C-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema

Yuko Nishikawa, Hidehiro Oku, Masahiro Tonari, Junko Matsuo, Jun Sugasawa, Tsunehiko Ikeda Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan Purpose: Idiopathic orbital inflammation (IOI) and orbital cellulitis can present similar clinical features, and the diagnoses of t...

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Autores principales:	Nishikawa Y, Oku H, Tonari M, Matsuo J, Sugasawa J, Ikeda T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	idiopathic orbital inflammation orbital cellulitis CRP WBC cut-off value. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/3530b6d4e58a43f18d65ab5acd836106
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spelling	oai:doaj.org-article:3530b6d4e58a43f18d65ab5acd8361062021-12-02T07:29:59ZC-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema1177-5483https://doaj.org/article/3530b6d4e58a43f18d65ab5acd8361062018-06-01T00:00:00Zhttps://www.dovepress.com/c-reactive-protein-may-be-useful-to-differentiate-idiopathic-orbital-i-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Yuko Nishikawa, Hidehiro Oku, Masahiro Tonari, Junko Matsuo, Jun Sugasawa, Tsunehiko Ikeda Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan Purpose: Idiopathic orbital inflammation (IOI) and orbital cellulitis can present similar clinical features, and the diagnoses of these two disorders are sometimes confused. The purpose of the present study was to determine whether or not inflammatory markers in the blood can be useful to differentiate between IOI and orbital cellulitis in cases with acute eyelid erythema and edema.Subjects and methods: In this retrospective single-institute study, we reviewed the medical records spanning the past 10 years at the Department of Ophthalmology, Osaka Medical College Hospital, Takatsuki, Osaka, Japan, and found 45 cases, with patients >15 years of age, with presumed IOI. Their blood samples were obtained within 5 days after the onset of IOI. Of those cases, 15 patients (10 males, 5 females, mean age of 56.9 years; range 38–76 years) presented acute eyelid erythema and edema, and were initially misdiagnosed as orbital cellulitis. Thus, inflammatory markers in the blood (ie, white blood cells [WBCs] and C-reactive protein [CRP]) of those 15 patients were analyzed with 17 patients (10 males, 7 females) having orbital cellulitis. The receiver operating characteristic curve analysis was performed to determine the optimal cut-off values. Results: The mean ± standard error (SE) levels of the WBC were 6.80±0.70×10³/µL in the IOI patients, and 8.54±0.91×10³/µL in the orbital cellulitis patients, and no significant differences were observed (P=0.15, Student’s t-test). However, the mean ± SE levels of CRP were 1.04±0.43 mg/dL in the IOI patients, yet were significantly increased to 4.65±1.21 mg/dL in the orbital cellulitis patients (P=0.01, Student’s t-test). The area under the curve value was 0.80 and the optimal cut-off value was 0.43 for orbital cellulitis, with sensitivity and specificity being 82% and 73%, respectively. Conclusion: The findings of this study indicate that CRP may be useful in distinguishing patients with idiopathic orbital inflammation from those with orbital cellulitis. Keywords: idiopathic orbital inflammation, orbital cellulitis, CRP, WBC, cut-off valueNishikawa YOku HTonari MMatsuo JSugasawa JIkeda TDove Medical Pressarticleidiopathic orbital inflammationorbital cellulitisCRPWBCcut-off value.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1149-1153 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	idiopathic orbital inflammation orbital cellulitis CRP WBC cut-off value. Ophthalmology RE1-994
spellingShingle	idiopathic orbital inflammation orbital cellulitis CRP WBC cut-off value. Ophthalmology RE1-994 Nishikawa Y Oku H Tonari M Matsuo J Sugasawa J Ikeda T C-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema
description	Yuko Nishikawa, Hidehiro Oku, Masahiro Tonari, Junko Matsuo, Jun Sugasawa, Tsunehiko Ikeda Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan Purpose: Idiopathic orbital inflammation (IOI) and orbital cellulitis can present similar clinical features, and the diagnoses of these two disorders are sometimes confused. The purpose of the present study was to determine whether or not inflammatory markers in the blood can be useful to differentiate between IOI and orbital cellulitis in cases with acute eyelid erythema and edema.Subjects and methods: In this retrospective single-institute study, we reviewed the medical records spanning the past 10 years at the Department of Ophthalmology, Osaka Medical College Hospital, Takatsuki, Osaka, Japan, and found 45 cases, with patients >15 years of age, with presumed IOI. Their blood samples were obtained within 5 days after the onset of IOI. Of those cases, 15 patients (10 males, 5 females, mean age of 56.9 years; range 38–76 years) presented acute eyelid erythema and edema, and were initially misdiagnosed as orbital cellulitis. Thus, inflammatory markers in the blood (ie, white blood cells [WBCs] and C-reactive protein [CRP]) of those 15 patients were analyzed with 17 patients (10 males, 7 females) having orbital cellulitis. The receiver operating characteristic curve analysis was performed to determine the optimal cut-off values. Results: The mean ± standard error (SE) levels of the WBC were 6.80±0.70×10³/µL in the IOI patients, and 8.54±0.91×10³/µL in the orbital cellulitis patients, and no significant differences were observed (P=0.15, Student’s t-test). However, the mean ± SE levels of CRP were 1.04±0.43 mg/dL in the IOI patients, yet were significantly increased to 4.65±1.21 mg/dL in the orbital cellulitis patients (P=0.01, Student’s t-test). The area under the curve value was 0.80 and the optimal cut-off value was 0.43 for orbital cellulitis, with sensitivity and specificity being 82% and 73%, respectively. Conclusion: The findings of this study indicate that CRP may be useful in distinguishing patients with idiopathic orbital inflammation from those with orbital cellulitis. Keywords: idiopathic orbital inflammation, orbital cellulitis, CRP, WBC, cut-off value
format	article
author	Nishikawa Y Oku H Tonari M Matsuo J Sugasawa J Ikeda T
author_facet	Nishikawa Y Oku H Tonari M Matsuo J Sugasawa J Ikeda T
author_sort	Nishikawa Y
title	C-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema
title_short	C-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema
title_full	C-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema
title_fullStr	C-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema
title_full_unstemmed	C-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema
title_sort	c-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/3530b6d4e58a43f18d65ab5acd836106
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C-reactive protein may be useful to differentiate idiopathic orbital inflammation and orbital cellulitis in cases with acute eyelid erythema and edema

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