initials: A
authors.lastname: Wrotek
authors.forename: Teresa
authors.initials: T
authors.lastname: Jackowska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Pawlik
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002414:Cations, Monovalent; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections; D005260:Female; D015870:Gene Expression; D006020:Glycopeptides / Q000097:blood* / Q000235:genetics; D006801:Humans; D007113:Immunity, Innate; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D018410:Pneumonia, Bacterial / Q000097:blood* / Q000276:immunology / Q000503:physiopathology; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood*
chemical_list: D002414:Cations, Monovalent; D006020:Glycopeptides; C048197:copeptins; D012964:Sodium