Abstract
Elastase, a neutral protease stored in the azurophillic granules of neutrophils, is immediately released during the process of phagocytosis and rapidly bound and inactivated by α1-proteinase inhibitor. This complex (E-α1-PI) is of high stability and can be identified by an ELISA-assay. In our study 95 % of all infants with neonatal septicemia and/or meningitis had significantly increased plasma levels of E-α1-PI at time of diagnosis (n=37). Only two patients with group B streptococcal septicemia (GBS) were missed initially, both of them displayed marked leukopenia and neutropenia at time of diagnosis. Nevertheless determination of E-α1-PI was helpful in distinguishing patients with early onset streptococcal disease (n=13) from those with hyaline membrane disease (HMD; n=30). 85 % of the neonates with GBS had increased plasma concentrations of E-α1-PI at age of diagnosis. In contrast all patients with HMD had E-α1-PI levels within the normal range. After initiation of therapy normalization of E-α1-PI levels was observed in all neonates who recovered from infection. These data suggest that E-α1-PI is a sensitive and rapidly responsive indicator of neonatal septicemia. In addition E-α1-PI may be helpful in monitoring the course of the disease.
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Speer, C., Gahr, M., Otte, J. et al. ELASTASE-α1-PROTEINASE INHIBITOR IN NEONATAL SEPTICEMIA AND HYALINE MEMBRANE DISEASE. Pediatr Res 22, 240 (1987). https://doi.org/10.1203/00006450-198708000-00163
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DOI: https://doi.org/10.1203/00006450-198708000-00163