GROUP-II PHOSPHOLIPASE-A(2) IN SERA OF FEBRILE PATIENTS WITH MICROBIOLOGICALLY OR CLINICALLY DOCUMENTED INFECTIONS

Group II phospholipase A2 (PLA2-II) is an inflammatory enzyme, which has been shown to be an acute-phase protein and to correlate with the severity of sepsis. In a prospective study, the concentration of PLA2-II in the sera of 46 patients with sepsis and nonseptic bacterial and viral infections was measured by a fluoroimmunoassay. The serum concentration of PLA2-II in patients with infections (median, 164.5 mug/L; range, 5.07-1,740 mug/L) was elevated 46-fold above normal concentrations (median, 3.61 mug/L; range, 1.32-25.25 mug/L). The concentration of PLA2-II was higher in patients with sepsis (median, 284.5 mug/L; range, 12.95-1,574 mug/L) and nonseptic bacterial infections (median, 210.6 mug/L; range, 5.07-1,740 mug/L) than in those with viral infections (median, 46.78 mug/L; range, 11.46-275.9 mug/L) (P = .0042). The concentration of PLA2-II correlated well with the concentration of C-reactive protein (CRP) (r = .613, P = .0001) but not with the concentration of pancreatic PLA2 (r = .089, P = .365). Measuring the serum concentration of PLA2-II is useful as an adjunct to the determination of CRP concentrations for differentiating bacterial from viral infection.