Delta Neutrophil Index as an Early Marker for Differential Diagnosis of Adult-Onset Still’s Disease and Sepsis
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Purpose: To investigate clinical implications of delta neutrophil index (DNI) to discriminate adult onset Still’s disease (AOSD) from sepsis. Materials and Methods:We reviewed the medical records of 13 patients with AOSD and 33 gender and age-matched patients with sepsis. In all subjects, microbial tests were performedto exclude or confirm sepsis. All laboratory data were measured two or three times during the first 3 days and represented by their mean levels. DNI was measured automatically by ADVIA 2120 for the first 3 days. Results: There were no significant differences in white blood cell counts, neutrophil proportion, erythrocytesedimentation rate and C-reactive protein between two groups. AOSD patientshad notably lower DNI than sepsis patients regardless of the presence of bacteremia or not. However, both DNI and ferritin were not significant independentfactors for predicting sepsis in the multivariate logistic regression analysis. Meanwhile, the area under the receiver operating characteristic curve (AUROC) of DNI was slightly higher than that of ferritin. When we set DNI of 2.75% as the cut-off value for predicting sepsis, 11 (84.6%) of AOSD patients had a DNI value below 2.75% and 2 (15.4%) of them had a DNI over 2.75% (relative risk for sepsis176). Conclusion: We suggest that DNI may be a useful marker for differential diagnosis of AOSD from sepsis in the early phase as supplementary to ferritin.
Abstract
Purpose: To investigate clinical implications of delta neutrophil index (DNI) to discriminate adult onset Still’s disease (AOSD) from sepsis. Materials and Methods:We reviewed the medical records of 13 patients with AOSD and 33 gender and age-matched patients with sepsis. In all subjects, microbial tests were performedto exclude or confirm sepsis. All laboratory data were measured two or three times during the first 3 days and represented by their mean levels. DNI was measured automatically by ADVIA 2120 for the first 3 days. Results: There were no significant differences in white blood cell counts, neutrophil proportion, erythrocytesedimentation rate and C-reactive protein between two groups. AOSD patientshad notably lower DNI than sepsis patients regardless of the presence of bacteremia or not. However, both DNI and ferritin were not significant independentfactors for predicting sepsis in the multivariate logistic regression analysis. Meanwhile, the area under the receiver operating characteristic curve (AUROC) of DNI was slightly higher than that of ferritin. When we set DNI of 2.75% as the cut-off value for predicting sepsis, 11 (84.6%) of AOSD patients had a DNI value below 2.75% and 2 (15.4%) of them had a DNI over 2.75% (relative risk for sepsis176). Conclusion: We suggest that DNI may be a useful marker for differential diagnosis of AOSD from sepsis in the early phase as supplementary to ferritin.
참고문헌 (21)
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