• Evangelos J Giamarellos-Bourboulis, Efterpi Apostolidou, Malvina Lada, Ioannis Perdios, Nikolaos K Gatselis, Iraklis Tsangaris, Marianna Georgitsi, Magdalini Bristianou, Theodora Kanni, Kalliopi Sereti, Miltiades A Kyprianou, Anastasia Kotanidou, Apostolos Armaganidis, and Hellenic Sepsis Study Group.
• Crit Care. 2013 Jan 1;17(5):R247.

IntroductionThe aim of this study was to investigate the kinetics of immunoglobulin M (IgM) during the different stages of sepsis.MethodsIn this prospective multicenter study, blood sampling for IgM measurement was done within the first 24 hours from diagnosis in 332 critically ill patients; in 83 patients this was repeated upon progression to more severe stages. Among these 83 patients, 30 patients with severe sepsis progressed into shock and IgM was monitored daily for seven consecutive days. Peripheral blood mononuclear cells (PBMCs) were isolated from 55 patients and stimulated for IgM production.ResultsSerum IgM was decreased in septic shock compared to patients with systemic inflammatory response syndrome (SIRS) and patients with severe sepsis. Paired comparisons at distinct time points of the sepsis course showed that IgM was decreased only when patients deteriorated from severe sepsis to septic shock. Serial measurements in these patients, beginning from the early start of vasopressors, showed that the distribution of IgM over time was significantly greater for survivors than for non-survivors. Production of IgM by PBMCs was significantly lower at all stages of sepsis compared with healthy controls.ConclusionsSpecific changes of circulating IgM occur when patients with severe sepsis progress into septic shock. The distribution of IgM is lower among non-survivors.

21 keywords...

hide…