The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Pneumonia

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Feb 22, 2014 (3 years and 1 month ago)

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The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


D
.

Taş
1
, E
.

Kunter
1
, H
.

Şevketbeyoğlu
2
, A
.
F
.
Aydın
3
, K
. Çe
lik
4
, Z
.

Kartaloğlu
1



1
GATA Haydarpaşa
Training Hospital, Department of Pulmonary Diseases


2
Van
Military Hospital,

Department of Pulmonary Diseases



3
İzmir
Military Hospital,

Department of Infectious Diseases


4
İzmir
Military Hospital, Department of Radiodiagnostics


The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Introduction





Chlamydia pneumoniae

and community
-
acquired pneumonia




The significance of extensivity degree of lung parenchymal infiltration




The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia





Aim



To

describe

the

levels

of

blood

keucocyte

count,

erythrocyte

sedimentation

rate



(ESR),

and

high

sensitive

C
-
Reactive

Protein

(hs
-
CRP)

and

to

investigate

the




relation

of

these

biomarkers

with

the

rate

of

parenchymal

infiltration

(RPI)

in




patients

with

Chlamydia

pneumoniae

pneumonia

(CPP)


The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Material and Method






Patients







Diagnostic method of CPP







Patients characteristics







Number of CPP cases















The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Material and Method






High resolution computerised tomography







Imaging method and time





Characteristics of infiltration






Defining the distribution width of the infiltration



Rate of parenchymal infiltration(%) = Number of sections showing infiltration by HRCTx100 / total
number of sections 2


In case of bilateral infiltrations in the same section, multiplied by 2


The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Statistical Analysis




Descriptive




Student t
-
Test




Pearson Correlation Analysis

The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Findings



Demographic data and leucocyte, ESR, hs
-
CRP levels of the patients




n

Minimum

Maximum

Mean

Std.

Deviation

Age

32

20,00

25,00

20,46

1,11

Smokers

(
Yes
/
No
)

19/11

-

-

-

-

Body mass i
nde
x

32

16,62

24,38

20,84

2,15

Leucocyte count

32

4600,00

21000,00

10131,2
5

4912,68

ESR

32

2,00

103,00

57,12

29,46

h
s
-
CRP

32

,04

10,24

3,17

3,64

The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Findings




Blood Leucocyte Count




High in 14 patients (43.7%), normal in 18 patients (56.3%)





Erythrocyte Sedimentation Rate




High in 27 patients (84.3%), normal in 5 patients (15.7%)




High Sensitive C
-
Reactive Protein Levels




High in 26 patients (81.2%), normal in 6 patients (18.8%)





The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Findings


The relation of leucocyte, sedimentation and hs
-
CRP with lung parenchymal infiltration rate



Leucocyte

ESR

h
s
-
CRP

Lung parenvhymal

i
nfiltra
tion

rate

(%)

Correlation

constant

(r)

0,011

0,102

0,476

Probability

(p)

0,952

0,580

0,006

The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Findings



The relation of hs
-
CRP and the lung parenchymal infiltration rate



Lung parenchymal infiltration rate (%)

60,00

50,00

40,00

30,00

20,00

10,00

0,00

hs
-
CRP (mg/L)

12,00

10,00

8,00

6,00

4,00

2,00

0,00

Observed

Linear



n=32

r=0,476

p=0,006

The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Discussion




In

CPP,

sedimentation

(
%
84
.
3
)

and

hs
-
CRP

(
%
81
.
2
)

had

a

high


sensitivity

while

sensitivity

of

leucocyte

count

(
%
43
.
7
)

was

moderate
.




There

was

only

one

patient

with

normal

sedimentation

and

hs
-
CRP

levels
.


These

two

biomarkers

together

had

a

sensitivity

of

96
.
8
%

for

CPP





Although

patients

were

not

different

in

terms

of

ESH

and

hs
-
CRP

(p

=


0
,
23
),


studying

these

two

biomarkers

together

as

acute

phase

reactants

may


be


more

useful

in

detecting

infectious

inflammation

















The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Discussion




We found a moderately significant correlation between hs
-
CRP



parenchymal infiltration







However, the correlation of blood leucocye count and ESH with parenchymal

infiltration was not significant statistically




These findings suggest that the increment of hs
-
CRP may be partially parallel

to the rate of lung parenchymal infiltration

The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation
Rate, High Sensitive C
-
Reactive Protein Levels and Pulmonary Parenchymal
Infiltration Rate in Young Male Patients with
Chlamydia Pneumoniae

Pneumonia


Conclusion



hs
-
CRP and ESR had an acceptable sensitivity while leucocyte count

had a

moderate sensitivity in patients with CPP





These

two

acute

phase

reactants

can

be

used

as

screening

tests


especially

in

crowded

living

conditions

with

the

risk

of

epidemia




We

found

that

hs
-
CRP

showed

a

moderately

positive

and

significant


correlation

with

lung

parenchymal

infiltration

while

leucocyte

and

ESR

levels


were

not

correlated

significantly
.




According

to

our

findings

hs
-
CRP

and

ESR

were

succesfull

in

detecting


infection

but

only

hs
-
CRP

was

correlated

with

the

rate

of

lung


infiltration
.

So,


hs
-
CRP

can

be

used

as

a

parameter

defining

the

severity

of

CPP,

but

to


confirm

these

findings

study

of

larger

series

is

needed
.