Abstract P-184: THE USE OF CD163 TO IDENTIFY PEDIATRIC CRITICALLY ILL PATIENTS WITH SECONDARY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

Abstract

Aims & Objectives: We aimed to assess the predictive value of the percent of CD163-positive (CD163+) peripheral blood monouclear cells (mCD163), soluble CD163 (sCD163), as well as combined using the index of sCD163 and mCD163 (msCD163) as differential diagnostic and prognostic biomarker in pediatric critical illness patients with sHLH. Methods We performed a prospective observational cohort study to enroll septic patients suspected with sHLH admitted to the pediatric intensive care unit (PICU) of Shanghai Children’s Hospital, Shanghai Jiao Tong University from July 2013 to June 2016. Results Sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect serum sCD163. And mCD163 was detected by flow cytometry. A total of 31 patients with sHLH and 38 patients with sepsis were enrolled in the study. The levels of sCD163, mCD163 and ferritin were significantly higher in patients with sHLH compared with patients with sepsis. The multivariable logistic regression analysis indicated that sCD163 and mCD163 were independent risk factors for sHLH. The area under the curve (AUC) for diagnosis sHLH of msCD163 was 0.878, which be superior to either sCD163 or mCD163. Moreover, the levels of mCD163, sCD163 and Ferritin were higher in non-survivors than in survivors of patients with sHLH (all P < 0.05). The AUC of msCD163 for prognostic was calculated as 0.727 (95% CI: 0.563–0.890, P = 0.017). Conclusions msCD163 index has higher discriminatory power to differentially identify pediatric HLH secondly to sepsis and be a potential prognostic marker in these patients.