Criteria of the systemic inflammatory response syndrome (SIRS) are known to include patients without systemic inflammation. Our aim was to explore additional markers of inflammation that would distinguish SIRS patients with systemic inflammation from patients without inflammation. The study included 100 acutely ill patients with SIRS. Peripheral blood neutrophil and monocyte CD11b expression, serum interleukin-6, interleukin-1β, tumour necrosis factor-α and C-reactive protein were determined, and severity of inflammation was evaluated by systemic inflammation composite score based on CD11b expression, C-reactive protein and cytokine levels. Levels of CD11b expression, C-reactive protein and interleukin-6 were higher in sepsis patients than in SIRS patients who met two criteria (SIRS2 group) or three criteria of SIRS (SIRS3 group). The systemic inflammation composite score of SIRS2 patients (median 1.5; range 0–8, n = 56) was lower than that of SIRS3 patients (3.5; range 0–9, n = 14, P = 0.013) and that of sepsis patients (5.0; range 3–10, n = 19, P< 0.001). The systemic inflammation composite score was 0 in 13/94 patients. In 81 patients in whom systemic inflammation composite scores exceeded 1, interleukin-6 was increased in 64 (79.0%), C-reactive protein in 59 (72.8%) and CD11b in 50 (61.7%). None of these markers, when used alone, identified all patients but at least one marker was positive in each patient. Quantifying phagocyte CD11b expression and serum interleukin-6 and C-reactive protein concurrently provides a means to discriminate SIRS patients with systemic inflammation from patients without systemic inflammation.
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Research Article|
March 01 1999
Systemic inflammatory response syndrome without systemic inflammation in acutely ill patients admitted to hospital in a medical emergency
Annika TAKALA;
1Department of Anaesthesia, Helsinki University Central Hospital, Anestesiaosasto, PO Box 260, FIN-00029 HYKS, Finland
Correspondence: Dr A. Takala.
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Irma JOUSELA;
Irma JOUSELA
1Department of Anaesthesia, Helsinki University Central Hospital, Anestesiaosasto, PO Box 260, FIN-00029 HYKS, Finland
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Klaus T. OLKKOLA;
Klaus T. OLKKOLA
1Department of Anaesthesia, Helsinki University Central Hospital, Anestesiaosasto, PO Box 260, FIN-00029 HYKS, Finland
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Sten-Erik JANSSON;
Sten-Erik JANSSON
*Department of Clinical Chemistry, PO Box 360, Helsinki University Central Hospital, Finland
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Marjatta LEIRISALO-REPO;
Marjatta LEIRISALO-REPO
†Department of Medicine, PO Box 340, Helsinki University Central Hospital, Finland, and
‡The Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland
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Olli TAKKUNEN;
Olli TAKKUNEN
1Department of Anaesthesia, Helsinki University Central Hospital, Anestesiaosasto, PO Box 260, FIN-00029 HYKS, Finland
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Heikki REPO
Heikki REPO
†Department of Medicine, PO Box 340, Helsinki University Central Hospital, Finland, and
‡The Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland
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Publisher: Portland Press Ltd
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 1999
1999
Clin Sci (Lond) (1999) 96 (3): 287–295.
Citation
Annika TAKALA, Irma JOUSELA, Klaus T. OLKKOLA, Sten-Erik JANSSON, Marjatta LEIRISALO-REPO, Olli TAKKUNEN, Heikki REPO; Systemic inflammatory response syndrome without systemic inflammation in acutely ill patients admitted to hospital in a medical emergency. Clin Sci (Lond) 1 March 1999; 96 (3): 287–295. doi: https://doi.org/10.1042/cs0960287
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