Monocytic Human Leukocyte Antigen-DR Expression Levels to Predict Outcome in Children With Severe Sepsis

Simple item page
dc.contributor.authorThangavel, Nanmaaran Periyannanen_US
dc.contributor.authorParameswaran, Narayananen_US
dc.contributor.authorManivannan, Prabhuen_US
dc.contributor.authorRamamoorthy, Jaikumar Govindaswamyen_US
dc.date.accessioned2025-05-09T10:00:42Z
dc.date.available2025-05-09T10:00:42Z
dc.date.issued2024-09
dc.description.abstractObjectives: To assess the association between monocytic Human Leukocyte Antigen-DR (mHLA-DR) expression and outcome in children with severe sepsis. Methods: Consecutive children, aged 29 days to 15 years, who were admitted with severe sepsis or septic shock in the pediatric intensive care unit (PICU) were enrolled. mHLA-DR expression [antigen bound per cell (ABC)] was assessed on two time points: between 72 to 120 hours (P1) and 121 to 168 hours (P2), of stay in PICU and the difference between the two was calculated as delta mHLA-DR. Outcomes were noted for survival, mortality and secondary infection during the hospital stay. Results: Forty-seven children with median (IQR) age 24 (10, 96) months and a median (IQR) duration of illness of 3 (3, 5) days, were enrolled consecutively. Pediatric Logistic Organ Dysfunction (PELOD) score >10 was observed in 63.8% children. 18 children succumbed. The median mHLA-DR levels (ABC) at P1 were significantly higher in children who survived as compared with those who expired (7409 vs. 2509, P = 0.004). Similarly, the median mHLA-DR levels (ABC) at P2 were higher in those who survived than the expired group (14728 vs. 2085, P = 0.001). The median delta mHLA-DR levels (ABC) were 4574 and 309 for the survived and expired group, respectively (P = 0.012). mHLA-DR at P1 (P = 0.004), mHLA-DR at P2 (P = 0.001) and delta mHLA-DR (P = 0.012) was significantly associated with mortality but not associated with secondary infection. A negative correlation was observed between PELOD score and mHLA-DR at P1 (r = -0.25, P = 0.46), at P2 (r = -0.425, P = 0.018) and delta mHLA-DR (r = -0.27, P = 0.41). The area under curve (95%CI) of mHLA-DR expression (ABC) at P2 for a cutoff of < 6631 was 0.966 (0.907, 1.0) to predict mortality in severe sepsis. Conclusion: mHLA-DR levels were significantly lower in children who succumbed than those who survived at both time points. mHLA-DR levels can be a useful biomarker to diagnose immune-paralysed state.en_US
dc.identifier.affiliationsDepartments of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, Indiaen_US
dc.identifier.affiliationsDepartments of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, Indiaen_US
dc.identifier.affiliationsDepartments of Pathology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, Indiaen_US
dc.identifier.affiliationsDepartments of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, Indiaen_US
dc.identifier.citationThangavel Nanmaaran Periyannan, Parameswaran Narayanan, Manivannan Prabhu, Ramamoorthy Jaikumar Govindaswamy . Monocytic Human Leukocyte Antigen-DR Expression Levels to Predict Outcome in Children With Severe Sepsis. Indian Pediatrics. 2024 Sep; 61(9): 845-850en_US
dc.identifier.issn0974-7559
dc.identifier.issn0019-6061
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/245724
dc.languageenen_US
dc.publisherThe Indian Academy of Pediatricsen_US
dc.relation.issuenumber9en_US
dc.relation.volume61en_US
dc.source.urihttps://indianpediatrics.net/sep2024/845.pdfen_US
dc.subjectmHLA-DRen_US
dc.subjectMortalityen_US
dc.subjectPediatric intensive care uniten_US
dc.subjectPELODen_US
dc.titleMonocytic Human Leukocyte Antigen-DR Expression Levels to Predict Outcome in Children With Severe Sepsisen_US
dc.typeJournal Articleen_US
Files
Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
ip2024v61n9p845.pdf
Size:
32.91 KB
Format:
Adobe Portable Document Format
Download
Collections
Indian Pediatrics