title: Copeptin as a serum biomarker of febrile seizures.
abstract: OBJECTIVE
  Accurate diagnosis of febrile seizures in children presenting after paroxysmal episodes associated with fever, is hampered by the lack of objective postictal biomarkers. The aim of our study was to investigate whether FS are associated with increased levels of serum copeptin, a robust marker of arginine vasopressin secretion.
  
  
  METHODS
  This was a prospective emergency-setting cross-sectional study of 161 children between six months and five years of age. Of these, 83 were diagnosed with febrile seizures, 69 had a febrile infection without seizures and nine had epileptic seizures not triggered by infection. Serum copeptin and prolactin levels were measured in addition to standard clinical, neurophysiological, and laboratory assessment.
  
  
  BACKGROUND
  NCT01884766.
  
  
  RESULTS
  Circulating copeptin was significantly higher in children with febrile seizures (median [interquartile range] 18.9 pmol/L [8.5-36.6]) compared to febrile controls (5.6 pmol/L [4.1-9.4]; p < 0.001), with no differences between febrile and epileptic seizures (21.4 pmol/L [16.1-46.6]; p = 0.728). In a multivariable regression model, seizures were the major determinant of serum copeptin (beta 0.509; p < 0.001), independently of clinical and baseline laboratory indices. The area under the receiver operating curve for copeptin was 0.824 (95% CI 0.753-0.881), significantly higher compared to prolactin (0.667 [0.585-0.742]; p < 0.001). The diagnostic accuracy of copeptin increased with decreasing time elapsed since the convulsive event (at 120 min: 0.879 [0.806-0.932] and at <60 min: 0.975 [0.913-0.997]).
  
  
  CONCLUSIONS
  Circulating copeptin has high diagnostic accuracy in febrile seizures and may be a useful adjunct for accurately diagnosing postictal states in the emergency setting.
authors.affiliation: Division of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Stöcklin
authors.affiliation: Department of Pediatrics, University Hospital of Patras, Patras, Greece.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Fouzas
authors.affiliation: Division of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
authors.forename: Paula
authors.initials: P
authors.lastname: Schillinger
authors.affiliation: Emergency Department, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
authors.forename: Sevgi
authors.initials: S
authors.lastname: Cayir
authors.affiliation: Department of Laboratory Medicine, University of Basel Hospital, Basel, Switzerland.
authors.forename: Roswitha
authors.initials: R
authors.lastname: Skendaj
authors.affiliation: Emergency Department, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
authors.forename: Michel
authors.initials: M
authors.lastname: Ramser
authors.affiliation: Division of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Weber
authors.affiliation: Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
authors.forename: Sven
authors.initials: S
authors.lastname: Wellmann
mesh_terms: D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007223:Infant; D007239:Infections / Q000150:complications; D008297:Male; D003294:Seizures, Febrile / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins