Decreased Platelet Parameters and Serum Uric Acid Levels Suggest Possibility of Acute Phase Reaction of Neonatal Sepsis
Enas Elnagar1*, Amal Abdel-Hameed2, Hanan Omar3, Mohamed El-Kalioby4 and Abdelmoneim Khashana5
1Lecturer of Pediatrics, Faculty of Medicine, Suez Canal University, Egypt
2Faculty of Medicine, Suez Canal University, Egypt
3Associate Professor of Clinical Pathology, Faculty of Medicine, Suez Canal University, Egypt
4Professor of Pediatrics, Faculty of Medicine, Suez Canal University, Egypt
5Associate Professor, Faculty of Medicine, Suez Canal University, Egypt
*Corresponding Author: Enas Elnagar, Lecturer of Pediatrics, Faculty of Medicine, Suez Canal University, Egypt.
May 24, 2021; Published: July 14, 2021
Neonatal sepsis represents an important cause of morbidity and mortality especially in low-resource settings. Early diagnosis and prompt treatment of neonatal sepsis improves outcome. The aim of this study is determine the role of platelet indices and serum uric acid level in the early diagnosis of neonatal sepsis and early detection of neonatal sepsis with easily accessible, inexpensive, and widely used laboratory tests. Retrospective case-control study the target population of this study consisted of 120 neonates who were divided into two groups, cases: 60 neonates who had clinical picture of sepsis with or without positive blood culture, and controls 60 healthy non-septic neonates of the same age and maturity. Platelet parameters followed in complete blood picture (CBC), and serum uric acid of all neonates. Our results showed decrease platelet parameters and serum uric acid in cases of neonatal sepsis so we can use these tools as predictors of neonatal sepsis. There was significant difference of platelet parameters and serum uric acid between cases and controls, significantly lower in neonates with sepsis compared to healthy controls. Decreased platelet parameters including (platelet count, mean platelet volume (MPV), platelet distribution width (PDW) and platelet crit (PCT) values suggest possibility of sepsis and should alert clinicians to the possibility of sepsis and to initiate or change antibiotic treatment. There was statistically significant difference between cases and controls regarding to uric acid.
Keywords: Neonatal Sepsis; Platelet Indices; Serum Uric Acid
- Camacho-Gonzalez A., et al. “Neonatal infectious diseases: evaluation of neonatal sepsis”. Pediatric Clinics of North America 2 (2013): 367-389.
- Guclu E., et al. “Effect of severe sepsis on platelet count and their indices”. African Health Science2 (2013): 333-338.
- Smertka M., et al. “Serum and urinary NGAL in septic newborns”. BioMed Research International (2014): 717318.
- Khashana A., et al. “Cortisol precursors in neonates with vasopressor-resistant hypotension in relationship to demographic characteristics”. Journal of Maternal-Fetal and Neonatal Medicine 18 (2018): 2473-2477.
- Khashana A., et al. “Cortisol intermediates and hydrocortisone responsiveness in critical neonatal disease”. Journal of Maternal-Fetal and Neonatal Medicine 14 (2017): 1721-1725.
- Kisacik B., et al. “Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis”. Joint Bone Spine3 (2008): 291-294.
- Oncel MY., et al. “Mean platelet volume in neonatal sepsis”. Journal of Clinical Laboratory Analysis 6 (2012): 493-496.
- Waring WS., et al. “Systemic uric acid administration increases serum antioxidant capacity in healthy volunteers”. Journal of Cardiovascular Pharmacology3 (2001): 365-371.
- Kapoor K., et al. “Lipid peroxidation and antioxidants in neonatal septicemia”. Journal of Tropical Pediatrics 5 (2006): 372-375.
- Ames BN., et al. “Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis”. Proceedings of the National Academy of Sciences of the United States of America 11 (1981): 6858-6862.
- Qin B., et al. “Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients”. Modern Rheumatology 3 (2016): 372-376.
- Karatekin G., et al. “Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers”. European Journal of Clinical Nutrition 4 (2009): 473-477.
- Dawson B and Trapp R. “Basic and clinical biostatistics”. Singapore 2001 (2004): 141-142.
- Gerdes JS and Polin R. “Early diagnosis and treatment of neonatal sepsis”. Indian Journal of Pediatrics1 (1998): 63-78.
- Steinhorn RH. “Diagnosis and treatment of pulmonary hypertension in infancy”. Early Human Development11 (2013): 865-874.
- von Elm E., et al. “The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies”. International Journal of Surgery12 (2014): 1495-1499.
- Hisamuddin E., et al. “Validity of C-reactive protein (CRP) for diagnosis of neonatal sepsis”. Pakistan Journal of Medical Sciences 3 (2015): 527-531.
- Lee YT., et al. “Pentraxin-3 as a marker of sepsis severity and predictor of mortality outcomes: A systematic review and meta-analysis”. Journal of Infection 1 (2018): 1-10.
- Shehab El-Din EM., et al. “Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt”. BioMed Research International (2015): 509484.
- Eyesus T., et al. “Bacterial etiologic agents causing neonatal sepsis and associated risk factors in Gondar, Northwest Ethiopia”. BMC Pediatrics1 (2017): 137.
- Park IH., et al. “Serum procalcitonin as a diagnostic marker of neonatal sepsis”. Korean Journal of Pediatric10 (2014): 451-456.
- Choudhary R., et al. “Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study”. International Journal of Contemporary Pediatrics5 (2018).
- Martins EC., et al. “Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study”. Revista Brasileira de Terapia Intensiva 1 (2019): 64-70.
- Elgendy F., et al. “Evaluation of hepcidin as a biomarker for neonatal sepsis”. Menoufia Medical Journal3 (2018): 977-982.
- Shalaby MM., et al. “Mean platelet volume and serum uric acid in neonatal sepsis: A case-control study”. Annals of Medicine and Surgery (Lond)20 (2017): 97-102.
- Aydın B., et al. “Mean platelet volume and uric acid levels in neonatal sepsis”. Indian Journal of Paediatrics 12 (2014): 1342-1346.
- Hooman N., et al. “The value of serum uric Acid as a mortality prediction in critically ill children”. Iranian Journal of Paediatrics3 (2010): 323-329.
- Karne T K., et al. “Study of Platelet Count and Platelet Indices in Neonatal Sepsis in Tertiary Care Institute”. Journal of Medical Sciences1 (2017): 55-60.
- Catal F., et al. “Mean platelet volume (MPV) may simply predict the severity of sepsis in preterm infants”. Clinical Laboratory7 (2014): 1193-1200.