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Volume 25, Number 2—February 2019
Research

Macrophage Activation Marker Soluble CD163 Associated with Fatal and Severe Ebola Virus Disease in Humans1

Anita K. McElroyComments to Author , Punya Shrivastava-Ranjan, Jessica R. Harmon, Roosecelis B. Martines, Luciana Silva-Flannery, Timothy D. Flietstra, Colleen S. Kraft, Aneesh K. Mehta, G. Marshall Lyon, Jay B. Varkey, Bruce S. Ribner, Stuart T. Nichol, Sherif R. Zaki, and Christina F. Spiropoulou
Author affiliations: University of Pittsburgh, Pittsburgh, Pennsylvania, USA (A.K. McElroy); Centers for Disease Control and Prevention, Atlanta (A.K. McElroy, P. Shrivastava-Ranjan, J.R. Harmon, R.B. Martines, L Silva-Flannery, T.D. Flietstra, S.T. Nichol, S.R. Zaki, C.F. Spiropoulou); Emory University School of Medicine, Atlanta, Georgia, USA (A.K. McElroy, C.S. Kraft, A.K. Mehta, G.M. Lyon, J.B. Varkey, B.S. Ribner)

Main Article

Table

Laboratory findings of patients with MAS, HLH, or EVD and their association with fatal EVD outcomes*

Laboratory finding MAS diagnostic value HLH diagnostic value EVD Associated with fatal EVD outcome References
Cytopenia >2 cell types
Anemia, g/dL <9 Rarely No (24,25)
Thrombocytopenia, x 103/mL <181 <100 Sometimes No (24,25)
Neutropenia, cells/mL

<1,000
Rarely
No
(16,26)
Hyperferritinemia, ng/mL >684 >500 Yes Yes (3,18)
Hypofibrinogenemia, mg/dL <360 <150 Sometimes Unknown (18)
Hypertriglyceridemia, mg/dL
>156
>265
Sometimes
Yes
This study
sIL-2R (sCD25), U/mL >2,400 Yes No (18); this study
Low or absent NK cell activity Yes Yes (27)
Hemophagocytosis in BM, spleen, or LN None reported (2)
Soluble CD163 Yes Yes This study
Elevated AST/ALT, U/L >48 Yes Yes (28)
Elevated D-dimer Yes Yes (3,18,28)

*ALT, alanine aminotransferase; AST, aspartate aminotransferase; BM, bone marrow; EVD, Ebola virus disease; HLH, hemophagocytic lymphohistiocytosis; LN, lymph node; MAS, macrophage activation syndrome; NK, natural killer; sIL-2R, soluble interleukin 2 receptor; –, feature not included in disease diagnostic criteria.

Main Article

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1Preliminary results from this study were presented at the American Association of Immunology annual meeting, May 4-8, 2018, Austin, Texas, USA.

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Page updated: January 16, 2019
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