1. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia D. Taş 1, E. Kunter 1, H. Şevketbeyoğlu 2, A.F.Aydın 3, K. Çelik 4, Z. Kartaloğlu 1 1 GATA Haydarpaşa Training Hospital, Department of Pulmonary Diseases 2 Van Military Hospital, Department of Pulmonary Diseases 3 İzmir Military Hospital, Department of Infectious Diseases 4 İzmir Military Hospital, Department of Radiodiagnostics

2. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Introduction Chlamydia pneumoniae and community-acquired pneumonia The significance of extensivity degree of lung parenchymal infiltration

3. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Aim To describe the levels of blood keucocyte count, erythrocyte sedimentation rate (ESR), and high sensitive C-Reactive Protein (hs-CRP) and to investigate the relation of these biomarkers with the rate of parenchymal infiltration (RPI) in patients with Chlamydia pneumoniae pneumonia (CPP)

4. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Material and Method Patients Diagnostic method of CPP Patients characteristics Number of CPP cases

5. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Material and Method High resolution computerised tomography Imaging method and time Characteristics of infiltration Defining the distribution width of the infiltration Rate of parenchymal infiltration(%) = Number of sections showing infiltration by HRCTx100 / total number of sections 2 In case of bilateral infiltrations in the same section, multiplied by 2

6. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Statistical Analysis Descriptive Student t-Test Pearson Correlation Analysis

7. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Findings Demographic data and leucocyte, ESR, hs-CRP levels of the patients nMinimumMaximumMean Std. Deviation Age3220,0025,0020,461,11 Smokers (Yes/No)19/11---- Body mass index3216,6224,3820,842,15 Leucocyte count324600,0021000,00 10131,2 5 4912,68 ESR322,00103,0057,1229,46 hs-CRP32,0410,243,173,64

8. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Findings Blood Leucocyte Count High in 14 patients (43.7%), normal in 18 patients (56.3%) Erythrocyte Sedimentation Rate High in 27 patients (84.3%), normal in 5 patients (15.7%) High Sensitive C-Reactive Protein Levels High in 26 patients (81.2%), normal in 6 patients (18.8%)

9. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Findings The relation of leucocyte, sedimentation and hs-CRP with lung parenchymal infiltration rate LeucocyteESRhs-CRP Lung parenvhymal infiltration rate (%) Correlation constant (r)0,0110,1020,476 Probability (p)0,9520,5800,006

10. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Findings The relation of hs-CRP and the lung parenchymal infiltration rate Lung parenchymal infiltration rate (%) 60,0050,0040,0030,0020,0010,000,00 hs-CRP (mg/L) 12,00 10,00 8,00 6,00 4,00 2,00 0,00 Observed Linear n=32 r=0,476 p=0,006

11. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Discussion In CPP, sedimentation (%84.3) and hs-CRP (%81.2) had a high sensitivity while sensitivity of leucocyte count (%43.7) was moderate. There was only one patient with normal sedimentation and hs-CRP levels. These two biomarkers together had a sensitivity of 96.8% for CPP Although patients were not different in terms of ESH and hs-CRP (p = 0,23), studying these two biomarkers together as acute phase reactants may be more useful in detecting infectious inflammation

12. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Discussion We found a moderately significant correlation between hs-CRP parenchymal infiltration However, the correlation of blood leucocye count and ESH with parenchymal infiltration was not significant statistically These findings suggest that the increment of hs-CRP may be partially parallel to the rate of lung parenchymal infiltration

13. The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia Conclusion hs-CRP and ESR had an acceptable sensitivity while leucocyte count had a moderate sensitivity in patients with CPP These two acute phase reactants can be used as screening tests especially in crowded living conditions with the risk of epidemia We found that hs-CRP showed a moderately positive and significant correlation with lung parenchymal infiltration while leucocyte and ESR levels were not correlated significantly. According to our findings hs-CRP and ESR were succesfull in detecting infection but only hs-CRP was correlated with the rate of lung infiltration. So, hs-CRP can be used as a parameter defining the severity of CPP, but to confirm these findings study of larger series is needed.