Page 162 - Abstract Book KONIKA 18

Emergency & Pediatric Intensive Care

P-EPIC-005 (Prime e-Poster)
Presepsin: A Promising Sepsis Biomarker in Children

1
Indra Ihsan , Rismala Dewi 2
Department of Child Health, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang,
West Sumatera and Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta , Indonesia
1
2
Abstract
Background Presepsin is a subtype of soluble CD14 and has been proposed as a new useful sepsis biomarker,
but its data in pediatric sepsis are still limited. Objective To compare the values of presepsin to other sepsis
biomarkers in children with suspected sepsis and observed whether the level influenced by non-infectious
inflammatory response. Methods A cross sectional study was conducted during March – December 2020 in
Cipto Mangunkusumo General Hospital, Jakarta. Fifty six hospitalized children aged 2 months – 10 years
old with suspected sepsis were enrolled. The diagnosis of sepsis was based on sepsis-3 criteria and blood
culture result. The biomarkers level and PELOD-2 score were measured at the time when the diagnosis of
sepsis was first made. The level of presepsin were measured using a PATHFAST® analyzer. Results Presepsin
levels were significantly higher in the proven sepsis group compared to unproven sepsis group (1183 vs. 369
pg/mL, P=0.001) as well as PCT levels (5.39 vs. 1.2 ng/mL, P=0.008). In other hand CRP and leukocytes
count were not significantly different. Seven out of 33 subjects in the sepsis group had a history of surgery.
The median value of presepsin levels did not significantly different between groups with or without history
of surgery (711 vs. 806 pg/mL, P{=0.402). PCT, CRP and leukocyte levels increased significantly in the
group with history of surgery (P<0.005). Conclusion Presepsin levels were significantly increased in sepsis
and not affected by non-infectious inflammatory response.
Keywords: CRP; leukocyte; PCT; presepsin; sepsis

P-EPIC-006
Multisystem Inflammatory Syndrome in Children Related to COVID-19:
An Enigmatic Case Report from South Sumatera

Indra Saputra, Yulia Iriani, Desti Handayani
Department of Child Health, Faculty of Medicine, Universitas Sriwijaya/Dr. Mohammad Hoesin General Hospital,
Palembang, South Sriwijaya, Indonesia
Abstract
Background Multisystem inflammatory syndrome in children (MIS-C) is considered a life-threatening
manifestation after COVID-19. It is crucial to know the atypical presentation of MIS-C to identify and provide
thorough treatment promptly. Objective To elaborate on the clinical and laboratory features of MIS-C and
emphasize the essential of serology testing in diagnose MIS-C. Case A 14-year-old female with juvenile
idiopathic arthritis was intubated and referred to the paediatric intensive care unit. She had a history of three
days of remittent fever, joint pain, mouth ulcer, fatigue, and rapid progressive loss of consciousness. The
SARS-CoV-2 IgG level was 71.04 U/mL, but PCR test was negative. The laboratory analysis showed evidence
of coagulopathy (D-dimer 7.76 µg/mL, Ferritin 1057.4 ng/mL, fibrinogen 422 mg/dL), elevated markers of
inflammation (CRP 62 mg/L, procalcitonin 17.42 ng/mL, LDH 662 U/L), and no other apparent microbial
cause of inflammation. The patient initially experienced fluid-refractory hypotension requiring vasopressors
but no improvement during treatment. Considering the diagnosis of MIS-C, intravenous immunoglobulin
(IVIG), fluid resuscitation and other metabolic supports were given to the patient. The patient was improved
and extubated after got IVIG. Conclusion Primary health care providers, emergency department physicians,
and paediatricians should be alert to clinical features suggesting MIS-C, specifically within endemic areas.
The serologic test is essential to provide evidence of recent SARS-CoV-2 infection in MIS-C cases.
Keywords: MIS-C; serologic test; SARS-CoV-2

114 KONIKA XVIII Abstract Book