NEOPTERIN PLASMA-CONCENTRATIONS PREDICT THE COURSE OF SEVERE ACUTE-PANCREATITIS

In a prospective, descriptive study in 25 patients with acute pancreat itis neopterin plasma concentrations were found to be associated with the severity of the disease, which was assessed using weights of the w orst 17 physiological abnormalities of the APACHE-III score over a 24 h period after hospital admission. Neopterin concentrations were highe r in severe pancreatitis (n = 10) compared to mild disease, and there existed a positive exponential correlation between neopterin and the A cute Physiology Score (r = 0.66). Higher neopterin concentrations were associated with the development of multiple organ failure (p = 0.012) and death (p = 0.019). At a cut-off concentration of 12 nmol/l the se nsitivity (80 %) and specificity (100 %) of neopterin for the discrimi nation between mild and severe clinical course of pancreatitis was mor e accurate than C-reactive protein at a risk threshold of 1.2 g/l (70 % and 87 %). Development of pancreatic necrosis was associated with hi gher neopterin concentrations than edematous pancreatitis (p < 0.001).