Could the C-reactive protein/albumin Ratio Predict Mortality in Patients with Common Variable İmmunodeficiency?
Yıl 2023,
Cilt: 45 Sayı: 4, 480 - 486, 20.07.2023
Recep Evcen
,
Fatih Çölkesen
,
Filiz Sadi Aykan
,
Mehmet Kılınç
,
Eray Yıldız
,
Ümmügülsüm Yılmaz Ergün
,
Tuğba Önalan
,
Fatma Arzu Akkuş
,
Selim Kahraman
,
Mehmet Emin Gerek
,
Şevket Arslan
Öz
Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency in adults. This study assessed the utility of using the C-reactive protein (CRP)/albumin ratio (CAR) at diagnosis to predict mortality in CVID patients. Between 2010 and 2022, hospital records and follow-up cards of patients with CVID were reviewed retrospectively. Seventy-five patients were included in the study. CRP 0–5 mg/L and albumin 3.5–5.5 g/dL were taken as references. The CAR was obtained by dividing the CRP value by the albumin value. Of the included patients, 41 (55%) were male and 34 (35%) were female. The median age was 38 (21–77) years. The mortality rate of the patients during the follow-up time was 20%. Of the patients, 41% had splenomegaly, 10.6% had malignancy, and 39% had bronchiectasis. The cut-off value of CAR to predict mortality was >2.18 (sensitivity: 88.4%, specificity: 90.1%). When the patients were classified according to the CAR, the mortality rate in the patient group with a CAR > 2.18 was statistically significantly higher than the patient group with a CAR ≤ 2.18. The CAR is a cheap, simple, and easily calculated parameter that can predict mortality in CVID patients.
Kaynakça
- 1. Chapel H, Cunningham-Rundles C. Update in understanding common variable immunodeficiency disorders (CVIDs) and the management of patients with these conditions. British journal of haematology. 2009;145:709-27.
- 2. Cunningham-Rundles C. How I treat common variable immune deficiency. Blood. 2010;116:7-15.
- 3. Chapel H, Lucas M, Lee M, et al. Common variable immunodeficiency disorders: division into distinct clinical phenotypes. Blood. 2008;112:277-86.
- 4. Bonilla FA, Barlan I, Chapel H, et al. International Consensus Document (ICON): Common Variable Immunodeficiency Disorders. The journal of allergy and clinical immunology In practice. 2016;4:38-59.
- 5. Resnick ES, Moshier EL, Godbold JH, et al. Morbidity and mortality in common variable immune deficiency over 4 decades. Blood. 2012;119:1650-7.
- 6. Cunningham-Rundles C, Bodian C. Common variable immunodeficiency: clinical and immunological features of 248 patients. Clinical immunology (Orlando, Fla). 1999;92:34-48.
- 7. Fairclough E, Cairns E, Hamilton J, et al. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clinical medicine (London, England). 2009;9:30-3.
- 8. Ranzani OT, Zampieri FG, Forte DN, et al. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PloS one. 2013;8:e59321.
- 9. Li YJ, Yao K, Lu MX, et al. Prognostic value of the C-reactive protein to albumin ratio: a novel inflammation-based prognostic indicator in osteosarcoma. OncoTargets and therapy. 2017;10:5255-61.
- 10. Picard C, Bobby Gaspar H, Al-Herz W, et al. International Union of Immunological Societies: 2017 Primary Immunodeficiency Diseases Committee Report on Inborn Errors of Immunity. Journal of clinical immunology. 2018;38:96-128.
- 11. Wei XL, Wang FH, Zhang DS, et al. A novel inflammation-based prognostic score in esophageal squamous cell carcinoma: the C-reactive protein/albumin ratio. BMC cancer. 2015;15:350.
- 12. Xu XL, Yu HQ, Hu W, et al. A Novel Inflammation-Based Prognostic Score, the C-Reactive Protein/Albumin Ratio Predicts the Prognosis of Patients with Operable Esophageal Squamous Cell Carcinoma. PloS one. 2015;10:e0138657.
- 13. Aghamohammadi A, Pouladi N, Parvaneh N, et al. Mortality and morbidity in common variable immunodeficiency. Journal of tropical pediatrics. 2007;53:32-8.
- 14. Seymour B, Miles J, Haeney M. Primary antibody deficiency and diagnostic delay. Journal of clinical pathology. 2005;58:546-7.
- 15. Quinti I, Agostini C, Tabolli S, et al. Malignancies are the major cause of death in patients with adult onset common variable immunodeficiency. Blood. 2012;120:1953-4.
- 16. Bagheri Y, Vosughi A, Azizi G, et al. Comparison of clinical and immunological features and mortality in common variable immunodeficiency and agammaglobulinemia patients. Immunology letters. 2019;210:55-62.
- 17. Sun P, Chen C, Xia Y, et al. The Ratio of C-Reactive Protein/Albumin is a Novel Inflammatory Predictor of Overall Survival in Cisplatin-Based Treated Patients with Metastatic Nasopharyngeal Carcinoma. Disease markers. 2017;2017:6570808.
- 18. Boileau J, Mouillot G, Gérard L, et al. Autoimmunity in common variable immunodeficiency: correlation with lymphocyte phenotype in the French DEFI study. Journal of autoimmunity. 2011;36:25-32.
- 19. Patuzzo G, Barbieri A, Tinazzi E, et al. Autoimmunity and infection in common variable immunodeficiency (CVID). Autoimmunity reviews. 2016;15:877-82.
C-reaktif protein/albümin Oranı Yaygın Değişken İmmün Yetmezliği Olan Hastalarda Mortaliteyi Tahmin Edebilir mi?
Yıl 2023,
Cilt: 45 Sayı: 4, 480 - 486, 20.07.2023
Recep Evcen
,
Fatih Çölkesen
,
Filiz Sadi Aykan
,
Mehmet Kılınç
,
Eray Yıldız
,
Ümmügülsüm Yılmaz Ergün
,
Tuğba Önalan
,
Fatma Arzu Akkuş
,
Selim Kahraman
,
Mehmet Emin Gerek
,
Şevket Arslan
Öz
Yaygın değişken immün yetersizlik (YDİY), yetişkinlerde en sık görülen semptomatik primer immün yetmezliktir. Bu çalışma, CVID hastalarında mortaliteyi tahmin etmek için tanıda C-reaktif protein (CRP)/albümin oranı (CAO) kullanmanın faydasını değerlendirdi. 2010-2022 yılları arasında YDİY'li hastaların hastane kayıtları ve takip kartları retrospektif olarak incelendi. Çalışmaya yetmiş beş hasta dahil edildi. CRP 0–5 mg/L ve albümin 3,5–5,5 g/dL referans olarak alındı. CAO, CRP değerinin albümin değerine bölünmesiyle elde edildi. Çalışmaya alınan hastaların 41'i (%55) erkek, 34'ü (%35) kadındı. Ortanca yaş 38 (21-77) idi. Takip süresi boyunca hastaların ölüm oranı %20 idi. Hastaların %41'inde splenomegali, %10.6'sında malignite ve %39'unda bronşektazi vardı. CAO'nın mortaliteyi öngörmek için kesme değeri >2,18 idi (duyarlılık: %88,4, özgüllük: %90,1). Hastalar CAO göre sınıflandırıldığında, CAO > 2,18 olan hasta grubunda mortalite oranı, CAO ≤ 2,18 olan hasta grubuna göre istatistiksel olarak anlamlı derecede yüksekti. CAO, YDİY hastalarda mortaliteyi tahmin edebilen ucuz, basit ve kolayca hesaplanabilen bir parametredir.
Kaynakça
- 1. Chapel H, Cunningham-Rundles C. Update in understanding common variable immunodeficiency disorders (CVIDs) and the management of patients with these conditions. British journal of haematology. 2009;145:709-27.
- 2. Cunningham-Rundles C. How I treat common variable immune deficiency. Blood. 2010;116:7-15.
- 3. Chapel H, Lucas M, Lee M, et al. Common variable immunodeficiency disorders: division into distinct clinical phenotypes. Blood. 2008;112:277-86.
- 4. Bonilla FA, Barlan I, Chapel H, et al. International Consensus Document (ICON): Common Variable Immunodeficiency Disorders. The journal of allergy and clinical immunology In practice. 2016;4:38-59.
- 5. Resnick ES, Moshier EL, Godbold JH, et al. Morbidity and mortality in common variable immune deficiency over 4 decades. Blood. 2012;119:1650-7.
- 6. Cunningham-Rundles C, Bodian C. Common variable immunodeficiency: clinical and immunological features of 248 patients. Clinical immunology (Orlando, Fla). 1999;92:34-48.
- 7. Fairclough E, Cairns E, Hamilton J, et al. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clinical medicine (London, England). 2009;9:30-3.
- 8. Ranzani OT, Zampieri FG, Forte DN, et al. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PloS one. 2013;8:e59321.
- 9. Li YJ, Yao K, Lu MX, et al. Prognostic value of the C-reactive protein to albumin ratio: a novel inflammation-based prognostic indicator in osteosarcoma. OncoTargets and therapy. 2017;10:5255-61.
- 10. Picard C, Bobby Gaspar H, Al-Herz W, et al. International Union of Immunological Societies: 2017 Primary Immunodeficiency Diseases Committee Report on Inborn Errors of Immunity. Journal of clinical immunology. 2018;38:96-128.
- 11. Wei XL, Wang FH, Zhang DS, et al. A novel inflammation-based prognostic score in esophageal squamous cell carcinoma: the C-reactive protein/albumin ratio. BMC cancer. 2015;15:350.
- 12. Xu XL, Yu HQ, Hu W, et al. A Novel Inflammation-Based Prognostic Score, the C-Reactive Protein/Albumin Ratio Predicts the Prognosis of Patients with Operable Esophageal Squamous Cell Carcinoma. PloS one. 2015;10:e0138657.
- 13. Aghamohammadi A, Pouladi N, Parvaneh N, et al. Mortality and morbidity in common variable immunodeficiency. Journal of tropical pediatrics. 2007;53:32-8.
- 14. Seymour B, Miles J, Haeney M. Primary antibody deficiency and diagnostic delay. Journal of clinical pathology. 2005;58:546-7.
- 15. Quinti I, Agostini C, Tabolli S, et al. Malignancies are the major cause of death in patients with adult onset common variable immunodeficiency. Blood. 2012;120:1953-4.
- 16. Bagheri Y, Vosughi A, Azizi G, et al. Comparison of clinical and immunological features and mortality in common variable immunodeficiency and agammaglobulinemia patients. Immunology letters. 2019;210:55-62.
- 17. Sun P, Chen C, Xia Y, et al. The Ratio of C-Reactive Protein/Albumin is a Novel Inflammatory Predictor of Overall Survival in Cisplatin-Based Treated Patients with Metastatic Nasopharyngeal Carcinoma. Disease markers. 2017;2017:6570808.
- 18. Boileau J, Mouillot G, Gérard L, et al. Autoimmunity in common variable immunodeficiency: correlation with lymphocyte phenotype in the French DEFI study. Journal of autoimmunity. 2011;36:25-32.
- 19. Patuzzo G, Barbieri A, Tinazzi E, et al. Autoimmunity and infection in common variable immunodeficiency (CVID). Autoimmunity reviews. 2016;15:877-82.