Could the C-reactive protein/albumin Ratio Predict Mortality in Patients with Common Variable İmmunodeficiency?
Abstract
Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency in adults. This study assessed the utility of using the C-reactive protein (CRP)/albumin ratio (CAR) at diagnosis to predict mortality in CVID patients. Between 2010 and 2022, hospital records and follow-up cards of patients with CVID were reviewed retrospectively. Seventy-five patients were included in the study. CRP 0–5 mg/L and albumin 3.5–5.5 g/dL were taken as references. The CAR was obtained by dividing the CRP value by the albumin value. Of the included patients, 41 (55%) were male and 34 (35%) were female. The median age was 38 (21–77) years. The mortality rate of the patients during the follow-up time was 20%. Of the patients, 41% had splenomegaly, 10.6% had malignancy, and 39% had bronchiectasis. The cut-off value of CAR to predict mortality was >2.18 (sensitivity: 88.4%, specificity: 90.1%). When the patients were classified according to the CAR, the mortality rate in the patient group with a CAR > 2.18 was statistically significantly higher than the patient group with a CAR ≤ 2.18. The CAR is a cheap, simple, and easily calculated parameter that can predict mortality in CVID patients.
Keywords
References
- 1. Chapel H, Cunningham-Rundles C. Update in understanding common variable immunodeficiency disorders (CVIDs) and the management of patients with these conditions. British journal of haematology. 2009;145:709-27.
- 2. Cunningham-Rundles C. How I treat common variable immune deficiency. Blood. 2010;116:7-15.
- 3. Chapel H, Lucas M, Lee M, et al. Common variable immunodeficiency disorders: division into distinct clinical phenotypes. Blood. 2008;112:277-86.
- 4. Bonilla FA, Barlan I, Chapel H, et al. International Consensus Document (ICON): Common Variable Immunodeficiency Disorders. The journal of allergy and clinical immunology In practice. 2016;4:38-59.
- 5. Resnick ES, Moshier EL, Godbold JH, et al. Morbidity and mortality in common variable immune deficiency over 4 decades. Blood. 2012;119:1650-7.
- 6. Cunningham-Rundles C, Bodian C. Common variable immunodeficiency: clinical and immunological features of 248 patients. Clinical immunology (Orlando, Fla). 1999;92:34-48.
- 7. Fairclough E, Cairns E, Hamilton J, et al. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clinical medicine (London, England). 2009;9:30-3.
- 8. Ranzani OT, Zampieri FG, Forte DN, et al. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PloS one. 2013;8:e59321.
- 9. Li YJ, Yao K, Lu MX, et al. Prognostic value of the C-reactive protein to albumin ratio: a novel inflammation-based prognostic indicator in osteosarcoma. OncoTargets and therapy. 2017;10:5255-61.
- 10. Picard C, Bobby Gaspar H, Al-Herz W, et al. International Union of Immunological Societies: 2017 Primary Immunodeficiency Diseases Committee Report on Inborn Errors of Immunity. Journal of clinical immunology. 2018;38:96-128.
- 11. Wei XL, Wang FH, Zhang DS, et al. A novel inflammation-based prognostic score in esophageal squamous cell carcinoma: the C-reactive protein/albumin ratio. BMC cancer. 2015;15:350.
- 12. Xu XL, Yu HQ, Hu W, et al. A Novel Inflammation-Based Prognostic Score, the C-Reactive Protein/Albumin Ratio Predicts the Prognosis of Patients with Operable Esophageal Squamous Cell Carcinoma. PloS one. 2015;10:e0138657.
- 13. Aghamohammadi A, Pouladi N, Parvaneh N, et al. Mortality and morbidity in common variable immunodeficiency. Journal of tropical pediatrics. 2007;53:32-8.
- 14. Seymour B, Miles J, Haeney M. Primary antibody deficiency and diagnostic delay. Journal of clinical pathology. 2005;58:546-7.
- 15. Quinti I, Agostini C, Tabolli S, et al. Malignancies are the major cause of death in patients with adult onset common variable immunodeficiency. Blood. 2012;120:1953-4.
- 16. Bagheri Y, Vosughi A, Azizi G, et al. Comparison of clinical and immunological features and mortality in common variable immunodeficiency and agammaglobulinemia patients. Immunology letters. 2019;210:55-62.
- 17. Sun P, Chen C, Xia Y, et al. The Ratio of C-Reactive Protein/Albumin is a Novel Inflammatory Predictor of Overall Survival in Cisplatin-Based Treated Patients with Metastatic Nasopharyngeal Carcinoma. Disease markers. 2017;2017:6570808.
- 18. Boileau J, Mouillot G, Gérard L, et al. Autoimmunity in common variable immunodeficiency: correlation with lymphocyte phenotype in the French DEFI study. Journal of autoimmunity. 2011;36:25-32.
- 19. Patuzzo G, Barbieri A, Tinazzi E, et al. Autoimmunity and infection in common variable immunodeficiency (CVID). Autoimmunity reviews. 2016;15:877-82.
C-reaktif protein/albümin Oranı Yaygın Değişken İmmün Yetmezliği Olan Hastalarda Mortaliteyi Tahmin Edebilir mi?
Abstract
Yaygın değişken immün yetersizlik (YDİY), yetişkinlerde en sık görülen semptomatik primer immün yetmezliktir. Bu çalışma, CVID hastalarında mortaliteyi tahmin etmek için tanıda C-reaktif protein (CRP)/albümin oranı (CAO) kullanmanın faydasını değerlendirdi. 2010-2022 yılları arasında YDİY'li hastaların hastane kayıtları ve takip kartları retrospektif olarak incelendi. Çalışmaya yetmiş beş hasta dahil edildi. CRP 0–5 mg/L ve albümin 3,5–5,5 g/dL referans olarak alındı. CAO, CRP değerinin albümin değerine bölünmesiyle elde edildi. Çalışmaya alınan hastaların 41'i (%55) erkek, 34'ü (%35) kadındı. Ortanca yaş 38 (21-77) idi. Takip süresi boyunca hastaların ölüm oranı %20 idi. Hastaların %41'inde splenomegali, %10.6'sında malignite ve %39'unda bronşektazi vardı. CAO'nın mortaliteyi öngörmek için kesme değeri >2,18 idi (duyarlılık: %88,4, özgüllük: %90,1). Hastalar CAO göre sınıflandırıldığında, CAO > 2,18 olan hasta grubunda mortalite oranı, CAO ≤ 2,18 olan hasta grubuna göre istatistiksel olarak anlamlı derecede yüksekti. CAO, YDİY hastalarda mortaliteyi tahmin edebilen ucuz, basit ve kolayca hesaplanabilen bir parametredir.
Keywords
References
- 1. Chapel H, Cunningham-Rundles C. Update in understanding common variable immunodeficiency disorders (CVIDs) and the management of patients with these conditions. British journal of haematology. 2009;145:709-27.
- 2. Cunningham-Rundles C. How I treat common variable immune deficiency. Blood. 2010;116:7-15.
- 3. Chapel H, Lucas M, Lee M, et al. Common variable immunodeficiency disorders: division into distinct clinical phenotypes. Blood. 2008;112:277-86.
- 4. Bonilla FA, Barlan I, Chapel H, et al. International Consensus Document (ICON): Common Variable Immunodeficiency Disorders. The journal of allergy and clinical immunology In practice. 2016;4:38-59.
- 5. Resnick ES, Moshier EL, Godbold JH, et al. Morbidity and mortality in common variable immune deficiency over 4 decades. Blood. 2012;119:1650-7.
- 6. Cunningham-Rundles C, Bodian C. Common variable immunodeficiency: clinical and immunological features of 248 patients. Clinical immunology (Orlando, Fla). 1999;92:34-48.
- 7. Fairclough E, Cairns E, Hamilton J, et al. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clinical medicine (London, England). 2009;9:30-3.
- 8. Ranzani OT, Zampieri FG, Forte DN, et al. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PloS one. 2013;8:e59321.
- 9. Li YJ, Yao K, Lu MX, et al. Prognostic value of the C-reactive protein to albumin ratio: a novel inflammation-based prognostic indicator in osteosarcoma. OncoTargets and therapy. 2017;10:5255-61.
- 10. Picard C, Bobby Gaspar H, Al-Herz W, et al. International Union of Immunological Societies: 2017 Primary Immunodeficiency Diseases Committee Report on Inborn Errors of Immunity. Journal of clinical immunology. 2018;38:96-128.
- 11. Wei XL, Wang FH, Zhang DS, et al. A novel inflammation-based prognostic score in esophageal squamous cell carcinoma: the C-reactive protein/albumin ratio. BMC cancer. 2015;15:350.
- 12. Xu XL, Yu HQ, Hu W, et al. A Novel Inflammation-Based Prognostic Score, the C-Reactive Protein/Albumin Ratio Predicts the Prognosis of Patients with Operable Esophageal Squamous Cell Carcinoma. PloS one. 2015;10:e0138657.
- 13. Aghamohammadi A, Pouladi N, Parvaneh N, et al. Mortality and morbidity in common variable immunodeficiency. Journal of tropical pediatrics. 2007;53:32-8.
- 14. Seymour B, Miles J, Haeney M. Primary antibody deficiency and diagnostic delay. Journal of clinical pathology. 2005;58:546-7.
- 15. Quinti I, Agostini C, Tabolli S, et al. Malignancies are the major cause of death in patients with adult onset common variable immunodeficiency. Blood. 2012;120:1953-4.
- 16. Bagheri Y, Vosughi A, Azizi G, et al. Comparison of clinical and immunological features and mortality in common variable immunodeficiency and agammaglobulinemia patients. Immunology letters. 2019;210:55-62.
- 17. Sun P, Chen C, Xia Y, et al. The Ratio of C-Reactive Protein/Albumin is a Novel Inflammatory Predictor of Overall Survival in Cisplatin-Based Treated Patients with Metastatic Nasopharyngeal Carcinoma. Disease markers. 2017;2017:6570808.
- 18. Boileau J, Mouillot G, Gérard L, et al. Autoimmunity in common variable immunodeficiency: correlation with lymphocyte phenotype in the French DEFI study. Journal of autoimmunity. 2011;36:25-32.
- 19. Patuzzo G, Barbieri A, Tinazzi E, et al. Autoimmunity and infection in common variable immunodeficiency (CVID). Autoimmunity reviews. 2016;15:877-82.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases, Health Care Administration |
| Journal Section | ORİJİNAL MAKALE |
| Authors | |
| Publication Date | July 20, 2023 |
| Published in Issue | Year 2023 Volume: 45 Issue: 4 |