Copeptin does not accurately predict disease severity in imported malaria

Malaria Journal

Research

Yolanda B de Rijke¹  Dennis A Hesselink²  Ewout J Hoorn²  Marlies E van Wolfswinkel³  Perry JJ van Genderen³  Rob Koelewijn⁴  Jaap J van Hellemond⁵ 

[1] Department of Clinical Chemistry, Erasmus MC, Rotterdam, The Netherlands;Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands;Department of Internal Medicine, Harbour Hospital and Institute for Tropical Diseases, Haringvliet 2, 3011, Rotterdam, TD, The Netherlands;Laboratory of Parasitology, Harbour Hospital and Institute for Tropical Diseases, Rotterdam, The Netherlands;Laboratory of Parasitology, Harbour Hospital and Institute for Tropical Diseases, Rotterdam, The Netherlands;Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands;

关键词: Malaria;    Imported;    Severity;    Biomarkers;    Copeptin;    Arginine vasopressin;    C-reactive protein;    CRP;    Traveller;   

DOI  :  10.1186/1475-2875-11-6

 received in 2011-08-11, accepted in 2012-01-05,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundCopeptin has recently been identified to be a stable surrogate marker for the unstable hormone arginine vasopressin (AVP). Copeptin has been shown to correlate with disease severity in leptospirosis and bacterial sepsis. Hyponatraemia is common in severe imported malaria and dysregulation of AVP release has been hypothesized as an underlying pathophysiological mechanism. The aim of the present study was to evaluate the performance of copeptin as a predictor of disease severity in imported malaria.MethodsCopeptin was measured in stored serum samples of 204 patients with imported malaria that were admitted to our Institute for Tropical Diseases in Rotterdam in the period 1999-2010. The occurrence of WHO defined severe malaria was the primary end-point. The diagnostic performance of copeptin was compared to that of previously evaluated biomarkers C-reactive protein, procalcitonin, lactate and sodium.ResultsOf the 204 patients (141 Plasmodium falciparum, 63 non-falciparum infection), 25 had severe malaria. The Area Under the ROC curve of copeptin for severe disease (0.66 [95% confidence interval 0.59-0.72]) was comparable to that of lactate, sodium and procalcitonin. C-reactive protein (0.84 [95% CI 0.79-0.89]) had a significantly better performance as a biomarker for severe malaria than the other biomarkers.ConclusionsC-reactive protein but not copeptin was found to be an accurate predictor for disease severity in imported malaria. The applicability of copeptin as a marker for severe malaria in clinical practice is limited to exclusion of severe malaria.

【 授权许可】

Unknown   
© van Wolfswinkel et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.