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  1. Article ; Online: Cardiac allograft vasculopathy in heart transplant recipients from hepatitis C viremic donors.

    Kadosh, Bernard S / Birs, Antoinette S / Flattery, Erin / Stachel, Maxine / Hong, Kimberly N / Xia, Yuhe / Gidea, Claudia / Aslam, Saima / Razzouk, Louai / Saraon, Tajinderpal / Goldberg, Randal / Rao, Shaline / Pretorius, Victor / Moazami, Nader / Smith, Deane E / Adler, Eric D / Reyentovich, Alex

    Clinical transplantation

    2024  Volume 38, Issue 4, Page(s) e15294

    Abstract: Background: Recent studies suggest the transplantation of Hepatitis C (HCV) hearts from viremic ...

    Abstract Background: Recent studies suggest the transplantation of Hepatitis C (HCV) hearts from viremic donors is associated with comparable 1 year survival to nonviremic donors. Though HCV viremia is a known risk factor for accelerated atherosclerosis, data on cardiac allograft vasculopathy (CAV) outcomes are limited. We compared the incidence of CAV in heart transplant recipients from HCV viremic donors (nucleic acid amplification test positive; NAT+) compared to non-HCV infected donors (NAT-).
    Methods: We retrospectively reviewed annual coronary angiograms with intravascular ultrasound from April 2017 to August 2020 at two large cardiac transplant centers. CAV was graded according to ISHLT guidelines. Maximal intimal thickness (MIT) ≥ 0.5 mm was considered significant for subclinical disease.
    Results: Among 270 heart transplant recipients (mean age 54; 77% male), 62 patients were transplanted from NAT+ donors. CAV ≥ grade 1 was present in 8.8% of the NAT+ versus 16.8% of the NAT- group at 1 year, 20% versus 28.8% at 2 years, and 33.3% versus 41.5% at 3 years. After adjusting for donor age, donor smoking history, recipient BMI, recipient, hypertension, and recipient diabetes, NAT+ status did not confer increased risk of CAV (HR.80; 95% CI.45-1.40, p = 0.43) or subclinical IVUS disease (HR.87; 95% CI.58-1.30, p = 0.49). Additionally, there was no difference in the presence of rapidly progressive lesions on IVUS.
    Conclusion: Our data show that NAT+ donors conferred no increased risk for early CAV or subclinical IVUS disease following transplantation in a cohort of heart transplant patients who were treated for HCV, suggesting the short-term safety of this strategy to maximize the pool of available donor hearts.
    MeSH term(s) Humans ; Male ; Middle Aged ; Female ; Tissue Donors ; Retrospective Studies ; Heart Transplantation/adverse effects ; Viremia/epidemiology ; Viremia/etiology ; Follow-Up Studies ; Hepatitis C/etiology ; Hepacivirus ; Allografts ; Transplant Recipients
    Language English
    Publishing date 2024-03-28
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/ctr.15294
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  2. Article: The SHELTER Trial of Transplanting Hepatitis C Virus-Infected Lungs Into Uninfected Recipients.

    Reese, Peter P / Diamond, Joshua M / Goldberg, David S / Potluri, Vishnu / Prenner, Stacey / Blumberg, Emily A / Van Deerlin, Vivianna M / Reddy, K Rajender / Mentch, Heather / Hasz, Richard / Woodards, Ashley / Gentile, Caren / Smith, Jennifer / Bermudez, Christian / Crespo, Maria M

    Transplantation direct

    2023  Volume 9, Issue 7, Page(s) e1504

    Abstract: SHELTER is a trial of transplanting lungs from deceased donors with hepatitis C virus (HCV ...

    Abstract SHELTER is a trial of transplanting lungs from deceased donors with hepatitis C virus (HCV) infection into HCV-negative candidates (sponsor: Merck; NCT03724149). Few trials have reported outcomes using thoracic organs from HCV-RNA
    Methods: This study is a single-arm trial of 10 lung transplants at a single center. Patients were included who were between 18 and 67 y of age and waitlisted for lung-only transplant. Patients were excluded who had evidence of liver disease. Primary outcome was HCV cure (sustained virologic response 12 wk after completing antiviral therapy). Recipients longitudinally reported QOL using the validated RAND-36 instrument. We also applied advanced methods to match HCV-RNA
    Results: Between November 2018 and November 2020, 18 patients were consented and opted-in for HCV-RNA
    Conclusions: SHELTER adds important evidence regarding the safety of transplanting HCV-RNA
    Language English
    Publishing date 2023-06-28
    Publishing country United States
    Document type Journal Article
    ISSN 2373-8731
    ISSN 2373-8731
    DOI 10.1097/TXD.0000000000001504
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: RNA Interference Therapy Targeting Apolipoprotein C-III in Hypertriglyceridemia.

    Gaudet, Daniel / Clifton, Peter / Sullivan, David / Baker, John / Schwabe, Christian / Thackwray, Susan / Scott, Russell / Hamilton, James / Given, Bruce / Melquist, Stacey / Zhou, Rong / Chang, Ting / San Martin, Javier / Watts, Gerald F / Goldberg, Ira J / Knowles, Joshua W / Hegele, Robert A / Ballantyne, Christie M

    NEJM evidence

    2023  Volume 2, Issue 12, Page(s) EVIDoa2200325

    Abstract: APOC3-Targeting RNAi for HypertriglyceridemiaThis randomized controlled trial examined the safety and side effects of the small interfering RNA ARO-APOC3 in healthy volunteers and patients with hypertriglyceridemia and chylomicronemia. ARO-APOC3 was ... ...

    Abstract APOC3-Targeting RNAi for HypertriglyceridemiaThis randomized controlled trial examined the safety and side effects of the small interfering RNA ARO-APOC3 in healthy volunteers and patients with hypertriglyceridemia and chylomicronemia. ARO-APOC3 was associated with few adverse events and no dose-limiting toxicities.
    MeSH term(s) Humans ; Apolipoprotein C-III/genetics ; RNA Interference ; Hypertriglyceridemia/complications
    Chemical Substances Apolipoprotein C-III
    Language English
    Publishing date 2023-11-17
    Publishing country United States
    Document type Journal Article
    ISSN 2766-5526
    ISSN (online) 2766-5526
    DOI 10.1056/EVIDoa2200325
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  4. Article ; Online: Imaging Fluorescent Nuclear Pore Complex Proteins in C. elegans.

    Lancaster, Courtney / Zavagno, Giulia / Groombridge, James / Raimundo, Adelaide / Weinkove, David / Hawkins, Tim / Robson, Joanne / Goldberg, Martin W

    Methods in molecular biology (Clifton, N.J.)

    2022  Volume 2502, Page(s) 373–393

    Abstract: C. elegans is a well-characterized and relatively simple model organism, making it attractive ... for studying nuclear pore complex proteins in cell and developmental biology. C. elegans is transparent and ... time. Here, we provide protocols to prepare both fixed and live C. elegans for confocal and light sheet ...

    Abstract C. elegans is a well-characterized and relatively simple model organism, making it attractive for studying nuclear pore complex proteins in cell and developmental biology. C. elegans is transparent and highly amendable to genetic manipulation. Therefore, it is possible to generate fluorescently tagged proteins and combine this with various light microscopy techniques to study protein behavior in space and time. Here, we provide protocols to prepare both fixed and live C. elegans for confocal and light sheet microscopy. This enables the analysis of nuclear pore complex proteins from embryonic stages to the aging adult.
    MeSH term(s) Animals ; Caenorhabditis elegans/genetics ; Caenorhabditis elegans/metabolism ; Caenorhabditis elegans Proteins/genetics ; Caenorhabditis elegans Proteins/metabolism ; Microscopy, Fluorescence/methods ; Nuclear Pore Complex Proteins/metabolism
    Chemical Substances Caenorhabditis elegans Proteins ; Nuclear Pore Complex Proteins
    Language English
    Publishing date 2022-04-12
    Publishing country United States
    Document type Journal Article
    ISSN 1940-6029
    ISSN (online) 1940-6029
    DOI 10.1007/978-1-0716-2337-4_24
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Securing wider EU commitment to the elimination of hepatitis C virus.

    Wedemeyer, Heiner / Tergast, Tammo L / Lazarus, Jeffrey V / Razavi, Homie / Bakoyannis, Kostas / Baptista-Leite, Ricardo / Bartoli, Marco / Bruggmann, Philip / Buşoi, Cristian-Silviu / Buti, Maria / Carballo, Manuel / Castera, Laurent / Colombo, Massimo / Coutinho, Rodrigo Sousa / Dadon, Yuval / Esmat, Gamal / Esteban, Rafael / Farran, Joan Colom / Gillyon-Powell, Mark /
    Goldberg, David / Hutchinson, Sharon / Janssen, Harry L A / Kalamitsis, George / Kondili, Loreta A / Lambert, John S / Marinho, Rui Tato / Maticic, Mojca / Patricello, Aldo / Peck-Radosavljevic, Markus / Pol, Stanislas / Poljak, Mario / Pop, Cora / Sokol, Tomislov / Sypsa, Vana / Tözün, Nurdan / Younossi, Zobair / Aghemo, Alessio / Papatheodoridis, George V / Hatzakis, Angelos

    Liver international : official journal of the International Association for the Study of the Liver

    2022  Volume 43, Issue 2, Page(s) 276–291

    Abstract: In 2016, the Hepatitis B and C Public Policy Association (HepBCPPA), gathered all the main ... stakeholders in the field of hepatitis C virus (HCV) to launch the now landmark HCV Elimination Manifesto ...

    Abstract In 2016, the Hepatitis B and C Public Policy Association (HepBCPPA), gathered all the main stakeholders in the field of hepatitis C virus (HCV) to launch the now landmark HCV Elimination Manifesto, calling for the elimination of HCV in the EU by 2030. Since then, many European countries have made progress towards HCV elimination. Multiple programmes-from the municipality level to the EU level-were launched, resulting in an overall decrease in viremic HCV infections and liver-related mortality. However, as of 2021, most countries are not on track to reach the 2030 HCV elimination targets set by the WHO. Moreover, the COVID-19 pandemic has resulted in a decrease in HCV diagnoses and fewer direct-acting antiviral treatment initiations in 2020. Diagnostic and therapeutic tools to easily diagnose and treat chronic HCV infection are now well established. Treating all patients with chronic HCV infection is more cost-saving than treating and caring for patients with liver-related complications, decompensated cirrhosis or hepatocellular carcinoma. It is more important than ever to reinforce and scale-up action towards HCV elimination. Yet, efforts urgently need the dedicated commitment of policymakers at all governmental and policy levels. Therefore, the third EU Policy Summit, held in March 2021, featured EU parliamentarians and other key decision makers to promote dialogue and take strides towards securing wider EU commitment to advance and achieve HCV elimination by 2030. We have summarized the key action points and reported the 'Call-to-Action' statement supported by all the major relevant European associations in the field.
    MeSH term(s) Humans ; Hepacivirus ; Antiviral Agents/therapeutic use ; Pandemics ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/epidemiology ; Hepatitis C, Chronic/prevention & control ; COVID-19 ; Hepatitis C/diagnosis ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Liver Neoplasms/drug therapy
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2022-12-14
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2102783-3
    ISSN 1478-3231 ; 1478-3223
    ISSN (online) 1478-3231
    ISSN 1478-3223
    DOI 10.1111/liv.15446
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Bempedoic acid: a promising novel agent for LDL-C lowering.

    Agarwala, Anandita / Goldberg, Anne C

    Future cardiology

    2020  Volume 16, Issue 5, Page(s) 361–371

    Abstract: ... LDL-C) by upregulating LDL receptors. Preclinical and completed Phase II and III clinical trials have ...

    Abstract Bempedoic acid (ETC-1002) is a novel, first-in-class, oral, small molecule that inhibits cholesterol biosynthesis in the same pathway as statins, thereby lowering low-density lipoprotein cholesterol (LDL-C) by upregulating LDL receptors. Preclinical and completed Phase II and III clinical trials have demonstrated promising results regarding its safety and efficacy across a variety of patient characteristics including statin intolerance and on a background of lipid-lowering therapy. Bempedoic acid is currently being evaluated in a cardiovascular outcomes trial to evaluate its effect on major cardiovascular events in patients with or at high risk for cardiovascular disease and with statin intolerance. In this review, we will discuss the history and development of bempedoic acid, relevant clinical trials, and its potential role as a lipid-lowering medication in the context of other currently available lipid-lowering therapies.
    MeSH term(s) Anticholesteremic Agents/therapeutic use ; Cholesterol, LDL ; Dicarboxylic Acids/therapeutic use ; Fatty Acids ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
    Chemical Substances Anticholesteremic Agents ; Cholesterol, LDL ; Dicarboxylic Acids ; Fatty Acids ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; 8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acid (1EJ6Z6Q368)
    Language English
    Publishing date 2020-05-28
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2274267-0
    ISSN 1744-8298 ; 1479-6678
    ISSN (online) 1744-8298
    ISSN 1479-6678
    DOI 10.2217/fca-2020-0016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2022 Clinical Practice Guideline.

    Awan, Ahmed Arslan Yousuf / Berenguer, Marina C / Bruchfeld, Annette / Fabrizi, Fabrizio / Goldberg, David S / Jia, Jidong / Kamar, Nassim / Mohamed, Rosmawati / Pessôa, Mário Guimarães / Pol, Stanislas / Sise, Meghan E / Balk, Ethan M / Gordon, Craig E / Adam, Gaelen / Cheung, Michael / Earley, Amy / Martin, Paul / Jadoul, Michel

    Annals of internal medicine

    2023  Volume 176, Issue 12, Page(s) 1648–1655

    Abstract: ... clinical practice guideline on prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease (CKD ... of hepatitis C virus (HCV) infection in patients with CKD (Chapter 2), management of HCV infection before and after ... 5). Recommendations in chapters on detection and evaluation of hepatitis C in CKD (Chapter 1) and ...

    Abstract Description: The Kidney Disease: Improving Global Outcomes (KDIGO) 2022 clinical practice guideline on prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease (CKD) is an update of the 2018 guideline from KDIGO.
    Methods: The KDIGO Work Group (WG) updated the guideline, which included reviewing and grading new evidence that was identified and summarized. As in the previous guideline, the WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of recommendations and used expert judgment to develop recommendations. New evidence led to updating of recommendations in the chapters on treatment of hepatitis C virus (HCV) infection in patients with CKD (Chapter 2), management of HCV infection before and after kidney transplant (Chapter 4), and diagnosis and management of kidney disease associated with HCV infection (Chapter 5). Recommendations in chapters on detection and evaluation of hepatitis C in CKD (Chapter 1) and prevention of HCV transmission in hemodialysis units (Chapter 3) were not updated because of an absence of significant new evidence.
    Recommendations: The 2022 updated guideline includes 43 graded recommendations and 20 ungraded recommendations, 7 of which are new or modified on the basis of the most recent evidence and consensus among the WG members. The updated guidelines recommend expanding treatment of hepatitis C with sofosbuvir-based regimens to patients with CKD glomerular filtration rate categories G4 and G5, including those receiving dialysis; expanding the donor pool for kidney transplant recipients by accepting HCV-positive kidneys regardless of the recipient's HCV status; and initiating direct-acting antiviral treatment of HCV-infected patients with clinical evidence of glomerulonephritis without requiring kidney biopsy. The update also addresses the use of immunosuppressive regimens in such patients.
    MeSH term(s) Humans ; Hepacivirus ; Antiviral Agents/therapeutic use ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/diagnosis ; Hepatitis C, Chronic/drug therapy ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/therapy ; Hepatitis C/drug therapy ; Kidney
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2023-12-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M23-2391
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  8. Article ; Online: Liver function tests in primary care provide a key opportunity to diagnose and engage patients with hepatitis C.

    McLeod, A / Hutchinson, S J / Weir, A / Barclay, S / Schofield, J / Frew, C Gillespie / Goldberg, D J / Heydtmann, M / Wilson-Davies, E

    Epidemiology and infection

    2022  Volume 150, Page(s) e133

    Abstract: Since the advent of direct-acting antiviral therapy, the elimination of hepatitis c virus (HCV ...

    Abstract Since the advent of direct-acting antiviral therapy, the elimination of hepatitis c virus (HCV) as a public health concern is now possible. However, identification of those who remain undiagnosed, and re-engagement of those who are diagnosed but remain untreated, will be essential to achieve this. We examined the extent of HCV infection among individuals undergoing liver function tests (LFT) in primary care. Residual biochemistry samples for 6007 patients, who had venous blood collected in primary care for LFT between July 2016 and January 2017, were tested for HCV antibody. Through data linkage to national and sentinel HCV surveillance databases, we also examined the extent of diagnosed infection, attendance at specialist service and HCV treatment for those found to be HCV positive. Overall HCV antibody prevalence was 4.0% and highest for males (5.0%), those aged 37-50 years (6.2%), and with an ALT result of 70 or greater (7.1%). Of those testing positive, 68.9% had been diagnosed with HCV in the past, 84.9% before the study period. Most (92.5%) of those diagnosed with chronic infection had attended specialist liver services and while 67.7% had ever been treated only 38% had successfully cleared infection. More than half of HCV-positive people required assessment, and potentially treatment, for their HCV infection but were not engaged with services during the study period. LFT in primary care are a key opportunity to diagnose, re-diagnose and re-engage patients with HCV infection and highlight the importance of GPs in efforts to eliminate HCV as a public health concern.
    MeSH term(s) Antiviral Agents/therapeutic use ; Hepacivirus ; Hepatitis C/diagnosis ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Hepatitis C Antibodies ; Hepatitis C, Chronic/diagnosis ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/epidemiology ; Humans ; Liver Function Tests ; Male ; Primary Health Care
    Chemical Substances Antiviral Agents ; Hepatitis C Antibodies
    Language English
    Publishing date 2022-06-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 632982-2
    ISSN 1469-4409 ; 0950-2688
    ISSN (online) 1469-4409
    ISSN 0950-2688
    DOI 10.1017/S0950268822000978
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  9. Article ; Online: Declining incidence of hepatitis C related hepatocellular carcinoma in the era of interferon-free therapies: A population-based cohort study.

    Innes, Hamish / McDonald, Scott A / Hamill, Victoria / Yeung, Alan / Dillon, John F / Hayes, Peter C / Went, April / Fraser, Andrew / Bathgate, Andrew / Barclay, Stephen T / Janjua, Naveed / Goldberg, David J / Hutchinson, Sharon J

    Liver international : official journal of the International Association for the Study of the Liver

    2022  Volume 42, Issue 3, Page(s) 561–574

    Abstract: ... of hepatitis C virus (HCV) related hepatocellular carcinoma (HCC) is not well understood at a population level ...

    Abstract Background & aims: The impact of interferon (IFN)-free therapies on the epidemiology of hepatitis C virus (HCV) related hepatocellular carcinoma (HCC) is not well understood at a population level. Our goal was to bridge this evidence gap.
    Methods: This study included all patients in Scotland with chronic HCV and a diagnosis of cirrhosis during 1999-2019. Incident cases of HCC, episodes of curative HCC therapy, and HCC-related deaths were identified through linkage to nationwide registries. Three time periods were examined: 1999-2010 (pegylated interferon-ribavirin [PIR]); 2011-2013 (First-generation DAA); and 2014-2019 (IFN-free era). We used regression modelling to determine time trends for (i) number diagnosed and living with HCV cirrhosis, (ii) HCC cumulative incidence, (iii) HCC curative treatment uptake and (iv) post-HCC mortality.
    Results: 3347 cirrhosis patients were identified of which 381 (11.4%) developed HCC. After HCC diagnosis, 140 (36.7%) received curative HCC treatment and there were 202 deaths from HCC. The average annual number of patients diagnosed and living with HCV cirrhosis was approximately seven times higher in the IFN-free versus the PIR era, whereas the number of incident HCCs was four times higher. However, the cumulative incidence of HCC was significantly lower in the IFN-free versus PIR era (sdHR: 0.65; 95%CI:0.47-0.88; P = .006). Among HCC patients, diagnosis in the IFN-free era was not associated with improved uptake of curative treatment (aOR:1.18; 95%CI:0.69-2.01; P = .54), or reduced post-HCC mortality (sdHR: 0.74; 95%CI:0.53-1.05; P = .09).
    Conclusions: The cumulative incidence of HCC is declining in HCV cirrhosis patients, but uptake of curative HCC therapy and post-HCC survival remains suboptimal.
    MeSH term(s) Antiviral Agents/therapeutic use ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/therapy ; Cohort Studies ; Hepatitis C/drug therapy ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/epidemiology ; Humans ; Incidence ; Liver Neoplasms/diagnosis ; Liver Neoplasms/epidemiology ; Liver Neoplasms/therapy
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2022-01-05
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2102783-3
    ISSN 1478-3231 ; 1478-3223
    ISSN (online) 1478-3231
    ISSN 1478-3223
    DOI 10.1111/liv.15143
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  10. Article ; Online: Clinical implications of extremely elevated C-reactive protein among febrile immunocompetent children.

    Saar, Shirley / Scheuerman, Oded / Zuabi, Tarek / Amarilyo, Gil / Abu, Mor / Goldberg, Lotem / Goldberg, Bar / Shirman, Nina / Vardi, Yoav / Pasternak, Yehonatan / Levinsky, Yoel

    Acta paediatrica (Oslo, Norway : 1992)

    2023  Volume 113, Issue 3, Page(s) 531–536

    Abstract: Aim: To identify the various diagnoses associated with extremely elevated C-reactive protein (CRP ...

    Abstract Aim: To identify the various diagnoses associated with extremely elevated C-reactive protein (CRP) (>30 mg/dL) among immunocompetent children and to evaluate its clinical implications during emergency department (ED) workup and hospital management.
    Methods: Children (3 months-18 years) with fever in ED were included, retrospectively. The cohort was divided into two groups-'extremely elevated CRP' (>30 mg/dL) and 'highly elevated CRP' (15-30 mg/dL).
    Results: Included were 1173 patients with CRP 15-30 mg/dL and 221 with CRP > 30 mg/dL. Bacterial infection was more prevalent among the extremely elevated CRP group (94.1% vs. 78.5%, respectively, p = 0.002). Specifically, bacterial pneumonia (52%), cellulitis (7.2%) and sepsis (4.1%) were more prevalent among this group. More of these patients were reported as 'Ill appearing' [78 (35.3%) vs. 166 (17.4%), p < 0.001]. They were more often treated with fluids [33 (14.9%) vs. 50 (5.3%), p < 0.001] and a higher portion of them required admission to an intensive care unit [11 (5.0%) vs. 16 (1.7%), p = 0.007].
    Conclusion: Febrile children with extremely elevated CRP showed greater illness severity (haemodynamic instability, PICU admissions), thus careful clinical attention is desirable in these cases. More than half of them had bacterial pneumonia, which reinforces the importance of relevant investigation when diagnosis is unclear.
    MeSH term(s) Child ; Humans ; C-Reactive Protein/metabolism ; Retrospective Studies ; Bacterial Infections/diagnosis ; Sepsis ; Fever/etiology ; Fever/diagnosis ; Pneumonia, Bacterial
    Chemical Substances C-Reactive Protein (9007-41-4)
    Language English
    Publishing date 2023-12-16
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 203487-6
    ISSN 1651-2227 ; 0365-1436 ; 0803-5253
    ISSN (online) 1651-2227
    ISSN 0365-1436 ; 0803-5253
    DOI 10.1111/apa.17060
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