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Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 14, 2006; 12(10): 1613-1616
Published online Mar 14, 2006. doi: 10.3748/wjg.v12.i10.1613
Soluble CD40 ligand in prediction of acute severe pancreatitis
Jean Louis Frossard, Philippe Morel, Brenda Kwak, Catherine Pastor, Thierry Berney, Léo Buhler, Alain Von Laufen, Sandrine Demulder, Francois Mach
Jean Louis Frossard, Catherine Pastor, Alain Von Laufen, Division of Gastroenterology, Geneva University Hospital, Genève, Switzerland
Philippe Morel, Thierry Berney, Sandrine Demulde, Clinic of Digestive Surgery, Geneva University Hospital, Genève, Switzerland
Brenda Kwak, François Mach, Division of Cardiology, Geneva University Hospital, Genève, Switzerland
Author contributions: All authors contributed equally to the work.
Supported by a grant from the Fonds de Pérequation des Hôpitaux Universitaires de Genève (to JLF) and Fondation Schmiedheiny
Correspondence to: JL Frossard, MD, Division de gastroentérologie, Hôpital cantonal universitaire,1211 Genève 14, Switzerland. jean-louis.frossard@hcuge.ch
Telephone: +41-022-3729340 Fax: +41-022-3729366
Received: August 8, 2005
Revised: August 14, 2005
Accepted: August 26, 2005
Published online: March 14, 2006

AIM: To assess the early predictability of the soluble CD40L (sCD40L) in pancreatitis severity.

METHODS: Between February 2000 and February 2003, 279 consecutive patients with acute pancreatitis were prospectively enrolled in our study. In this report, 40 patients with mild and 40 patients with severe pancreatitis were randomly studied. sCD40L concentrations were measured 48 hours after admission.

RESULTS: sCD40L levels were significantly higher 48 hours after admission in severe pancreatitis than in mild pancreatitis. Using a cutoff of 1 000 pg/L, the sensitivity and specificity of sCD40L to detect a severe course of the disease were 78% and 62% respectively compared to 72% and 81% for CRP. Logistic regression analysis found that CRP was the only statistically significant marker able to detect a severe course of the disease.

CONCLUSION: These findings indicate that CRP remains a valuable marker to determine the severity and prognosis of acute pancreatitis whereas sCD40L levels should be assessed in further studies.

Keywords: Acute pancreatitis, Prognostic factor, sCD40