PMN ELASTASE IN BONE AND JOINT INFECTIONS

PMN (polymorphonuclear neutrophil) elastase is a proteolytic enzyme wh ich is a biochemical marker for abnormal granulocyte stimulation. In i nflammation and sepsis, excessive neutrophil stimulation results in si gnificant amounts of PMN elastase being released into the plasma which indicates the severity of the disease and ifs prognosis. In 62 patien ts with osteomyelitis or suppurative arthritis, PMN elastase had a dia gnostic sensitivity of 81%, which is comparable to the nonspecific ery throcyte sedimentation rate. Sensitivity of C-reactive protein (CRP) w as 71%, fibrinogen 54% and leucocyte count 26%. PMN elastase was also useful in the follow Lip of patients with bone and joint infections; i n the early post-operative period it became normal more quickly than t he other findings unless the patients developed complications. Ten day s after operation, PMN elastase was normal in 75% of the patients comp ared to the CRP which became normal in only 25%. Later both results we re similar: on discharge from hospital, PMN elastase was normal in 77% and CRP in 71%.