Detection of Cytokeratin-19 caused by Intestinal Epithelial Cell Damage in Childhood Diarrhea

Hwang, Ja Young; Seo, Se Young; Hahn, Seong Hoon; Kim, So Young; Kim, Hyun Hee; Lee, Won Bae

Abstract

PURPOSE
Acute gastroenteritis in infancy is a very common disease with a frequency of a billion diarrhea per year, leading to 3 to 5 million deaths. Since the etiology is not always clear, the treatment plan can be quite difficult to make. The laboratory examinations of stool culture, along with complete blood counts may sometimes be helpful to find bacterial etiology, while occult blood in stool merely means the presence of gastrointestinal tract bleeding. We evaluated the presence of cytokeratin-19 in stools in differentiating bacterial and non-bacterial causes of childhood diarrhea to establish appropriate treatment plans.
METHODS
Among 201(male 124 patients, female 77 patients) patients with diarrhea, cytokeratin-19 examined by ELISA was positive in 40 patients. Laboratory findings including peripheral blood leukocytes count with differential count, ESR, CRP were compared between the cytokeratin-19 positive and negative groups. We also investigated the correlation between cytokeratin-19 and stool culture, leukocytes, rotavirus antegen test, and occult blood in stool.
RESULTS
The leukocytes count, neutrophil count in peripheral blood and ESR were higher in cytokeratin-19 positive group(P=0.030). There was significant correlation between serum CRP and cytokeratin-19(P=0.007). Sensitivity of cytokeratin-19 was 0.30 and specificity was 0.86 in serum CRP positive group and negative group.
CONCLUSION
Cytokeratin-19 in stool was significantly increased in correlation with leukocytes and neutrophil count in peripheral blood, ESR, serum CRP and the specificity of cytokeratin-19 was 0.86 in the serum CRP positive group and the negative group. Therefore, the quantitification of cytokeratin-19 in stool was considered as indicator of differential diagnosis between clinically bacterial and non-bacterial infection groups.