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LDH concentration in nasal-wash fluid as a biochemical predictor of bronchiolitis severity.
- Source :
-
Pediatrics [Pediatrics] 2010 Feb; Vol. 125 (2), pp. e225-33. Date of Electronic Publication: 2010 Jan 25. - Publication Year :
- 2010
-
Abstract
- Objective: Because the decision to hospitalize an infant with bronchiolitis is often supported by subjective criteria and objective indicators of bronchiolitis severity are lacking, we tested the hypothesis that lactate dehydrogenase (LDH), which is released from injured cells, is a useful biochemical indicator of bronchiolitis severity.<br />Patients and Methods: We retrospectively analyzed a study of children <24 months old presenting to the emergency department with bronchiolitis. Demographic, clinical information, nasal wash (NW), and serum specimens were obtained. NW samples were analyzed for respiratory viruses, caspase 3/7 activity, and a panel of cytokines and chemokines. Total LDH activity was tested in NW samples and sera.<br />Results: Of 101 enrolled children (median age: 5.6 months), 98 had NW specimens available. A viral etiology was found for 82 patients (83.6%), with respiratory syncytial virus (RSV) (66%) and rhinovirus (19%) being the most common viruses detected. Concentrations of LDH in NW specimens were independent from those in sera and were higher in children with RSV infection or with dual infection. Significant correlations were found between NW LDH and NW cytokines/chemokines. Similarly, NW LDH correlated with NW-caspase 3/7 activity (r = 0.75; P < .001). In a multivariate analysis, NW LDH concentration in the upper quartile was significantly associated with a reduced risk of hospitalization (odds ratio: 0.19 [95% confidence interval: 0.05-0.68]; P = .011).<br />Conclusions: NW LDH levels in young children with bronchiolitis varied according to viral etiology and disease severity. Values in the upper quartile were associated with approximately 80% risk reduction in hospitalization, likely reflecting a robust antiviral response. NW LDH may be a useful biomarker to assist the clinician in the decision to hospitalize a child with bronchiolitis.
- Subjects :
- Apoptosis physiology
Bronchiolitis virology
Cytokines metabolism
Female
Hospitalization statistics & numerical data
Humans
Infant
Infant, Newborn
Logistic Models
Male
Multivariate Analysis
Respiratory Syncytial Virus Infections complications
Respiratory Syncytial Virus Infections metabolism
Retrospective Studies
Severity of Illness Index
Bronchiolitis metabolism
L-Lactate Dehydrogenase analysis
Nasal Lavage Fluid chemistry
Subjects
Details
- Language :
- English
- ISSN :
- 1098-4275
- Volume :
- 125
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 20100751
- Full Text :
- https://doi.org/10.1542/peds.2009-0411