Neutrophil CD64 expression is associated with severity and prognosis of disseminated intravascular coagulation

IntroductionAlthough neutrophil can be activated by microcirculatory disturbances in DIC, its relation with the severity and prognosis of DIC has not been elucidated. We investigated the relationship between neutrophil activation and DIC severity and determined the prognostic value of neutrophil activation markers in patients with DIC.Materials and methodsWe measured two neutrophil activation markers, neutrophil CD64 expression and plasma neutrophil elastase, in 94 patients with suspected DIC and 55 healthy controls. Neutrophil CD64 expression and plasma neutrophil elastase were measured using CD64 quantitation kit, and PMN Elastase enzyme immunoassay kit.ResultsNeutrophil CD64 expression and plasma neutrophil elastase level were significantly increased in patients with overt and non-overt DIC compared to normal controls (P < 0.001, each). Neutrophil CD64 expression showed a significant linear trend of increase with increasing DIC score (P < 0.001). In DIC patients, significant differences were observed between those with and without infection both in overt (P = 0.003) and non-overt DIC (P = 0.004). Neutrophil CD64 expression was significantly increased in 28-day non-survival group compared to survival group in both overt (P < 0.001) and non-overt DIC (P = 0.032). The 28-day survival rate showed a stronger association with the neutrophil CD64 expression (P < 0.001) than with DIC score (P = 0.028) or plasma neutrophil elastase level (P = 0.246).ConclusionsNeutrophil CD64 expression is significantly correlated with DIC severity and has a good predictive value for the 28-day mortality in patients suspected of having DIC. Neutrophil CD64 expression might be useful in monitoring the disease course and in predicting mortality in DIC patients.