tetano
Editor, Senior Moderator
Heart Lung
. 2023 Nov 18:64:24-30.
doi: 10.1016/j.hrtlng.2023.11.005. Online ahead of print. Reduced IgG2 with thrombocytopenia predicts mortality in patients with influenza pneumonia
Wenxin Liu[SUP] 1 [/SUP], Xiaomei Zhang[SUP] 2 [/SUP], Dan Wang[SUP] 2 [/SUP], Xiaobo Yu[SUP] 2 [/SUP], Shubin Guo[SUP] 3 [/SUP], Fei Teng[SUP] 4 [/SUP]
Affiliations
Background: Thrombocytopenia is a common disorder during influenza that is related to high mortality.
Objectives: A prospective study was performed to investigate the association of immunoglobulin subclass changes accompanying incident thrombocytopenia with clinical outcomes in patients with severe influenza.
Methods: 96 influenza patients were recruited and divided into two groups, patients with thrombocytopenia (n = 30) and patients without thrombocytopenia (n = 66). Plasma microarrays were used for quantitative analysis of immunoglobulins. The endpoint was 28-day mortality. Continuous platelet count, d-dimer, level of each Ig subclass and other variables were compared between the two groups. Kaplan-Meier curve was taken to analyze the 28-day survival rate of the two groups and Cox regression analysis was performed to identify variables independently associated with 28-day mortality.
Results: Patients with thrombocytopenia had significantly high values of d-dimer at admission and when platelet lowest with high SOFA score. Their IgA2, IgG2, and IgG4 values were also lower than those without thrombocytopenia. Patients without thrombocytopenia had a higher 28-day survival rate than those in the thrombocytopenia group. In the multivariate Cox regression model, age (HR = 1.036, 95%CI = 1.011-1.062), IgG2 (HR = 0.990, 95%CI = 0.982-0.998), platelet minimum within 28 days (HR = 0.991, 95%CI = 0.982-0.999) and d-dimer when platelet lowest (HR = 1.091, 95%CI = 1.047-1.137) were independently related to 28-day mortality.
Conclusion: Decreased IgG2 may be associated with thrombocytopenia. A coexistence of thrombocytopenia, IgG2 reduction and d-dimer elevation may improve the accuracy of mortality prediction in patients with influenza pneumonia.
Keywords: IgG2; Influenza; Prediction; Thrombocytopenia.
. 2023 Nov 18:64:24-30.
doi: 10.1016/j.hrtlng.2023.11.005. Online ahead of print. Reduced IgG2 with thrombocytopenia predicts mortality in patients with influenza pneumonia
Wenxin Liu[SUP] 1 [/SUP], Xiaomei Zhang[SUP] 2 [/SUP], Dan Wang[SUP] 2 [/SUP], Xiaobo Yu[SUP] 2 [/SUP], Shubin Guo[SUP] 3 [/SUP], Fei Teng[SUP] 4 [/SUP]
Affiliations
- PMID: 37984100
- DOI: 10.1016/j.hrtlng.2023.11.005
Background: Thrombocytopenia is a common disorder during influenza that is related to high mortality.
Objectives: A prospective study was performed to investigate the association of immunoglobulin subclass changes accompanying incident thrombocytopenia with clinical outcomes in patients with severe influenza.
Methods: 96 influenza patients were recruited and divided into two groups, patients with thrombocytopenia (n = 30) and patients without thrombocytopenia (n = 66). Plasma microarrays were used for quantitative analysis of immunoglobulins. The endpoint was 28-day mortality. Continuous platelet count, d-dimer, level of each Ig subclass and other variables were compared between the two groups. Kaplan-Meier curve was taken to analyze the 28-day survival rate of the two groups and Cox regression analysis was performed to identify variables independently associated with 28-day mortality.
Results: Patients with thrombocytopenia had significantly high values of d-dimer at admission and when platelet lowest with high SOFA score. Their IgA2, IgG2, and IgG4 values were also lower than those without thrombocytopenia. Patients without thrombocytopenia had a higher 28-day survival rate than those in the thrombocytopenia group. In the multivariate Cox regression model, age (HR = 1.036, 95%CI = 1.011-1.062), IgG2 (HR = 0.990, 95%CI = 0.982-0.998), platelet minimum within 28 days (HR = 0.991, 95%CI = 0.982-0.999) and d-dimer when platelet lowest (HR = 1.091, 95%CI = 1.047-1.137) were independently related to 28-day mortality.
Conclusion: Decreased IgG2 may be associated with thrombocytopenia. A coexistence of thrombocytopenia, IgG2 reduction and d-dimer elevation may improve the accuracy of mortality prediction in patients with influenza pneumonia.
Keywords: IgG2; Influenza; Prediction; Thrombocytopenia.