Ann Pediatr Res | Volume 7, Issue 2 | Research Article | Open Access

The Role of Serum Myelin Basic Protein in Prediction of Neurological Morbidity in Critically ill Children

Saleh NY^1*, Abo El Fotoh WA¹, El Hefenawy SM² and Garib MI¹

¹Department of Pediatrics, Menoufia University, Egypt ²Department of Medical Biochemistry and Molecular Biology, Menoufia University, Egypt

^*Correspondance to: Nagwan Yossery Saleh 

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Abstract

Background: It is well established that white matter is more resistant than gray matter to ischemic changes. An increase in Myelin Basic Protein (MBP) represents damage to white matter and thus reflects more severe neurological injury, demonstrating its potential in predicting neurological outcome. Therefore, we aimed to assess role of MBP in prediction of neurological outcome in critically ill children. Methods: The included 45 critically ill children were divided into two groups according to Pediatric Cerebral Performance Category (PCPC) score into: Group 1: Patients with favorable neurological outcome with a PCPC score of 1-3. Group 2: Patients with unfavorable neurological outcome with a PCPC score of 4-6. Serum MBP of patients was performed on admission and 7 days later. Results: Serum MBP was significantly elevated in patients with unfavorable neurological outcome after 1 week. Multivariate logistic regression analysis demonstrated that MBP after 7 days is the most important independent risk factor for predicting neurological deterioration. Poor baseline PCPC had the largest Area Under the Curve (AUC) for predicting poor neurological outcome followed by MBP after 7 days and then GCS at admission, add to this, poor baseline PCPC had the largest AUC to predict mortality followed by GCS at admission then PRISM and pSOFA and finally MBP after 7 days. Conclusion: MBP after 7 days was superior to conventional laboratory markers and clinical scoring systems as the most important independent risk factor for predicting neurological deterioration. Also, GCS at admission, PRISM, pSOFA scores, and platelet counts were significantly associated with unfavorable neurological outcomes.

Keywords:

Children; Critical; Myelin basic protein; Neurological outcomes

Citation:

Saleh NY, Abo El Fotoh WA, El Hefenawy SM, Garib MI. The Role of Serum Myelin Basic Protein in Prediction of Neurological Morbidity in Critically ill Children. Ann Pediatr Res. 2023;7(2):1078..