Serum Haptoglobin Levels Research Articles

Perioperative Serum Free Hemoglobin and Haptoglobin Levels in Valvular and Aortic Surgery With Cardiopulmonary Bypass: Their Associations With Postoperative Kidney Injury

To observe the perioperative free hemoglobin and haptoglobin levels and to assess their associations with the risk of postoperative acute kidney injury (pAKI) in adult patients undergoing valvular and aortic surgery requiring cardiopulmonary bypass (CPB). A single-center, prospective, observational study. Public teaching hospital. The study comprised 74 adult patients without chronic renal failure who underwent cardiovascular surgery requiring CPB from 2014 to 2020. Perioperative free hemoglobin and haptoglobin levels during the study period were obtained from study participants. The primary outcome was pAKI defined by the Kidney Disease: Improving Global Outcomes criteria. Of the 74 patients in this study, pAKI occurred in 25 patients (33.8%). The free hemoglobin level began to increase after the initiation of CPB and reached a peak level at 30 minutes after weaning from CPB. It returned to the baseline level on postoperative day one. Haptoglobin levels were the highest after anesthesia induction and decreased continuously until postoperative day one. In the multivariate analysis, maximum free hemoglobin and minimum haptoglobin were associated independently with increased risk of pAKI (adjusted odds ratio 1.33 [95% confidence interval 1.12-1.58; p = 0.001] and 0.95 [95% confidence interval 0.91-1.00; p = 0.03], respectively). The free hemoglobin level began to have an independent association with pAKI at one hour after commencement of CPB, and the independent association disappeared at postoperative day one. This study found that the perioperative increase of the free hemoglobin level and the decrease of the haptoglobin level had independent associations with the risk of pAKI.

Estimation of Apolipoprotein A1, Haptoglobin and Alpha 2macroglobulin with some Biochemical Metabolic Markers in Nonalcoholic Fatty Liver Disease Iraqi Patients

"non-alcoholic fatty liver disease" starts with hepatic lipid accumulation and is a dangerous factor for disease development.
 Thus, we aimed to determine the serum levels of haptoglobin,alpha2 macroglobulin, apolipoprotein A1, gamma-glutamyl transferase, hemoglobin A1c, Total bilirubin, Triglyceride, cholesterol, low-density lipoprotein, high-density lipoprotein, very low-density lipoprotein, urea, and creatinine among patients with nonalcoholic fatty liver disease and healthy individuals. This study was carried out on 60 patients with NAFLD and 30 healthy subjects who were attending the Gastroenterology and Hepatology Teaching Hospital/Baghdad from August /2019 to March /2020. Patients data included age, sex, BMI, and abdominal ultrasound with other medical information. Serum samples were collected and then some biochemical tests were done by an Autoanalyzer, while serum apolipoprotein A1, haptoglobin, and Alpha 2maacroglobulin were measured by ELISA technique.
 The study found that obesity (70%) and dyslipidemia (50%) are more common in NAFLD patients than another metabolic disease such as hypertension (20%) and diabetes mellitus (type 1 and 2) (3% and 30%) respectively. Also, the results showed a significant difference among the age group (p=0.006). NAFLD subjects had a highly significant elevation (p=0.000) in the mean ± SD of BMI, FBS, HbA1c, AST, ALP, cholesterol, triglyceride, LDL, VLDL, and Alpha 2 macroglobulin compared with the healthy control. Serum ALT and total bilirubin (mean ± SD) were significantly elevated (p=0.001) in NAFLD subjects (54.28±23.05IU/L and 14.47±9.65 µmole/l respectively) when compared with the mean± SD of healthy control. In addition, the results revealed a significant elevation (P=0.027) in the mean ± SD of serum albumin in NAFLD patients when compared with mean ± SD of healthy control and a significant elevation (P=0.002)in the mean ± SD of the LDL of the NAFLD patients as compared to the healthy control. However, the results showed a highly significant decrease (P=0.000) in the mean ± SD of serum HDL, Apolipoprotein, and haptoglobin. Furthermore, the present study observed that the optimal cut-off value was ≤67.13ng/ml for haptoglobin with a sensitivity and specificity of 80% and 93.33% respectively. In addition, the results revealed that the optimal cut-off value was >257ng/ml for Alpha 2Macroglobulin with a sensitivity and specificity of 73.33% and 86.67% respectively. The study found an optimal cut-off value of ≤86 ng/ml for Apolipoprotein A1 with a sensitivity and specificity of 85% and 90% respectively.

Serum haptoglobin concentrations in feline inflammatory bowel disease and small-cell alimentary lymphoma: a potential biomarker for feline chronic enteropathies.

The aim of this study was to evaluate serum haptoglobin as a biomarker to differentiate between small-cell alimentary lymphoma and inflammatory bowel disease in cats. Client-owned domestic cats with and without chronic gastrointestinal signs were enrolled in the study. Serum was collected from each patient and serum haptoglobin levels were measured using ELISA. In cats with gastrointestinal signs, histopathologic evaluation of endoscopic biopsies harvested from the intestinal tract was used to separate them into inflammatory bowel disease and small-cell lymphoma cohorts. Serum haptoglobin levels were statistically analyzed and compared among the three groups: healthy cats; cats with inflammatory bowel disease; and cats with small-cell alimentary lymphoma. Sixty-two cats were enrolled in the study, including 20 clinically normal cats, 14 cats with small-cell alimentary lymphoma and 28 cats with inflammatory bowel disease. The mean ± SD serum haptoglobin was 73.2 ± 39.1 mg/dl in normal cats, 115.3 ± 72.8 mg/dl in cats with inflammatory bowel disease and 133.1 ± 86.1 mg/dl in cats with small-cell alimentary lymphoma. Cats with inflammatory bowel disease and lymphoma had significantly higher serum haptoglobin than controls, with P values of 0.0382 and 0.0138, respectively. There was no statistical difference between the inflammatory bowel disease and lymphoma cohorts (P = 0.4235). For every one unit increase in serum haptoglobin, the odds of gastrointestinal inflammatory disease (inflammatory bowel disease or small-cell alimentary lymphoma) increased by 1.41% (P = 0.0165). Serum haptoglobin is a useful biomarker for distinguishing between normal cats and those with gastrointestinal inflammatory disease, but it could not significantly differentiate between inflammatory bowel disease and lymphoma. Additional studies may be beneficial in determining the prognostic significance of serum haptoglobin as it may relate to the severity of gastrointestinal inflammation.

Repeated Administration of Clinical Doses of Tramadol and Tapentadol Causes Hepato- and Nephrotoxic Effects in Wistar Rats

Tramadol and tapentadol are fully synthetic and extensively used analgesic opioids, presenting enhanced therapeutic and safety profiles as compared with their peers. However, reports of adverse reactions, intoxications and fatalities have been increasing. Information regarding the molecular, biochemical, and histological alterations underlying their toxicological potential is missing, particularly for tapentadol, owing to its more recent market authorization. Considering the paramount importance of liver and kidney for the metabolism and excretion of both opioids, these organs are especially susceptible to toxicological damage. In the present study, we aimed to characterize the putative hepatic and renal deleterious effects of repeated exposure to therapeutic doses of tramadol and tapentadol, using an in vivo animal model. Male Wistar rats were randomly divided into six experimental groups, composed of six animals each, which received daily single intraperitoneal injections of 10, 25 or 50 mg/kg tramadol or tapentadol (a low, standard analgesic dose, an intermediate dose and the maximum recommended daily dose, respectively). An additional control group was injected with normal saline. Following 14 consecutive days of administration, serum, urine and liver and kidney tissue samples were processed for biochemical, metabolic and histological analysis. Repeated administration of therapeutic doses of both opioids led to: (i) increased lipid and protein oxidation in liver and kidney, as well as to decreased total liver antioxidant capacity; (ii) decreased serum albumin, urea, butyrylcholinesterase and complement C3 and C4 levels, denoting liver synthesis impairment; (iii) elevated serum activity of liver enzymes, such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and γ-glutamyl transpeptidase, as well as lipid profile alterations, also reflecting hepatobiliary commitment; (iv) derangement of iron metabolism, as shown through increases in serum iron, ferritin, haptoglobin and heme oxygenase-1 levels. In turn, elevated serum cystatin C, decreased urine creatinine output and increased urine microalbumin levels were detected upon exposure to tapentadol only, while increased serum amylase and urine N-acetyl-β-D-glucosaminidase activities were observed for both opioids. Collectively, these results are compatible with kidney injury. Changes were also found in the expression levels of liver- and kidney-specific toxicity biomarker genes, upon exposure to tramadol and tapentadol, correlating well with alterations in lipid profile, iron metabolism and glomerular and tubular function. Histopathological analysis evidenced sinusoidal dilatation, microsteatosis, mononuclear cell infiltrates, glomerular and tubular disorganization, and increased Bowman’s spaces. Although some findings are more pronounced upon tapentadol exposure, our study shows that, when compared with acute exposure, prolonged administration of both opioids smooths the differences between their toxicological effects, and that these occur at lower doses within the therapeutic range.

Investigating the Prevalence of Anaemia in Rural Gambia, in Relation to Levels of Zinc Protoporphyrin, Haemoglobin and Haptoglobin (Phenotype and Genotype)

Abstract Objectives To find out the overlapping and correlating relationships between serum haptoglobin level, haptoglobin genotype and phenotype, blood haemoglobin level and zinc protoporphyrin (measured in washed RBCs) in association to prevalence of anaemia. It will focus on comparing all the mention components in contrast to each other. The study will also look for the frequency distribution of the major HP alleles. Methods 1278 participants were randomly selected. Blood samples collected by trained nurses. Data generation was done at the Medical research council (keneba field station) research site. Data Analysis was conducted at the university of Chester with the assistance of the computer department team. Results P = 0.000 indicating anaemia prevalence with HP 1 allele. P > 0.05 when ID, IDA and AI relates with HP genotype. Positive correlation between ZnPP and HP serum level, but negative between ZnPP and Hb. P = 0.000 between ZnPP and IDA. P = 0.024 between HP genotype and Hb level. P = 0.013 between HP genotype and HP serum. P = 0.100 between HP genotype and ZnPP. P = 0.000 between ZnPP and IDA. P = 0.024 between HP genotype and Hb. ZnPP shared a positive correlation with HP serum level, and a negative correlation with Hb level. The correlation significant = 0.01 level (2-tailed) P = 0.01. The correlation between HP genotype and HP serum level was significant with P = 0.013, but the correlation between HP genotype and ZnPP was not significant with P = 0.100. Conclusions HP genotype had association with anaemia prevalence and more occurrence was observed in carriers of the type ‘1’ allele. It had no association with ID, IDA and AI. HP genotype had association with HP serum level and Hb level but had no association with ZnPP level. ZnPP level was observed to have had association with HP serum level, Hb level and IDA; but had no association with ID and AI in the region. Funding Sources All the resources used in this study were from MRC Keneba (International Nutrition Group) which is supported by funds from the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement (Hennig et al., 2015).

Maternal Serum Haptoglobin Levels as a Marker of Preterm Premature Rupture of Membranes.

We aimed to investigate the prognostic value of maternal serum haptoglobin levels in patients presenting with preterm premature rupture of fetal membranes (PPROM) during the second and the third trimesters of pregnancy. In this case control study, 60 patients were recruited (30 pregnant women with PPROM between 26-34 weeks of gestation and 30 healthy, gestational-age-matched pregnant women without PPROM). White blood cell count (WBC), interleukin 6 (IL-6), C-reactive protein (CRP), sedimentation rate, and haptoglobin levels were measured. The mean age, gestational week, gravida, and parity of the 2 groups were statistically comparable (P>0.001). There was a statistically significant difference between the 2 groups in terms of haptoglobin values (p<0.001). The mean haptoglobin level was 115.5+33.1(mg/dl) in the PPROM group and 66.5+42.6 (mg/dl) in the control group. ROC curve analysis was performed to determine whether the level of haptoglobin alone could diagnose PPROM as an independent marker. It was shown that the level of 94.5 mg/dL for haptoglobin could indicate the diagnosis of PPROM with 80% sensitivity and specificity CONCLUSION: Maternal serum haptoglobin levels may be a diagnostic marker for suspected PPROM cases when membrane rupture diagnosis is not accurate based on physical examination and other diagnostic tests.

Sarcoptes canis ile Enfekte Köpeklerde Serum Amiloid-A, Haptoglobin ve Seruloplazmin Seviyelerinin Belirlenmesi

This study was aimed to determine serum amyloid-a (SAA), haptoglobin (Hp) and ceruloplasmin (Cp) levels in dogs infected with Sarcoptes canis. The animal material of the study was consisted of 25 dogs with different age, gender and race (13 female, 12 male) which were bearing symptoms such as itching, rash and crusting and were diagnosed as Sarcoptes canis in the clinics of Internal Medicine Department of Veterinary Faculty, Kafkas University. 10 healthy dogs of different age, sex and race (4 female, 6 male) were used for the control group. Biochemical analysis revealed that the SAA and Hp values of the sick animals were statistically different than healthy animals (P<0.001). Similarly, when the serum Cp values of sick animals were compared with those of healthy animals, the difference was statistically significant (P<0.05). Obtained results showed that investigated acute phase proteins were found increased in dogs with Sarcoptes canis with local skin damage. It was concluded that acute phase proteins, SAA, Hp and Cp can be used as inflammatory indicators in sarcoptic mange in dogs.

Causal Association of Haptoglobin With Obesity in Mexican Children: A Mendelian Randomization Study.

Little is known about the association between haptoglobin level and cardiometabolic traits. A previous genome-wide association study identified rs2000999 in the HP gene as the stronger genetic contributor to serum haptoglobin level in European populations. We investigated the association of HP rs2000999 with serum haptoglobin and childhood and adult obesity in up to 540/697 and 592/691 Mexican cases and controls, respectively. Anthropometric and biochemical data were collected. Serum haptoglobin was measured by an immunoturbidimetry assay. HP rs2000999 was genotyped using the TaqMan technology. Mendelian randomization analysis was performed using the Wald and inverse variance weighting methods. Haptoglobin level was positively associated with childhood and adult obesity. HP rs2000999 G allele was positively associated with haptoglobin level in children and adults. HP rs2000999 G allele was positively associated with childhood but not adult obesity. The association between HP rs2000999 and childhood obesity was removed after adjusting for haptoglobin level. In a Mendelian randomization analysis, haptoglobin level genetically predicted by HP rs2000999 showed a significant causal effect on childhood obesity by the Wald and inverse variance weighting methods. Our data provide evidence for the first time for a causal positive association between serum haptoglobin level and childhood obesity in the Mexican population. Our study contributes to the genetic elucidation of childhood obesity and proposes haptoglobin as an important biomarker and treatment target for obesity.

A RARE CASE REPORT OF EVANS SYNDROME IN PREGNANCY

The simultaneous or sequential development of autoimmune hemolytic anemia (AIHA) and idiopathic thrombocytopenic purpura (ITP) is known as Evans syndrome,which is very rare in pregnancy.We experienced a case of Evans syndrome in pregnancy.A 23-year-old primigravida with 37 weeks of gestation presented to the labor room with Evans syndrome. Her blood reports revealed features of hemolysis with macrocytic anemia, thrombocytopenia, elevated LDH, and low serum haptoglobin levels, and a direct antiglobulin test (DAT) was positive. A healthy female newborn with 3200 g was delivered by cesarean section.After delivery, DAT remained positive, and her platelet count falls markedly, and bone marrow transplantation was done.When Evans syndrome diagnosed during pregnancy, close and careful observation is essential because it can worsen both the maternal and fetal condition.

Abstract P5-04-21: Analysis of serum immune biomarkers for response to therapeutic personalized peptide vaccination in patients with metastatic breast cancer

Abstract Purpose: Our results from the previous clinical trials using personalized peptide vaccines (PPV) combined conventional chemo-hormonal therapies have confirmed the potential for clinical benefit in patients who had higher IgG antibody and/or CTL response to the immunized PPV (SABCS 2018 U Toh etc.). The aim of this study is to evaluate the association between the serum immunologic factors including cytokines, haptoglobin (HP), B-cell activating factor (BAFF) etc. and the clinical outcome of patients(pt) with metastatic breast cancer (mBC) who treated by personalized peptide vaccines (PPV). Methods: Peripheral blood samples from 57 pts and 52 pts obtained before and after the vaccination of PPV, respectively. Serum HP and IL-6 were analyzed by ELISA(R&amp;D Systems, Life Technologies)and bead-based multiplex assays(Luminex 200 system)were performed for GM-CSF,IFN-γ,TNF-α, BAFF, TGF-β, IFNγ-induced protein 10(IP-10), IL-1β, IL-2,-4,-5,-8, -10. The association between each factor and clinical outcome was statistically evaluated. Results: Pt’s group (n=28) with low BAFF and high HP level (&amp;gt;544 pg/ml), high IFN-γ and high HP level or low IL-8 and high HP level before PPV treatment showed a significantly shorter median survival time (MST; p=0.015;0.068;0.002, respectively). There was no difference in high BAFF, low IFN-γ or high IL-8 level group(n=29). In contrast, pt’s group with low serum level of IL-10, GM-CSF, IL-5, IL-4 and low HP level (&amp;lt;544 pg/ml MV) after PPV treatment associated with significantly shorter MST (p=0.002; 0.001; 0.001; &amp;lt;0.001, respectively). Conclusions: The combination of serum levels of HP and BAFF, IFN-γ or cytokines of IL-8, -10, - 5, -4 might be useful prognostic biomarkers for mBC pts receiving PPV therapy. Citation Format: Uhi Toh, Shuko Saku, Yuko Takao, Sayaka Sakurai, Miki Takenaka, Shigeki Shichijo, Kyogo Itoh, Yoshito Akagi. Analysis of serum immune biomarkers for response to therapeutic personalized peptide vaccination in patients with metastatic breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-04-21.

Evaluation of yeast supplementation in steers housed under suitable temperature–humidity index

ABSTRACT The objective of the experiment was to study the effect temperature–humidity index and of live Saccharomyces cerevisiae (NCYC Sc47 E1702) supplementation on protein fractions and haptoglobin serum levels in steers during the growing and finishing phases. Forty Charolais steers were divided into two equal groups: treatment (YS) and control (C). Each animal of the YS group received 5 g/day of yeast supplement added to the same ration of C group. Blood samples were analyzed for total proteins (TP), protein fractions (albumin, α1 -, α2-, β1-, β2 -,γ- globulins) and haptoglobin (Hp). Ratios between albumin and globulins (A/G) were calculated. Yeast supplementation had a positive effect on TP, albumin, α1, and β1- globulin levels. Starting from day 1, the differences between C and YS increased during the growing phase and decreased during the finishing phase. Haptoglobin was lower in YS group than C group during growing and finishing phases. These results suggest that the inclusion of Saccharomyces cerevisae in the diet of feedlot steers can modulate protein metabolism as well as haptoglobin concentration when animals are housed in suitable THI conditions.

Efficacy of repeated ovum pick-up in Podolic cattle for preservation strategies: a pilot study

The study evaluated the effects of eCG treatment prior to ovum pick up (OPU) on follicular population, oocyte and embryo yields in summer and autumn in Podolic cattle. The effects of repeated OPU on cattle wellbeing was also documented. Twenty-six animals were used, and split into two groups, treatment (OPU; n = 18) and control (CG; n = 8). The OPU cattle were subsequently split into two subgroups (n = 9) and underwent repeated OPU, without and with eCG priming, for a total of 8 sessions (4 sessions/season). Follicular population, oocyte and embryo yields were recorded in those sub-groups. CG was handled in the same manner of OPU, except for epidural anaesthesia and follicular aspiration. Biochemical profile, serum protein electrophoresis and haptoglobin levels were analysed in OPU and CG. Hormonal priming increased the number of medium follicles (1.7 ± 0.2 vs 0.9 ± 0.2, p < .05), while it decreased the recovery rate and number of cumulus-enclosed oocytes (COCs) (recovery rate: 38.3 ± 3.5 vs 60.5 ± 4.0%; COCs: 2.3 ± 0.3 vs 3.4 ± 0.4, respectively; p < .01). However, priming increased cleavage (72.9 ± 5.7 vs 49.4 ± 5.4; p < .05) and blastocyst (41.1 ± 5.7 vs 23.0 ± 4.2; p = .054) rates. With regard to season’s effect, a higher number of COCs was recorded in autumn than in summer (3.1 ± 0.4 vs 2.6 ± 0.3; p < .05) without affecting though the number of embryos produced (0.9 on average). Since haematological parameters did not vary between OPU and CG, our preliminary data suggest that repeated OPU may be used as a conservation strategy in Podolic cattle without affecting wellbeing. Highlights Podolic cattle is an endangered Italian breed, reared in semi-extensive/extensive systems Ovum pick-up (OPU) can be carried out in this breed without impairing animal health and welfare The eCG treatment before OPU (priming) did not improve the number of embryos produced per donor.

Transplantation-Associated Microangiopathy (TAM) in Recipients of HLA-Haploidentical Hematopoietic Stem Cell Transplants Using Ptcy, CNI and MMF for GvHD Prophylaxis

Transplant-associated microangiopathy (TAM) is a life-threatening complication after allogeneic transplantation, related to endothelial toxicity caused by chemoradiotherapy, infections, immunosuppressive drugs and GvHD. Clinical manifestations include severe thrombocytopenia, microangiopathic hemolysis and organ dysfunction (e.g. renal, neurological) in the absence of disseminated intravascular coagulation. The reported incidence of TAM after allogeneic hematopoietic stem cell transplantation (HSCT) varies between 0,5 to 70%. Data for TAM occurrence and outcome in the context of HLA-haploidentical transplantation (haplo-HSCT) are rare. Here, we report our experience on TAM incidence, disease manifestation, treatment and outcome in T-cell-replete haplo-HSCT using PTCY as GvHD prophylaxis. We retrospectively analyzed the treatment course of 148 adult patients undergoing haplo-HSCT with regard to the incidence of TAM at our center from January 2012 to April 2019. The diagnosis of TAM required the fulfillment of the criteria as defined by Ruutu et al., Haematologica 2007. Median age of the entire cohort was 54 years (23-74). The majority of patients was transplanted for myeloid disease (60%). Postgrafting immunosuppression consisted of PTCY, CNI and MMF in all patients. Median follow-up time upon survivors was 3 years (4 months - 7 years). Twenty of 148 patients developed TAM, with a cumulative incidence of 10% at day 100. Median interval from haplo-HSCT to TAM onset was 63 days (23-295 days), with seven patients showing TAM after day +100. Median platelet count at diagnosis was 20 x 109/L (range: 6-116), predominantly de novo or worsening thrombocytopenia. Median LDH level was 437 IU/L (305-1445 IU/L). Serum haptoglobin levels were decreased in 85% of the TAM patients. 12/20 patients had active infection at the time of TAM diagnosis, most commonly viral (10/12). All but three patients presented with concurrent active acute GvHD requiring systemic steroid treatment in 16 patients Renal function abnormalities were diagnosed in 55% of the patients affected by TAM, with 4 patients requiring hemodialysis. Nine patients developed grade III hypertension and three patients showed neurologic dysfunction. Upon diagnosis of TAM, CNI dose was reduced (7 patients) or temporarily discontinued (7 patients). No switch to another CNI was performed. FFPs were transfused in nine patients, three patients underwent plasma exchange therapy without any effect. In four patients rituximab was applied. With a CI of 18% vs 2% (p0.002) using a PBSC graft was a risk factor for TAM development when compared to BM. Neither origin of disease (myeloid/lymphoid) nor sex of patient/donor or conditioning intensity (RIC/MAC) influenced the incidence significantly. Estimated one-year and three-year overall survival did not differ between the TAM and the non-TAM cohort (61% vs 61% and 46% vs 47%, p=0.9). Only one patient died because of TAM. With an incidence of 10% at day +100 at our center TAM is a serious but not rare complication after haplo-HSCT using PTCY, CNI and MMF for GvHD prophylaxis. However, in our cohort disease course was moderate with low TAM-associated mortality. The use of a PBSC graft was the only factor influencing TAM incidence. Disclosures Hiddemann: F. Hoffmann-La Roche: Research Funding.

Validation of Hemolytic Anemia Codes in the French Hospital Database

Introduction: Hemolytic anemia is a group of rare diseases. National databases are useful data sources to assess the epidemiology and the management of such diseases. The French national health database covers the entire French population (66 million inhabitants). It links sociodemographic data, out-hospital data including dispensing data and hospital data. As a consequence, this database is very useful for population-based studies on rare diseases. For instance, it has been used for epidemiological and pharmacoepidemiological studies on immune thrombocytopenia. Diseases are identified using the national hospital database (named PMSI) that contains discharge diagnoses for all hospital stays in all private and public hospitals in France. This study was aimed at assessing the positive predictive value (PPV) of hemolytic anemia diagnoses in the French hospital database. Methods: In the PMSI database, every hospital stay contains one primary diagnosis, and possibly one related and several associated diagnoses. They are coded using the International Classification of Diseases, 10th revision (ICD-10) by the physician in charge of the patient or trained nurses from the medical chart. We selected all hospital stays at Toulouse University Hospital, South of France (2860 beds) with a diagnosis of hemolytic anemia (D55.0-D59.9 ICD-10 codes) between January 2017 and December 2017. Medical charts and biological data were reviewed. Hemolytic anemia was defined by anemia with high reticulocyte count (&amp;gt;150 x 109/L), plus at least two of the three following signs of hemolysis: low serum haptoglobin level, hyperbilirubinemia and elevated serum lactate dehydrogenase level. PPVs and their 95% confidence intervals (CI) were calculated by categories of hemolytic anemia: autoimmune hemolytic anemia (AIHA; D59.1 ICD-10 code), enzyme deficiency (D55.0-D55.9 ICD-10 codes), hereditary spherocytosis (D58.0 ICD-10 code) and hemoglobinopathy (D56.0-D57.9 and D58.2 ICD-10 codes). AIHA was defined by positive direct antiglobulin test (DAT); enzyme deficiency was defined by low enzyme dosage and negative DAT; hereditary spherocytosis was defined by negative DAT and either positive flow cytometry osmotic fragility test either positive eosin-5'-maleimide binding test; hemoglobinopathy was defined by compatible blood count and positive hemoglobin electrophoresis. Results: During the study period, 54 patients had at least one hospital stay with a discharge diagnosis of AIHA, 12 with enzyme deficiency, 10 with hereditary spherocytosis, 92 with thalassemia and 285 with sickle cell disease. We further excluded 13 patients due to missing data, precluding disease classification. AIHA was confirmed in 49/53 patients; the PPV was 92.5% (95% CI: 85.3%-99.6%). Enzyme deficiency was confirmed in 8/12 patients (including G6PD deficiency: 7/9) and hereditary spherocytosis in 10/10 patients. Thalassemia was confirmed in 72/83 patients; the PPV was 86.7% (95% CI: 79.5%-94.0%); however, the code of thalassemia type was not adequately coded in most cases (PPV&amp;lt;30%). Sickle cell disease was confirmed in 279/284 patients; the PPV was 98.2% (95% CI: 96.7%-99.8%). Conclusions: Overall, this study confirms high PPV values for hemolytic anemia discharge diagnoses recorded in the French hospital database, allowing epidemiological studies using this source of data. Disclosures Moulis: CSL Behring: Research Funding; Amgen pharma: Research Funding, Speakers Bureau; Novartis pharma: Research Funding, Speakers Bureau.

Serum haptoglobin levels are associated with renal function decline in type 2 diabetes mellitus patients in a Chinese Han population

AimsWe investigated whether serum haptoglobin (Hp) levels play a role in the development and progression of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients in a Chinese Han population, which has not been previously investigated. MethodsWe recruited 233 participants who had suffered from T2DM for more than 10 years, including 118 subjects with DKD (case) and 115 subjects without DKD (control). Serum Hp levels were measured by an enzyme-linked immunosorbent assay. ResultsSerum Hp levels were significantly higher (P = 0.0258) in case group (2.74 (1.77, 3.48) g/L) than control (2.29 (0.98, 3.48) g/L). The serum Hp level was significantly positively associated with both logarithmically transformed (log-transformed) serum creatinine (r = 0.1663, P = 0.011) and albuminuria levels (r = 0.1793, P = 0.0062) and was negatively associated with the log-transformed estimated glomerular filtration rate (r = −0.1482, P = 0.0237). Multiple linear regression analysis revealed that serum Hp levels were significantly correlated with serum creatinine levels (P = 0.0088) after adjusting for confounding risk factors. ConclusionsOur findings suggest that serum Hp levels may be used as a potential biomarker for the early diagnosis and monitoring of DKD in T2DM patients.

Chronic inflammation markers are associated with risk of pancreatic cancer in the Swedish AMORIS cohort study

BackgroundNested case-control studies examining the association between serum markers of chronic inflammation, focused on three specific biomarkers (CRP, IL-8 and TNF-α), and risk of pancreatic cancer have reported no associations. In this study, we evaluated associations between standard pre-diagnostic serum markers of chronic inflammation (CRP, albumin, haptoglobin and leukocytes) and pancreatic cancer risk in the Swedish Apolipoprotein-related MORtality RISk (AMORIS) prospective cohort study.MethodsWe selected all participants (≥20 years old) with baseline measurements of CRP, albumin, haptoglobin and leukocytes between 1985 and 1996 (n = 61,597). Participants were excluded if they had a history of chronic pancreatitis and all individuals were free from pancreatic cancer at baseline. Cox proportional multivariable hazards regression analysis was carried out for medical cut-offs of CRP, albumin, haptoglobin and leukocytes.ResultsWe observed an increased risk of pancreatic cancer for those individuals with higher levels of serum haptoglobin (≥1.4 g/L), CRP (≥10 mg/L) and leukocytes (≥10 × 109 cells/L) compared to those with haptoglobin levels < 1.4 g/L, CRP levels < 10 mg/L and Leukocyte levels < 10 × 109 cells/L [haptoglobin HR: 2.23 (95% CI 1.72–2.88), CRP HR: 1.32 (95% CI 1.00–1.74), leukocytes HR: 2.20 (95% CI 1.52–3.18)]. No associations were noted for serum albumin.ConclusionsWe found an increased risk of pancreatic cancer associated with pre-diagnostic serum levels of haptoglobin, CRP and leukocytes. Our finding suggests a possible role of chronic inflammation in the aetiology of pancreatic cancer and highlight the need to further investigate this association.

Alkaline phosphatase and haptoglobin as predictor of neonatal jaundice

Background: The term kernicterus refers to the clinical features of bilirubin encephalopathy. Its risk is increased in term babies with very high bilirubin levels. Kernicterus is also known to occur at lower levels of bilirubin in term babies who have risk factors and in preterm babies. Objective: The aim of the present study was to investigate whether serum alkaline phosphatse & haptoglobin (Hp) level could be used for the early diagnosis and prediction of hyperbilirubinemia in newborns. Methodology: The study is a prospective clinical study design, which was carried out in Pediatric Department, Faculty of Medicine, Aswan University Hospital. The study included 100 newborns with gestational age more than 35wk delivered in obstetric department. Results: Our study showed no statistically significant difference between jaundiced and non- jaundiced cases regarding the mode of delivery, maternal gravidity and parity. As regards previous sibiling affected, we found a significant relation between clinically appearing jaundice and previous sibling affected with neonatal hyperbillirubinemia, which may reflect genetic susceptibility for hyperbillirubinemia. No significant relationship between gestational age and clinically appearing jaundice. When assessing the relationship between clinically appearing jaundice and birth weight, our results revealed no significant relationship. Conclusion: The cord blood alkaline phosphatase level is not only a useful predictor for severe neonatal jaundice but also can predict the early onset of neonatal hyperbilirubinemia and expected methods of treatment in healthy newborns more than 35 weeks gestational age.

Alkaline phosphatase and haptoglobin as predictor of neonatal jaundice

Background: The term kernicterus refers to the clinical features of bilirubin encephalopathy. Its risk is increased in term babies with very high bilirubin levels. Kernicterus is also known to occur at lower levels of bilirubin in term babies who have risk factors and in preterm babies. Objective: The aim of the present study was to investigate whether serum alkaline phosphatse & haptoglobin (Hp) level could be used for the early diagnosis and prediction of hyperbilirubinemia in newborns. Methodology: The study is a prospective clinical study design, which was carried out in Pediatric Department, Faculty of Medicine, Aswan University Hospital. The study included 100 newborns with gestational age more than 35wk delivered in obstetric department. Results: Our study showed no statistically significant difference between jaundiced and non- jaundiced cases regarding the mode of delivery, maternal gravidity and parity. As regards previous sibiling affected, we found a significant relation between clinically appearing jaundice and previous sibling affected with neonatal hyperbillirubinemia, which may reflect genetic susceptibility for hyperbillirubinemia. No significant relationship between gestational age and clinically appearing jaundice. When assessing the relationship between clinically appearing jaundice and birth weight, our results revealed no significant relationship. Conclusion: The cord blood alkaline phosphatase level is not only a useful predictor for severe neonatal jaundice but also can predict the early onset of neonatal hyperbilirubinemia and expected methods of treatment in healthy newborns more than 35 weeks gestational age.

Comparison of serum procalcitonin, haptoglobin and C-reactive protein levels in goats with Corynebacterium pseudotuberculosis

This study was conducted to investigate the response of acute phase proteins, mainly Haptoglobin, C-reactive protein, Procalcitonin and the negative acute phase response, especially albumin in goats suffering from C. pseudotuberculosis. A total of 19 Turkish hair goats between the ages of 1.5 and 2 years in a special dairy farm was selected for the study, consisting of 9 healthy animals and 10 with C. pseudotuberculosis. There was a statistically significant difference in serum haptoglobin, C-reactive protein, procalcitonin and albumin levels in goats with C. pseudotuberculosis, compared to the control group (p less than 0.05). The results showed that Haptoglobin, C-reactive protein and Procalcitonin produce a higher, and Alb a lower, response in goats with C. pseudotuberculosis compared to the control. The presented study suggests that C. pseudotuberculosis can influence the level of acute phase proteins in goats. These results indicate that monitoring a number of acute phase proteins can increase the diagnostic information available for this disease.

The haptoglobin promoter polymorphism rs5471 is the most definitive genetic determinant of serum haptoglobin level in a Ghanaian population

BackgroundThe serum haptoglobin (HP) level varies in various clinical conditions and among individuals. Recently, the common HP alleles, rs5472, and rs2000999 have been reported to associate with serum HP level, but no studies have been done on Africans. Here, we explored the relationship of not only these polymorphisms but also rs5470 and rs5471 to the serum HP level in 121 Ghanaians. MethodsGenotyping of rs2000999 was performed by PCR using hydrolysis probes, while the other polymorphisms have been already genotyped. Serum HP level was measured by a sandwich ELISA. ResultsWe observed a significant association between rs5471 and the serum HP level (p = 0.026). It was also observed within the subgroups of HP2/HP2 and HP2/HP1. In addition, we detected a trend toward lower HP levels for individuals with the A allele of rs2000999 than those without A, but it was not statistically significant (p = 0.156). However, we did not observe the clear associations between other polymorphisms and serum HP level that were observed for Europeans and Asians because of the small sample size and the complexity of SNPs affecting the HP level. ConclusionsWe suggest that rs5471 is a strong genetic determinant of HP levels in Ghanaians, and this seems to be characteristic of Africans. Further investigation using large scale samples will help in understanding the genetic background of individual variability of the serum HP level.