Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2020; 8(1): 200-207
Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.200
Value of dynamic plasma cell-free DNA monitoring in septic shock syndrome: A case report
Jing-Ping Liu, Shi-Chang Zhang, Shi-Yang Pan
Jing-Ping Liu, Shi-Chang Zhang, Shi-Yang Pan, Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Liu JP participated in data collection; Zhang SC and Pan SY conceived and coordinated the study; all authors participated in manuscript writing.
Supported by National Natural Science Foundation of China, No. 81672100 and No. 81671836; and the Key Laboratory for Laboratory Medicine of Jiangsu Province of China, No. ZDXKB2016005.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shi-Yang Pan, PhD, Professor, Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Guangzhou Road No. 300, Nanjing 210029, Jiangsu Province, China. sypan@njmu.edu.cn
Received: September 2, 2019
Peer-review started: September 2, 2019
First decision: November 13, 2019
Revised: November 18, 2019
Accepted: November 30, 2019
Article in press: November 30, 2019
Published online: January 6, 2020
Processing time: 126 Days and 15.9 Hours
Abstract
BACKGROUND

Mortality due to septic shock is relatively high. The dynamic monitoring of plasma cell-free DNA (cfDNA) can guide the treatment of septic shock.

CASE SUMMARY

Herein, we present a typical case of septic shock syndrome caused by the bacilli Acinetobacter baumannii and Pantoea. The patient complained of abdominal pain, fever and chills upon admission to the Emergency Department. Marked decreases in white blood cells and procalcitonin (PCT) were observed after the patient received continuous renal replacement and extracorporeal membrane oxygenation. Plasma cfDNA levels were consistently high, peaking at 1366.40 ng/mL, as measured by a duplex real-time PCR assay with an internal control, which was developed as a novel method for the accurate quantification of cfDNA. The patient died of septic shock on HD 8, suggesting that cfDNA could be used to monitor disease progression more effectively than PCT and the other inflammatory factors measured in this case.

CONCLUSION

CfDNA may be a promising marker that complements other inflammatory factors to monitor disease progression in patients with septic shock.

Keywords: Septic shock; Acinetobacter baumannii; Cell-free DNA; Case report

Core tip: Mortality due to septic shock is relatively high. Several biomarkers have been evaluated for predicting mortality in patients with septic shock, but none have been shown to be entirely useful in clinical applications. Herein, we report a typical case and review the literature. This case might contribute to improving our understanding of cell-free DNA (cfDNA) in monitoring disease progression during septic shock. This report also suggests that cfDNA could be used to more effectively monitor disease progression than procalcitonin and other inflammatory factors.