Clinical utility of diagnostic guidelines and putative biomarkers in lymphangioleiomyomatosis.

Respir Res

Division of Therapeutics and Molecular Medicine, National Centre for Lymphangioleiomyomatosis and Nottingham Respiratory Biomedical Research Unit, Queen's Medical Centre, University of Nottingham, Nottingham, UK.

Published: April 2012

Background: Lymphangioleiomyomatosis is a rare disease occurring almost exclusively in women. Diagnosis often requires surgical biopsy and the clinical course varies between patients with no predictors of progression. We evaluated recent diagnostic guidelines, clinical features and serum biomarkers as diagnostic and prognostic tools.

Methods: Serum vascular endothelial growth factor-D (VEGF-D), angiotensin converting enzyme (ACE), matrix metalloproteinases (MMP) -2 and -9, clinical phenotype, thoracic and abdominal computerised tomography, lung function and quality of life were examined in a cohort of 58 patients. 32 healthy female controls had serum biomarkers measured.

Results: Serum VEGF-D, ACE and total MMP-2 levels were elevated in patients. VEGF-D was the strongest discriminator between patients and controls (median = 1174 vs. 332 pg/ml p < 0.0001 with an area under the receiver operating characteristic curve of 0.967, 95% CI 0.93-1.01). Application of European Respiratory Society criteria allowed a definite diagnosis without biopsy in 69%. Adding VEGF-D measurement to ERS criteria further reduced the need for biopsy by 10%. VEGF-D was associated with lymphatic involvement (p = 0.017) but not the presence of angiomyolipomas.

Conclusions: Combining ERS criteria and serum VEGF-D reduces the need for lung biopsy in LAM. VEGF-D was associated with lymphatic disease but not lung function.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3431996PMC
http://dx.doi.org/10.1186/1465-9921-13-34DOI Listing

Publication Analysis

Top Keywords

diagnostic guidelines
8
serum biomarkers
8
clinical
4
clinical utility
4
utility diagnostic
4
guidelines putative
4
putative biomarkers
4
biomarkers lymphangioleiomyomatosis
4
lymphangioleiomyomatosis background
4
background lymphangioleiomyomatosis
4

Similar Publications

Background: Psychoeducation positively influences the psychological components of chronic low back pain (CLBP) in conventional treatments. The digitalization of health care has led to the discussion of virtual reality (VR) interventions. However, CLBP treatments in VR have some limitations due to full immersion.

View Article and Find Full Text PDF

Cardiovascular disease is the main cause of mortality in Mexico as well as the rest of the world, with dyslipidemia being one of the main risk factors. Despite the importance of its epidemiological impact, there is still -among primary care physicians- a lack of knowledge ranging from the basic concepts for diagnosis to the most recent recommendations for treatment. This document consisting of 10 questions is done by experts in this field.

View Article and Find Full Text PDF

WHO's 2013 PMTCT guidelines recommended lifelong antiretroviral therapy (ART) for HIV-infected pregnant and breastfeeding women, exclusive breastfeeding (EBF), nevirapine prophylaxis (NVP) and early infant diagnosis (EID) for HIV-exposed-breastfed infants. We examined the association between knowledge and adherence to these guidelines among 550 HIV-infected pregnant women in Maharashtra, India. Knowledge of PMTCT guidelines was assessed using a structured-questionnaire during enrollment.

View Article and Find Full Text PDF

Introduction: Appropriate antibiotic use requires using the right antibiotic, at the right dose, for the right duration, and at the right time. Drug-resistant diseases cause numerous deaths globally a year, and antibiotic stewardship is a cornerstone in fighting antibiotic resistance. This study focuses on tracking the antibiotic prescribing practices in Palestine and improving future antibiotic prescribing.

View Article and Find Full Text PDF

Objectives: This study aimed to determine the metabolic syndrome (MS) prevalence in a sample of adolescents, to calculate their continuous metabolic syndrome scores, and to determine the associations of continuous metabolic syndrome score with overweight/obesity and selected cardiometabolic and lifestyle factors.

Methods: We enrolled a sample of 2,590 adolescents (1,180 males, mean age 17.1 ± 1.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!