Corticosteroid-binding globulin: A possible early predictor of infection in acute necrotizing pancreatitis
(2007) In Scandinavian Journal of Gastroenterology 42(11). p.1354-1361- Abstract
- Objective. Infected pancreatic necrosis is the main cause of death in patients with acute pancreatitis, and therefore its early prediction is of utmost importance. Endogenous cortisol metabolism plays a basic role both in the course of acute pancreatitis and in the process of infection. The purpose of this study was to analyze corticosteroid-binding globulin (CBG), total cortisol, calculated free cortisol and adrenocorticotropic hormone as potential early predictors in order to differentiate between infected pancreatic necrosis and sterile pancreatic necrosis in patients with acute pancreatitis. Material and methods. Serum levels of CBG, total cortisol, calculated free cortisol, and plasma levels of adrenocorticotropic hormone were... (More)
- Objective. Infected pancreatic necrosis is the main cause of death in patients with acute pancreatitis, and therefore its early prediction is of utmost importance. Endogenous cortisol metabolism plays a basic role both in the course of acute pancreatitis and in the process of infection. The purpose of this study was to analyze corticosteroid-binding globulin (CBG), total cortisol, calculated free cortisol and adrenocorticotropic hormone as potential early predictors in order to differentiate between infected pancreatic necrosis and sterile pancreatic necrosis in patients with acute pancreatitis. Material and methods. Serum levels of CBG, total cortisol, calculated free cortisol, and plasma levels of adrenocorticotropic hormone were determined in 109 consecutive patients with acute pancreatitis. C-reactive protein was measured as the control parameter. Thirty-five patients developed necrotizing pancreatitis and 10 developed infection of the necrosis. Blood was monitored for 6 days after the onset of pain; 30 healthy individuals served as controls. Results. Of all parameters only CBG showed a significant difference ( p = 0.0318) in its peak levels measured in the first 48 h in patients with sterile (26.5 mu g/ml, range 21.3-34.7) and infected (16.0 mu g/ml, range 15.2-25.0) necrosis at a cut-off level of 16.8 mu g/ml. That difference was further preserved for the first 6 days after onset of pain. Conclusions. In our group of patients, a decreased CBG level below 16.8 g/ml within the initial 48 h of acute pancreatitis was an early predictor of later infected pancreatic necrosis, with a positive predictive value of 100% and a negative predictive value of 87.5%. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/653348
- author
- Muller, Christophe A. ; Belyaev, Orlin ; Vogeser, Michael ; Weyhe, Dirk ; Gloor, Beat ; Strobel, Oliver ; Werner, Jens ; Borgström, Anders LU ; Buchler, Markus W. and Uhl, Waldemar
- organization
- publishing date
- 2007
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- acute necrotizing pancreatitis, corticosteroid-binding globulin, predictors of infection
- in
- Scandinavian Journal of Gastroenterology
- volume
- 42
- issue
- 11
- pages
- 1354 - 1361
- publisher
- Taylor & Francis
- external identifiers
-
- wos:000249956200012
- scopus:35148842614
- ISSN
- 1502-7708
- DOI
- 10.1080/00365520701416691
- language
- English
- LU publication?
- yes
- id
- 3a40b222-a999-4e2f-99ea-4d8672d56d90 (old id 653348)
- date added to LUP
- 2016-04-01 15:17:11
- date last changed
- 2022-01-28 04:37:39
@article{3a40b222-a999-4e2f-99ea-4d8672d56d90,
abstract = {{Objective. Infected pancreatic necrosis is the main cause of death in patients with acute pancreatitis, and therefore its early prediction is of utmost importance. Endogenous cortisol metabolism plays a basic role both in the course of acute pancreatitis and in the process of infection. The purpose of this study was to analyze corticosteroid-binding globulin (CBG), total cortisol, calculated free cortisol and adrenocorticotropic hormone as potential early predictors in order to differentiate between infected pancreatic necrosis and sterile pancreatic necrosis in patients with acute pancreatitis. Material and methods. Serum levels of CBG, total cortisol, calculated free cortisol, and plasma levels of adrenocorticotropic hormone were determined in 109 consecutive patients with acute pancreatitis. C-reactive protein was measured as the control parameter. Thirty-five patients developed necrotizing pancreatitis and 10 developed infection of the necrosis. Blood was monitored for 6 days after the onset of pain; 30 healthy individuals served as controls. Results. Of all parameters only CBG showed a significant difference ( p = 0.0318) in its peak levels measured in the first 48 h in patients with sterile (26.5 mu g/ml, range 21.3-34.7) and infected (16.0 mu g/ml, range 15.2-25.0) necrosis at a cut-off level of 16.8 mu g/ml. That difference was further preserved for the first 6 days after onset of pain. Conclusions. In our group of patients, a decreased CBG level below 16.8 g/ml within the initial 48 h of acute pancreatitis was an early predictor of later infected pancreatic necrosis, with a positive predictive value of 100% and a negative predictive value of 87.5%.}},
author = {{Muller, Christophe A. and Belyaev, Orlin and Vogeser, Michael and Weyhe, Dirk and Gloor, Beat and Strobel, Oliver and Werner, Jens and Borgström, Anders and Buchler, Markus W. and Uhl, Waldemar}},
issn = {{1502-7708}},
keywords = {{acute necrotizing pancreatitis; corticosteroid-binding globulin; predictors of infection}},
language = {{eng}},
number = {{11}},
pages = {{1354--1361}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Gastroenterology}},
title = {{Corticosteroid-binding globulin: A possible early predictor of infection in acute necrotizing pancreatitis}},
url = {{http://dx.doi.org/10.1080/00365520701416691}},
doi = {{10.1080/00365520701416691}},
volume = {{42}},
year = {{2007}},
}