The Diagnostic Value of Progranulin in Early Onset Sepsis in Preterm Neonates

Document Type : Review Article

Authors

1 Lecturer of Pediatrics Faculty of Medicine, Ain Shams University,cairo ,egypt.

2 Professor of Pediatrics Faculty of Medicine, Ain Shams University.

3 Pediatrics department ،faculty of medicine ,ain shams university

4 Lecturer of Clinical Pathology Faculty of Medicine, Ain Shams University, cairo , egypt.

5 M.B.B.CH, Banha University,egypt

6 Lecturer of Clinical Pathology Faculty of Medicine, Ain Shams University,cairo,egypt.

Abstract

Background: Early onset sepsis (EOS) presents a significant challenge in neonatal care. Recent research indicates that progranulin (PRGN) levels may be elevated in response to bacterial infections, suggesting its potential as a biomarker for sepsis.
Aim of Work: To assess the diagnostic utility of PGRN as an early biomarker for detecting early onset sepsis in preterm newborns.
Methods: Case-control research has been performed on 90 preterm newborns admitted to the neonatal intensive care unit (NICU) at Ain Shams University Hospital between February 2022 and August 2022. All neonates were enrolled within seventy-hours hours of birth and presented with suspected neonatal sepsis. Participants have been separated into two groups depend on the blood cultures obtained at admission: the EOS group and the non-EOS group. Serum PGRN levels were measured in both groups at admission time.
Results: A significant elevation in median concentration of C-reactive protein (CRP) and PRGN was observed in the EOS group in comparison with the non-EOS group (p-value less than 0.001). Receiver operating characteristic (ROC) curve analysis has been utilized to evaluate the diagnostic performance of PGRN in discriminating between the EOS case' group and the non-EOS control group. The optimal cutoff value for distinguishing between EOS and non-EOS groups was determined to be >150 ng/ml, yielding a diagnostic sensitivity of 95.6%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 95.7%, and area under the curve (AUC) of 0.999. These findings suggest that patients with PGRN values >150 ng/ml are likely to be EOS patients. Furthermore, a significant negative correlation was observed between PRGN and birth weight (r: -0.50, p-value: 0.001) and gestational age (r: -0.38, p-value: 0.01) in the EOS group.
Conclusion: Progranulin demonstrates potential as a promising biomarker for the diagnosis of early-onset sepsis in newborns.

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