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The Monoethylglycinexylidide (MEGX) Test as a Marker of Hepatic Dysfunction in Septic Patients with Pneumonia

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Published/Copyright: June 1, 2005
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Volume 38 Issue 11

Abstract

The aim of this study was to monitor hepatic function in patients with pneumonia meeting the sepsis criteria of the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) and to determine if hepatic dysfunction is related to the systemic inflammatory response. Twenty patients were recruited. The monoethylglycinexylidide (MEGX) test was carried out on days 1–10 after admittance to the intensive care unit. Blood samples for determination of serum concentrations of hyaluronic acid, C-reactive protein (CRP), interleukin (IL)-6, IL-8, IL-10 and conventional liver function tests (aspartate aminotransferase, alanine aminotransferase, bilirubin, albumin) were also drawn. Patients were classified into two groups according to illness severity estimated by the simplified acute physiology score (SAPS II) on the day of admission. Patients in group I (n=10) had a SAPS II probability of mortality >3% while those in group II (n=10) had a SAPS II < 3%. The MEGX level over the first five days was significantly lower in group I than in group II (p<0.0001). Significant inverse correlations during the first 5 days were observed between the MEGX 30 min test results and IL-6, CRP and SAPS II and more modest correlations with hyaluronic acid (p=0.0025) and IL-10 (p=0.021). The conventional liver function tests did not differ between the two groups and were mostly within the respective reference ranges. We conclude that the MEGX test is a sensitive marker of liver dysfunction early in sepsis and that low MEGX values are associated with an enhanced inflammatory response.

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Published Online: 2005-06-01
Published in Print: 2000-11-12

Copyright © 2000 by Walter de Gruyter GmbH & Co. KG

Articles in the same Issue

  1. European Meeting on Biomarkers of Organ Damage and Dysfunction Selected Papers from the Meeting Held in Cambridge, UK April 3rd-7th, 2000
  2. Kidney Retrieval Conditions Influence Damage to Renal Medulla: Evaluation by Proton Nuclear Magnetic Resonance (NMR) Spectroscopy
  3. Citrate, Acetate and Renal Medullary Osmolyte Excretion in Urine as Predictor of Renal Changes after Cold Ischaemia and Transplantation
  4. Comparison of Proteolytic Enzymes and Glutathione S-Transferase Levels in Non-Heart-Beating Donors' (NHBD) Kidney Perfusates
  5. Assessment of Non-Heart-Beating Donor (NHBD) Kidneys for Viability on Machine Perfusion
  6. Low Levels of Urinary Albumin Excretion Are Associated with Cardiovascular Risk Factors in the General Population
  7. Evaluation of a Fully Automated Assay to Measure C-Telopeptide of Type I Collagen in Serum
  8. Bone Turnover Markers and Estradiol Level in Postmenopausal Women
  9. External Quality Assessment of Bone Metabolism Marker Assays. Initial Experiences in a UK NEQAS Programme
  10. The Monoethylglycinexylidide (MEGX) Test as a Marker of Hepatic Dysfunction in Septic Patients with Pneumonia
  11. Transforming Growth Factor-β1 as a Surrogate Marker of Hepatic Dysfunction in Chronic Liver Diseases
  12. A New Approach to the Evaluation of Liver Graft Function by Nuclear Magnetic Resonance Spectroscopy. A Comparative Study between Euro-Collins and University of Wisconsin Solutions
  13. Metallothionein and Heat Shock Protein Expression during Acute Liver Injury and Regeneration in Rats
  14. Biochemical Evaluation of Patients with Acute Pancreatitis
  15. Screening for Acute Myocardial Injury: Creatine Kinase Is Comparable to Myoglobin
  16. Different Time Frames for the Occurrence of Elevated Levels of Cardiac Troponin T and C-Reactive Protein in Patients with Acute Myocardial Infarction
  17. Determination of Decision Limits for ACS:Systems Cardiac Troponin I
  18. Stability of Cardiac Troponins and CK-MB Mass Isoenzyme
  19. Cytokines as Plasma Markers of Abdominal Aortic Aneurysm
  20. The Early Fall in Levels of S-100 β in Traumatic Brain Injury
  21. Protein S-100β in Brain and Serum after Deep Hypothermic Circulatory Arrest in Rabbits: Relationship to Perivascular Astrocytic Swelling
  22. The Effect of Continuous Treatment with Sodium Nitroprusside on the Serum Kinetics of the Brain Marker Protein S-100β in Neonates Undergoing Corrective Cardiac Surgery by Means of Hypothermic Cardiopulmonary Bypass
  23. Differentiated Therapy with Prostaglandin E1 (Alprostadil) after Orthotopic Liver Transplantation: the Usefulness of Procalcitonin (PCT) and Hepatic Artery Resistive Index (RI) for the Evaluation of Early Graft Function and Clinical Course
  24. The Postoperative Course of γ-Glutamyl Transpeptidase – a Marker of Cytomegalovirus (CMV) Replication Risk?
  25. TNF-α and Its Receptors Mediate Graft Rejection and Loss after Liver Transplantation
  26. Impact of Ig-Therasorb® Immunoapheresis on Stability of Xenogeneic Ex Vivo Porcine Liver Perfusion – Value of Aminotransferases and Flow Rates for the Assessment of Metabolic Graft Viability
  27. The Effect of Human Organ Preservation and Albumin Flush Solution on In Vitro Cell Metabolic Activity
  28. An Ex Vivo Model of Tolerance vs. Rejection: Comparison of Different Signal Transducers and Activators of Transcription, STAT1, STAT4, STAT5 and STAT6
  29. Detection of Cytomegalovirus (CMV) Antigens in Kidney Biopsies and Transplant Nephrectomies as a Marker for Renal Graft Dysfunction
  30. Comparison of Five Cyclosporin Immunoassays with HPLC
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  32. Pharmacodynamic Monitoring of Mycophenolate Mofetil
https://doi.org/10.1515/CCLM.2000.169

Articles in the same Issue

  1. European Meeting on Biomarkers of Organ Damage and Dysfunction Selected Papers from the Meeting Held in Cambridge, UK April 3rd-7th, 2000
  2. Kidney Retrieval Conditions Influence Damage to Renal Medulla: Evaluation by Proton Nuclear Magnetic Resonance (NMR) Spectroscopy
  3. Citrate, Acetate and Renal Medullary Osmolyte Excretion in Urine as Predictor of Renal Changes after Cold Ischaemia and Transplantation
  4. Comparison of Proteolytic Enzymes and Glutathione S-Transferase Levels in Non-Heart-Beating Donors' (NHBD) Kidney Perfusates
  5. Assessment of Non-Heart-Beating Donor (NHBD) Kidneys for Viability on Machine Perfusion
  6. Low Levels of Urinary Albumin Excretion Are Associated with Cardiovascular Risk Factors in the General Population
  7. Evaluation of a Fully Automated Assay to Measure C-Telopeptide of Type I Collagen in Serum
  8. Bone Turnover Markers and Estradiol Level in Postmenopausal Women
  9. External Quality Assessment of Bone Metabolism Marker Assays. Initial Experiences in a UK NEQAS Programme
  10. The Monoethylglycinexylidide (MEGX) Test as a Marker of Hepatic Dysfunction in Septic Patients with Pneumonia
  11. Transforming Growth Factor-β1 as a Surrogate Marker of Hepatic Dysfunction in Chronic Liver Diseases
  12. A New Approach to the Evaluation of Liver Graft Function by Nuclear Magnetic Resonance Spectroscopy. A Comparative Study between Euro-Collins and University of Wisconsin Solutions
  13. Metallothionein and Heat Shock Protein Expression during Acute Liver Injury and Regeneration in Rats
  14. Biochemical Evaluation of Patients with Acute Pancreatitis
  15. Screening for Acute Myocardial Injury: Creatine Kinase Is Comparable to Myoglobin
  16. Different Time Frames for the Occurrence of Elevated Levels of Cardiac Troponin T and C-Reactive Protein in Patients with Acute Myocardial Infarction
  17. Determination of Decision Limits for ACS:Systems Cardiac Troponin I
  18. Stability of Cardiac Troponins and CK-MB Mass Isoenzyme
  19. Cytokines as Plasma Markers of Abdominal Aortic Aneurysm
  20. The Early Fall in Levels of S-100 β in Traumatic Brain Injury
  21. Protein S-100β in Brain and Serum after Deep Hypothermic Circulatory Arrest in Rabbits: Relationship to Perivascular Astrocytic Swelling
  22. The Effect of Continuous Treatment with Sodium Nitroprusside on the Serum Kinetics of the Brain Marker Protein S-100β in Neonates Undergoing Corrective Cardiac Surgery by Means of Hypothermic Cardiopulmonary Bypass
  23. Differentiated Therapy with Prostaglandin E1 (Alprostadil) after Orthotopic Liver Transplantation: the Usefulness of Procalcitonin (PCT) and Hepatic Artery Resistive Index (RI) for the Evaluation of Early Graft Function and Clinical Course
  24. The Postoperative Course of γ-Glutamyl Transpeptidase – a Marker of Cytomegalovirus (CMV) Replication Risk?
  25. TNF-α and Its Receptors Mediate Graft Rejection and Loss after Liver Transplantation
  26. Impact of Ig-Therasorb® Immunoapheresis on Stability of Xenogeneic Ex Vivo Porcine Liver Perfusion – Value of Aminotransferases and Flow Rates for the Assessment of Metabolic Graft Viability
  27. The Effect of Human Organ Preservation and Albumin Flush Solution on In Vitro Cell Metabolic Activity
  28. An Ex Vivo Model of Tolerance vs. Rejection: Comparison of Different Signal Transducers and Activators of Transcription, STAT1, STAT4, STAT5 and STAT6
  29. Detection of Cytomegalovirus (CMV) Antigens in Kidney Biopsies and Transplant Nephrectomies as a Marker for Renal Graft Dysfunction
  30. Comparison of Five Cyclosporin Immunoassays with HPLC
  31. In Vitro Pentamer Formation as a Biomarker of Tacrolimus-Related Immunosuppressive Activity after Liver Transplantation
  32. Pharmacodynamic Monitoring of Mycophenolate Mofetil
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