Early prognostic markers of severe Astrakhan spotted fever


DOI: https://dx.doi.org/10.18565/epidem.2022.12.2.50-4

Vasilkova V.V., Galimzyanov Kh.M., Kantemirova B.I.

Astrakhan State Medical University, Ministry of Health of Russia, Astrakhan, Russia
There is currently a transformation of the clinical symptoms of Astrakhan spotted fever (ASF): cases of its severe course, complications, and death have become more common. Among the complications of ASF, acute renal failure (ARF) is most frequently diagnosed at the present stage. On hospital admission, no clinical and laboratory markers indicating the onset of the pathogenetic process in the kidneys have yet been detected; creatinine and urea remain within the normal range or are recorded at the upper reference values. Neutrophilic gelatinase-associated lipocalin (NGAL) that has shown its diagnostic and informational value is proposed to be studied as an early marker of the severe course of ASF and renal complications thereof.
Objective. To assess the diagnostic and prognostic values of determining NGAL in patients with ASF.
Subjects and methods. Solid-phase enzyme immunoassay was used to study the plasma concentration of lipocalin in patients with ASF depending on disease severity and (initial, peak) period. Forty-nine patients who were treated for ASF were followed up in the A.M. Nichoga Regional Infectious Diseases Clinical Hospital in Astrakhan. Most of the cases were rural residents (63%), individuals at the age of over 60 years (89.7%).
Results. Just on hospital admission with the still normal values of creatinine and urea, the level of lipocalin increased statistically significantly compared to the control values in apparently healthy volunteers – 511.27±146.06 ng/ml (p <  0,001) for severe ASF and 173.95±40.1 ng/ml (p < 0.05) for moderate ASF.
Conclusion. The paper has demonstrated the diagnostic value of studying the plasma level of lipocalin as an early informative marker to confirm the development of ARF and to determine its severity in ASF.

Literature


1. Малеев В.В., Степанов А.В., Тарасевич И.В., Вит­ковская В.А. Клинико-эпидемиологические особенности средиземноморской лихорадки в Астраханской области. Терапевтический архив 1998; (11): 6–10.


Maleev V.V., Stepanov A.V., Tarasevich I.V., Vitkovskaya V.A. [Clinical and epidemiological features of Mediterranean fever in the Astrakhan Region]. Therapeutic Archive 1998; (11): 6–10. (In Russ.).


2. Малеев В.В., Шерышева Ю.В., Касимова Н.Б., Галимзянов Х.М. Современные представления об астраханской риккетсиозной лихорадке и ее лечении. Инфекционные болезни 2006; 4(4): 43–9.


Maleev V.V., Sherysheva U.V., Kasimova N.B., Galimzyanov H.M. [Current views on Astrakhan rickettsial fever and its treatment]. Infectious Diseases 2006; 4(4): 43–9. (In Russ.).


3. Покровский В.И., Касимова Н.Б., Галимзянов Х.М., Морозова Ю.В. Клинико-патогенетические и иммунологические особенности астраханской риккетсиозной лихорадки. Учебное пособие. Астрахань, 2005. 91 с.


Pokrovsky V.I., Kasimova N.B., Galimzyanov H.M., Morozova Y.V. [Clinical, pathogenetic and immunological features of Astrakhan rickettsial fever. Tutorial]. Astrakhan, 2005. 91 p. (In Russ.).


4. Углева С.В., Акимкин В.Г., Понежева Ж.Б., Ахмерова Р.Р., Спиренкова А.Е., Черникова Ю.Ю., Шабалина С.В. Эпидемиологическая общность и различия актуальныхдля Астраханской области трансмиссивных инфекций. Эпидемиология и Вакцинопрофилактика 2021; 20(6): 63–71. DOI:10.31631/2073-3046-2021-20-6-63-71


Ugleva S.V., Akimkin V.G., Ponezheva J.B., Akhmerova R.R., Spirenkova A.E., Chernikova Yu.Yu., Shabalina S.V. [Epidemiological commonalities and differences of transmissible infections relevant to Astrakhan Region]. Epidemiology and Vaccine Prophylaxis 2021; 20(6): 63–71. (In Russ.). DOI:10.31631/2073-3046-2021-20-6-63-71


5. Углева С.В., Шабалина С.В. Риккетсиозы в регионе Нижнего Поволжья. Журнал микробиологии, эпидемиологии и иммунобиологии 2021; 98(2): 231–8. DOI: 10.36233/0372-9311-60


Ugleva S.V., Shabalina S.V. [Rickettsioses in the Lower Volga Region]. Journal of Microbiology, Epidemiology and Immunobiology 2021; 98(2): 231–8. (In Russ.). DOI: 10.36233/0372-9311-60


6. Бедлинская Н.Р., Галимзянов Х.М., Лазарева Е.Н., Мирекина Е.В., Кантемирова Б.И., Горева О.Н. Клиническое течение Астраханской риккетсиозной лихорадки в зависимости от наличия тромбогеморрагического синдрома. Инфекционные болезни 2016; 14: 31.


Bedlinskaya N.R., Galimzyanov H.M., Lazareva E.N., Mirekina E.V., Kantemirova B.I., Goreva O.N. [Clinical course of Astrakhan rickettsial fever depending on the presence of thrombohaemorrhagic syndrome]. Infectious Diseases 2016; 14: 31. (In Russ.).


7. Галимзянов Х.М., Малеев В.В., Черенов И.В., Аршба Т.Е., Черенова Л.П. Дифференциальная диагностика Крымской геморрагической лихорадки и Астраханской риккетсиозной лихорадкиь. Инфекционные болезни 2006; 4(1): 67–70.


Galimzyanov H.M., Maleev V.V., Cherenov I.V., Arshba T.E, Cherenova L.P. [Differential diagnosis of Crimean haemorrhagic fever and Astrakhan rickettsial fever.]Infectious Diseases 2006; 4(1): 67–70. (In Russ.).


8. Карпенко С.Ф. Сравнительная характеристика клинических проявлений и нейтрофильной защиты при коксиеллезе и Астраханской риккетсиозной лихорадке. Астраханский медицинский журнал 2010; 5(4): 37–41.


Karpenko S.F. [Comparative characterization of clinical manifestations and neutrophil protection in coxiellosis and Astrakhan rickettsial fever]. Astrakhan Medical Journal 2010; 5(4): 37–41. (In Russ.).


9. Лазарева Е.Н., Галимзянов Х.М., Малеев В.В. Клинико-лабораторные критерии дифференциальной диагностики сезонных лихорадок в Астраханской области. Инфекционные болезни 2015; 13(2):


Lazareva E.N., Galimzyanov H.M., Maleev V.V. [Clinical and laboratory criteria for differential diagnosis of seasonal fevers in Astrakhan Region]. Infectious diseases 2015; 13(2): 30–8. (In Russ.).


10. Шайхуллина Л.Р., Хунафина Д.Х., Мурзабаева Р.Т., Бурганова А.Н., Старостина В.И., Кутлугужина Ф.Г., Куватова Н.Д. Принципы терапии неотложных состояний при инфекционных заболеваниях. Вестник Башкирского государственного медицинского университета 2013; (4): 14–8.


Shaikhullina L.R., Khunafina D.H., Murzabaeva R.T., Burganova A.N., Starostina V.I., Kutluguzhina F.G., Kuvatova N.D. [Principles of therapy of emergency states in infectious diseases]. Vestnik Bashkirskogo gosudarstvennogo meditsinskogo universiteta 2013; (4): 14–8. (In Russ.).


11. Мингазова Э.М., Валишин Д.А., Гильманов А.Ж., Шайхуллина Л.Р. Анализ изменений показателей сывороточного цистатина С, креатинина и ренального липокалина, ассоциированного с желатиназой нейтрофилов, у больных геморрагической лихорадкой с почечным синдромом. Журнал инфектологии 2015; 7(3): 64–71.


Mingazova E.M., Valishin D.A., Gilmanov A.J., Shaikhullina L.R. [Analysis of changes in serum cystatin C, creatinine and renal lipocalin associated with neutrophil gelatinase in patients with hemorrhagic fever with renal syndrome]. J. Infectiol. 2015; 7(3): 64–71. (In Russ.).


12. Liu K.-T., Liu Y.-H., Lin C.-Y., Ming-Ju T., Ya-Ling H., Meng-Chi Y. Serum neutrophil gelatinase-associated lipocalin and resistin are associated with dengue infection in adults. BMC Infect.Dis. 2016; 16 (1): 441. DOI: 10.1186/s12879-016-1759-9


About the Autors


Vera V. Vasilkova, Cand. Med. Sci., Associate Professor, Head, Department of Infectious Diseases and Epidemiology, Astrakhan State Medical University, Ministry of Health of Russia, Astrakhan, Russia vasilkova.ver@yandex.ru; https://orcid.org/0000-0002-7539-1910
Professor Khalil M. Galimzyanov , MD, Astrakhan State Medical University, Ministry of Health of Russia, Astrakhan, Russia; https://orcid.org/0000-0002-6263-8814
Bela I. Kantemirova, MD, Associate Professor, Professor, Department of Pharmacology, Astrakhan State Medical University, Ministry of Health of Russia, Astrakhan, Russia belakantemi-rova@rambler.ru; https://orcid.org/0000-0003-3278-2556


Similar Articles


Бионика Медиа