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Differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) patients are vulnerable to infections. We aim to explore the approach to differentiate active infection from disease activity in pediatric SLE patients. Fifty pediatric SLE patients presenting with 185 clinical visits were collected. The associations between both c...

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Autores principales: Luo, Kai-Ling, Yang, Yao-Hsu, Lin, Yu-Tsan, Hu, Ya-Chiao, Yu, Hsin-Hui, Wang, Li-Chieh, Chiang, Bor-Luen, Lee, Jyh-Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670442/
https://www.ncbi.nlm.nih.gov/pubmed/33199770
http://dx.doi.org/10.1038/s41598-020-76789-6
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author Luo, Kai-Ling
Yang, Yao-Hsu
Lin, Yu-Tsan
Hu, Ya-Chiao
Yu, Hsin-Hui
Wang, Li-Chieh
Chiang, Bor-Luen
Lee, Jyh-Hong
author_facet Luo, Kai-Ling
Yang, Yao-Hsu
Lin, Yu-Tsan
Hu, Ya-Chiao
Yu, Hsin-Hui
Wang, Li-Chieh
Chiang, Bor-Luen
Lee, Jyh-Hong
author_sort Luo, Kai-Ling
collection PubMed
description Systemic lupus erythematosus (SLE) patients are vulnerable to infections. We aim to explore the approach to differentiate active infection from disease activity in pediatric SLE patients. Fifty pediatric SLE patients presenting with 185 clinical visits were collected. The associations between both clinical and laboratory parameters and the outcome groups were analyzed using generalized estimating equations (GEEs). These 185 visits were divided into 4 outcome groups: infected-active (n = 102), infected-inactive (n = 11), noninfected-active (n = 59), and noninfected-inactive (n = 13) visits. Multivariate GEE (generalized estimating equation) analysis showed that SDI, SLEDAI-2K, neutrophil‐to‐lymphocyte ratio (NLR), hemoglobin, platelet, RDW-to-platelet ratio (RPR), and C3 are predictive of flare (combined calculated AUC of 0.8964 and with sensitivity of 82.2% and specificity of 90.9%). Multivariate GEE analysis showed that SDI, fever temperature, CRP, procalcitonin (PCT), lymphocyte percentage, NLR, hemoglobin, and renal score in SLEDAI-2k are predictive of infection (combined calculated AUC of 0.7886 and with sensitivity of 63.5% and specificity of 89.2%). We can simultaneously predict 4 different outcome with accuracy of 70.13% for infected-active group, 10% for infected-inactive group, 59.57% for noninfected-active group, and 84.62% for noninfected-inactive group, respectively. Combination of parameters from four different domains simultaneously, including inflammation (CRP, ESR, PCT), hematology (Lymphocyte percentage, NLR, PLR), complement (C3, C4), and clinical status (SLEDAI, SDI) is objective and effective to differentiate flares from infections in pediatric SLE patients.
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spelling pubmed-76704422020-11-18 Differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus Luo, Kai-Ling Yang, Yao-Hsu Lin, Yu-Tsan Hu, Ya-Chiao Yu, Hsin-Hui Wang, Li-Chieh Chiang, Bor-Luen Lee, Jyh-Hong Sci Rep Article Systemic lupus erythematosus (SLE) patients are vulnerable to infections. We aim to explore the approach to differentiate active infection from disease activity in pediatric SLE patients. Fifty pediatric SLE patients presenting with 185 clinical visits were collected. The associations between both clinical and laboratory parameters and the outcome groups were analyzed using generalized estimating equations (GEEs). These 185 visits were divided into 4 outcome groups: infected-active (n = 102), infected-inactive (n = 11), noninfected-active (n = 59), and noninfected-inactive (n = 13) visits. Multivariate GEE (generalized estimating equation) analysis showed that SDI, SLEDAI-2K, neutrophil‐to‐lymphocyte ratio (NLR), hemoglobin, platelet, RDW-to-platelet ratio (RPR), and C3 are predictive of flare (combined calculated AUC of 0.8964 and with sensitivity of 82.2% and specificity of 90.9%). Multivariate GEE analysis showed that SDI, fever temperature, CRP, procalcitonin (PCT), lymphocyte percentage, NLR, hemoglobin, and renal score in SLEDAI-2k are predictive of infection (combined calculated AUC of 0.7886 and with sensitivity of 63.5% and specificity of 89.2%). We can simultaneously predict 4 different outcome with accuracy of 70.13% for infected-active group, 10% for infected-inactive group, 59.57% for noninfected-active group, and 84.62% for noninfected-inactive group, respectively. Combination of parameters from four different domains simultaneously, including inflammation (CRP, ESR, PCT), hematology (Lymphocyte percentage, NLR, PLR), complement (C3, C4), and clinical status (SLEDAI, SDI) is objective and effective to differentiate flares from infections in pediatric SLE patients. Nature Publishing Group UK 2020-11-16 /pmc/articles/PMC7670442/ /pubmed/33199770 http://dx.doi.org/10.1038/s41598-020-76789-6 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Luo, Kai-Ling
Yang, Yao-Hsu
Lin, Yu-Tsan
Hu, Ya-Chiao
Yu, Hsin-Hui
Wang, Li-Chieh
Chiang, Bor-Luen
Lee, Jyh-Hong
Differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus
title Differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus
title_full Differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus
title_fullStr Differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus
title_full_unstemmed Differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus
title_short Differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus
title_sort differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670442/
https://www.ncbi.nlm.nih.gov/pubmed/33199770
http://dx.doi.org/10.1038/s41598-020-76789-6
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