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Ischemia modified albumin is a useful marker of early neonatal sepsis

Presented at the Neonatal Society 2016 Spring Meeting.

Khashana A, Ayoub A, Younes S, Abdelrahman A

Department Of Paediatrics and Neonatology, Suez Canal University Hospital, Ismailia, Egypt.

Background: Serum Ischemia Modified Albumin (IMA) is a recently discovered biomarker that is affected by disease processes that include inflammation, tissue ischemia and oxidative stress (1-4). Our study aimed to evaluate the role of serum IMA as a marker of early neonatal sepsis.

Methods: A cross-sectional comparative study. 60 neonates were studied: 30 of them with mean gestational age 35.4 weeks and diagnosed to have early onset sepsis; and 30 healthy controls with mean gestational age 36.5 weeks. History, clinical examination and measurement of IMA were performed for both study groups. An evaluation for sepsis was carried out by analysing full blood count, C-reactive protein, and blood cultures. The control group included age and sex matched neonates from a healthy mother with no antenatally or postnatally detected diseases, had no clinical suspicion of neonatal sepsis, and did not receive antibiotics. The results of each group are expressed as mean ± standard deviation. Group differences were assessed by t-test, and Pearson’s coefficient (r) was used. p < 0.05 was considered to indicate significance. Ethical approval was obtained from the research ethics committee of the Faculty of Medicine, Suez Canal University.

Results: A statistically significant difference in serum IMA was found serum IMA concentration between the sepsis group and control group: 82.7 ± 20.5 and 24.4 ± 4.4 ng/ml respectively (p < 0.0001). We found no statistically significant difference in serum IMA between full term and preterm neonates with sepsis: IMA of 74.3 ± 42.3 ng / ml versus mean IMA of 88.2±16 ng/ml, p = 0.0977. There were no significant differences in serum IMA based on the sex of patient: male neonates with sepsis had mean IMA 79.4 ±18.4 ng / ml while female neonates with sepsis had IMA of 86 ± 22.6 ng /ml, p=0.389. There was no difference in serum IMA between infants who died and those who survived: mean IMA 85.2 ± 22.3 ng/ml versus 82.3 ± 20.7 ng/ml, p=0.795.

Conclusion: Serum IMA is elevated in neonates with sepsis and may prove to be a useful marker of neonatal sepsis.

Corresponding author: abdelmoneim_khashana@hotmail.com

References
1. Sbarouni E, Georgiadou P and Voudris V. Ischemia-modified albumin changes: Review and clinical implications. Clin Chem Lab Med 2011; 49: 177-84.
2. Roy D, Quiles J, Gaze DC, Collinson P, Kaski JC, Baxter GF. Role of reactive oxygen species on the formation of the novel diagnostic marker ischaemia modified albumin. Heart. 2006; 92: 113-114.
3. Piva SJ, Duarte MM, Da Cruz IB, Coelho AC, Moreira AP, Tonello R. Ischemia-modified albumin as an oxidative stress biomarker in obesity. Clin Biochem. 2011;44:345–7.
4. Yerlikaya FH, Kurban S, Mehmetoglu I, Annagur A, Altunhan H, Erbay E. Serum ischemia-modified albumin levels at diagnosis and during treatment of late-onset neonatal sepsis. J Matern Fetal Neonatal Med. 2014;27(17):1723-7.

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