Akut Romatizmal Ateşi Olan Çocuklarda İskemi Modifiye Albümin Güvenilir Bir Biyobelirteç Olmayabilir
Abstract
Amaç: Akut romatizmal ateş (ARA), erişkin dönemde ciddi kardiyak komplikasyonlara neden olma potansiyeli nedeniyle, gelişmekte olan bölgelerde önemli sağlık sorunları oluşturmaktadır. Bu çalışma, orta rakımlı bir bölgede ARA tanısı konulan çocuklarda enflamasyon için bir biyobelirteç olarak iskemi modifiye albüminin (IMA) rolünü araştırmayı amaçlamaktadır.
Yöntem: Ocak 2019 ve Mayıs 2020 tarihleri arasında yapılan çalışmaya 25 ARA hastası ve 25 sağlıklı çocuktan oluşan bir kontrol grubu dahil edildi. Tanı ve tedavi sonrası serum IMA düzeyi ölçümlerinin yanı sıra klinik ve ekokardiyografik değerlendirmeler yapıldı.
Bulgular: ARA hastalarında C-reaktif protein ve eritrosit sedimantasyon hızı gibi akut faz reaktanları yükselirken, IMA seviyelerinin hem tanı hem de tedavi sonrasında kontrol grubundakilerden önemli ölçüde fark bulunmadığı saptandı. Spesifik olarak, IMA düzeyleri tanı anında (0,62 ± 0,73 ng/ml), tedavi sonrasına (1,18 ± 0,94 ng/ml) kıyasla daha düşüktü. İskemi modifiye albuminin CRP ile bir korelasyonu yoktu, ancak ESR ile negatif bir korelasyon olduğu gözlendi.
Sonuç: Bu bulgular, IMA'nın ortal irtifa bir bölgede yaşayan çocuklarda ARA'nin teşhisi ve izlenmesi için güvenilir bir biyobelirteç olmayabileceğini ve akut romatizmal ateş hastalarında yapılan önceki çalışmalara göre farklılık gösterdiği bulundu. Bu popülasyonda rakımın ve diğer çevresel faktörlerin IMA düzeyleri üzerindeki etkilerini araştırmak için daha fazla araştırma yapılması gerekmektedir.
References
- Libby P. Braunwald's heart disease-E-book: a textbook of cardiovascular medicine: Elsevier Health Sciences, 2021.
- Mou H, Shao J, Zhang J, Yang J, Yu S, Wang H. Ischemia-modified Albumin to Evaluate Short-term Prognostic of Patients with Acute Coronary Syndrome. J Coll Physicians Surg Pak 2021;30:841-845.
- Erenler AK, Yardan T, Kati C, Altuntaş M, Türedi S. Role of ischemia-modified albumin in clinical practice. Lab Med. 2015;39:241-247.
- Toker A, Karatas Z, Altin H, Karaarslan S, Cicekler H, Alp H. Evaluation of serum ischemia modified albumin levels in acute rheumatic fever before and after therapy. Indian J Pediatr 2014;81:120-5.
- Karatas Z, Baysal T, Sap F, Alp H, Mehmetoglu I. Increased ischaemia-modified albumin is associated with inflammation in acute rheumatic fever. Cardiol Young 2014;24:430-6.
- Gewitz MH, Baltimore RS, Tani LY et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation 2015;131:1806-18.
- Kaplan EL, Rothermel CD, Johnson DR. Antistreptolysin O and anti-deoxyribonuclease B titers: normal values for children ages 2 to 12 in the United States. Pediatrics 1998;101:86-8.
- Steer AC, Vidmar S, Ritika R et al. Normal ranges of streptococcal antibody titers are similar whether streptococci are endemic to the setting or not. Clin Vaccine Immunol 2009;16:172-5.
- Chen CB, Hammo B, Barry J, Radhakrishnan K. Overview of Albumin Physiology and its Role in Pediatric Diseases. Curr Gastroenterol Rep 2021;23:11.
- Cannon J, Roberts K, Milne C, Carapetis JR. Rheumatic Heart Disease Severity, Progression and Outcomes: A Multi-State Model. J Am Heart Assoc 2017;6.
- Parnaby MG, Carapetis JR. Rheumatic fever in indigenous Australian children. J Paediatr Child Health 2010;46:527-33.
- Carapetis JR, Beaton A, Cunningham MW et al. Acute rheumatic fever and rheumatic heart disease. Nat Rev Dis Primers 2016;2:15084.
- Kumar RK, Tandon R. Rheumatic fever & rheumatic heart disease: the last 50 years. Indian J Med Res 2013;137:643-58.
- Gok M, Kundi H, Kiziltunc E, Topcuoglu C, Ornek E. The relationship between ischaemia-modified albumin and good coronary collateral circulation. Kardiol Pol 2018;76:370-375.
- Pipikos T, Kapelouzou A, Tsilimigras DI et al. Stronger correlation with myocardial ischemia of high-sensitivity troponin T than other biomarkers. J Nucl Cardiol 2019;26:1674-1683.
- Mangoni AA, Zinellu A. Ischemia-modified albumin in rheumatic diseases: A systematic review and meta-analysis. Immun Inflamm Dis 2024;12:e1324.
- Dawn I, Biswas G. Assessment of serum Ischemia Modified Albumin (IMA) Levels in Acute Rheumatic Fever. Int J Hum and Health Sci (IJHHS);5:222-225.
- Caliskan A, Yavuz C, Karahan O et al. Serum ischaemia-modified albumin level is an irrelevant predictive factor for ischaemic duration in mesenteric ischaemia. Perfusion 2014;29:226-30.
- Sbarouni E, Georgiadou P, Koutelou M, Sklavainas I, Panagiotakos D, Voudris V. Ischaemia-modified albumin in dilated cardiomyopathy. Ann Clin Biochem 2009;46:241-3.
- Roy D, Quiles J, Sharma R et al. Ischemia-modified albumin concentrations in patients with peripheral vascular disease and exercise-induced skeletal muscle ischemia. Clin Chem 2004;50:1656-60.
- Demir H, Topkaya BÇ, Erbay A, Doğan M, Yücel D. Ischaemia-modified albumin elevation after percutaneous coronary intervention reflects albumin concentration rather than ischaemia. Ann. Clin. Biochem. 2009;46:327-331.
- Gaze DC, Crompton L, Collinson P. Ischemia-modified albumin concentrations should be interpreted with caution in patients with low serum albumin concentrations. Med Princ Pract 2006;15:322-4.
Abstract
Aim: Acute rheumatic fever (ARF) poses significant health challenges in developing regions, particularly due to its potential to cause severe cardiac complications. This study investigates the role of ischemia-modified albumin (IMA) as a biomarker for inflammation in children diagnosed with ARF in a moderate altitude area. Methods: Conducted between January 2019 and May 2020 at a regional hospital located at the moderate altitude, the study included 25 ARF patients and a control group of 25 healthy children. Clinical assessments and echocardiographic evaluations were performed, alongside serum IMA level measurements at diagnosis and post-treatment. Results: indicated that while acute phase reactants such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were elevated in ARF patients, IMA levels were not significantly different from those in the control group, both at diagnosis and after treatment. Specifically, IMA levels were lower at diagnosis (0.62 ± 0.73 ng/ml) compared to post-treatment (1.18 ± 0.94 ng/ml), with no consistent correlation to CRP, although a negative correlation with ESR was observed. Conclusion: These findings suggest that IMA may not be a reliable biomarker for diagnosing and monitoring ARF in children in moderate region, challenging previous claims about its utility in patients with acute rheumatic fever. Further research is warranted to explore the effects of altitude and other environmental factors on IMA levels in this population.
References
- Libby P. Braunwald's heart disease-E-book: a textbook of cardiovascular medicine: Elsevier Health Sciences, 2021.
- Mou H, Shao J, Zhang J, Yang J, Yu S, Wang H. Ischemia-modified Albumin to Evaluate Short-term Prognostic of Patients with Acute Coronary Syndrome. J Coll Physicians Surg Pak 2021;30:841-845.
- Erenler AK, Yardan T, Kati C, Altuntaş M, Türedi S. Role of ischemia-modified albumin in clinical practice. Lab Med. 2015;39:241-247.
- Toker A, Karatas Z, Altin H, Karaarslan S, Cicekler H, Alp H. Evaluation of serum ischemia modified albumin levels in acute rheumatic fever before and after therapy. Indian J Pediatr 2014;81:120-5.
- Karatas Z, Baysal T, Sap F, Alp H, Mehmetoglu I. Increased ischaemia-modified albumin is associated with inflammation in acute rheumatic fever. Cardiol Young 2014;24:430-6.
- Gewitz MH, Baltimore RS, Tani LY et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation 2015;131:1806-18.
- Kaplan EL, Rothermel CD, Johnson DR. Antistreptolysin O and anti-deoxyribonuclease B titers: normal values for children ages 2 to 12 in the United States. Pediatrics 1998;101:86-8.
- Steer AC, Vidmar S, Ritika R et al. Normal ranges of streptococcal antibody titers are similar whether streptococci are endemic to the setting or not. Clin Vaccine Immunol 2009;16:172-5.
- Chen CB, Hammo B, Barry J, Radhakrishnan K. Overview of Albumin Physiology and its Role in Pediatric Diseases. Curr Gastroenterol Rep 2021;23:11.
- Cannon J, Roberts K, Milne C, Carapetis JR. Rheumatic Heart Disease Severity, Progression and Outcomes: A Multi-State Model. J Am Heart Assoc 2017;6.
- Parnaby MG, Carapetis JR. Rheumatic fever in indigenous Australian children. J Paediatr Child Health 2010;46:527-33.
- Carapetis JR, Beaton A, Cunningham MW et al. Acute rheumatic fever and rheumatic heart disease. Nat Rev Dis Primers 2016;2:15084.
- Kumar RK, Tandon R. Rheumatic fever & rheumatic heart disease: the last 50 years. Indian J Med Res 2013;137:643-58.
- Gok M, Kundi H, Kiziltunc E, Topcuoglu C, Ornek E. The relationship between ischaemia-modified albumin and good coronary collateral circulation. Kardiol Pol 2018;76:370-375.
- Pipikos T, Kapelouzou A, Tsilimigras DI et al. Stronger correlation with myocardial ischemia of high-sensitivity troponin T than other biomarkers. J Nucl Cardiol 2019;26:1674-1683.
- Mangoni AA, Zinellu A. Ischemia-modified albumin in rheumatic diseases: A systematic review and meta-analysis. Immun Inflamm Dis 2024;12:e1324.
- Dawn I, Biswas G. Assessment of serum Ischemia Modified Albumin (IMA) Levels in Acute Rheumatic Fever. Int J Hum and Health Sci (IJHHS);5:222-225.
- Caliskan A, Yavuz C, Karahan O et al. Serum ischaemia-modified albumin level is an irrelevant predictive factor for ischaemic duration in mesenteric ischaemia. Perfusion 2014;29:226-30.
- Sbarouni E, Georgiadou P, Koutelou M, Sklavainas I, Panagiotakos D, Voudris V. Ischaemia-modified albumin in dilated cardiomyopathy. Ann Clin Biochem 2009;46:241-3.
- Roy D, Quiles J, Sharma R et al. Ischemia-modified albumin concentrations in patients with peripheral vascular disease and exercise-induced skeletal muscle ischemia. Clin Chem 2004;50:1656-60.
- Demir H, Topkaya BÇ, Erbay A, Doğan M, Yücel D. Ischaemia-modified albumin elevation after percutaneous coronary intervention reflects albumin concentration rather than ischaemia. Ann. Clin. Biochem. 2009;46:327-331.
- Gaze DC, Crompton L, Collinson P. Ischemia-modified albumin concentrations should be interpreted with caution in patients with low serum albumin concentrations. Med Princ Pract 2006;15:322-4.
Details
| Primary Language | English |
|---|---|
| Subjects | Cardiovascular Medicine and Haematology (Other) |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | June 30, 2025 |
| Submission Date | December 10, 2024 |
| Acceptance Date | April 18, 2025 |
| Published in Issue | Year 2025 Volume: 8 Issue: 2 |
The articles in the Journal of "Acta Medica Nicomedia" are open access articles licensed under a Creative Commons Attribution-ShareAlike 4.0 International License at the web address https://dergipark.org.tr/tr/pub/actamednicomedia