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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
https://doi.org/10.20515/otd.1273621

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
https://doi.org/10.20515/otd.1273621

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.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları, Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Recep Evcen 0000-0002-6124-5816

Fatih Çölkesen 0000-0002-6595-1267

Filiz Sadi Aykan 0000-0002-8941-5573

Mehmet Kılınç 0000-0003-1117-6872

Eray Yıldız 0000-0002-9596-1773

Ümmügülsüm Yılmaz Ergün 0000-0001-5922-9959

Tuğba Önalan 0000-0003-2427-5925

Fatma Arzu Akkuş 0000-0003-0519-7132

Selim Kahraman 0000-0001-8471-7313

Mehmet Emin Gerek 0000-0003-4792-0544

Şevket Arslan 0000-0002-0343-0159

Yayımlanma Tarihi 20 Temmuz 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 45 Sayı: 4

Kaynak Göster

Vancouver Evcen R, Çölkesen F, Sadi Aykan F, Kılınç M, Yıldız E, Yılmaz Ergün Ü, Önalan T, Akkuş FA, Kahraman S, Gerek ME, Arslan Ş. Could the C-reactive protein/albumin Ratio Predict Mortality in Patients with Common Variable İmmunodeficiency?. Osmangazi Tıp Dergisi. 2023;45(4):480-6.


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