Antonelli A, Ferri C, Ferrari SM, Galetta F, Franzoni F, Santoro G, Marco SD, Ghiri E, Fallahi P. High circulating N-terminal pro-brain natriuretic peptide and tumor necrosis factor-α in mixed cryoglobulinemia. World J Gastroenterol 2009; 15(40): 5074-5079 [PMID: 19860001 DOI: 10.3748/wjg.15.5074]
Corresponding Author of This Article
Alessandro Antonelli, MD, Department of Internal Medicine, University of Pisa, School of Medicine, Pisa, 56100 Italy. a.antonelli@med.unipi.it
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Brief Article
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World J Gastroenterol. Oct 28, 2009; 15(40): 5074-5079 Published online Oct 28, 2009. doi: 10.3748/wjg.15.5074
High circulating N-terminal pro-brain natriuretic peptide and tumor necrosis factor-α in mixed cryoglobulinemia
Alessandro Antonelli, Clodoveo Ferri, Silvia Martina Ferrari, Fabio Galetta, Ferdinando Franzoni, Gino Santoro, Salvatore De Marco, Emiliano Ghiri, Poupak Fallahi
Alessandro Antonelli, Silvia Martina Ferrari, Fabio Galetta, Ferdinando Franzoni, Gino Santoro, Emiliano Ghiri, Poupak Fallahi, Department of Internal Medicine, University of Pisa, School of Medicine, Pisa 56100, Italy
Clodoveo Ferri, Department of Internal Medicine, Rheumatology Unit, University of Modena & Reggio E., School of Medicine, Modena 41100, Italy
Salvatore De Marco, Division of Medicine V, Cisanello Hospital, Pisa 56100, Italy
Author contributions: Antonelli A, Ferri C, Fallahi P made substantial contributions to the conception and design of the paper, to the acquisition and interpretation of data, to the statistical analysis, and to the drafting of the manuscript; Ferrari SM, Galetta F, Franzoni F, Santoro G, Ghiri E, De Marco S contributed to the acquisition of data and to the statistical analysis.
Correspondence to: Alessandro Antonelli, MD, Department of Internal Medicine, University of Pisa, School of Medicine, Pisa, 56100 Italy. a.antonelli@med.unipi.it
Telephone: +39-50-992318 Fax: +39-50-553414
Received: May 12, 2009 Revised: September 25, 2009 Accepted: October 2, 2009 Published online: October 28, 2009
Abstract
AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV).
METHODS: Serum NTproBNP and TNF-α levels were assayed in 50 patients with MC+HCV, and in 50 sex- and age-matched controls.
RESULTS: Cryoglobulinemic patients showed significantly higher mean NTproBNP and TNF-α levels than controls (P < 0.001; Mann-Whitney U test). By defining high NTproBNP level as a value higher than 125 pg/mL (the single cut-off point for outpatients under 75 years of age), 30% of MC+HCV and 6% of controls had high NTproBNP (χ2, P < 0.01). With a cut-off point of 300 pg/mL (used to rule out heart failure (HF) in patients under 75 years of age), 8% of MC+HCV and 0 controls had high NTproBNP (χ2, P < 0.04). With a cut-off point of 900 pg/mL (used for ruling in HF in patients aged 50-75 years; such as the patients of our study), 6% of MC+HCV and 0 controls had high NTproBNP (χ2, P = 0.08).
CONCLUSION: The study demonstrates high levels of circulating NTproBNP and TNF-α in MC+HCV patients. The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.
