Eqbal, Farea

Background: Acute pancreatitis (AP) is a common emergency condition with high morbidity, mortality, and socio-economic impact. Soluble urokinase plasminogen activator receptor (suPAR) is a potential biomarker for AP prognosis. This study systematically reviews the literature on suPAR’s prognostic roles in assessing AP severity, organ failure, mortality, and other pathological markers. Methods: A comprehensive search of 5 databases up to March 19, 2023, was conducted, selecting cohort studies that examined suPAR’s relationship with AP outcomes. Outcome variables included AP severity, organ failure, mortality, hospital stay length, and suPAR’s association with other inflammatory markers. Our paper has been registered on Prospero (ID: CRD42023410628). Results: Nine prospective observational studies with 1033 AP patients were included. Seven of eight studies found suPAR significantly elevated in severe acute pancreatitis ( P < .05). Four studies showed suPAR effectively predicted organ failure risk, and 4 studies concluded suPAR significantly predicted mortality ( P < .05). The review had no high-risk studies, enhancing credibility. Conclusion: suPAR is a valuable prognostic marker in AP, significantly predicting severity, organ failure, hospital stay length, and mortality. Further large-scale studies are needed to explore suPAR’s role in other clinical outcomes related to AP disease course, to establish it as a mainstay of AP prognosis.

Abstract Introduction An unusual association between thyroid dysfunction and autoimmune encephalitis (AE) was noticed when patients presented with low free triiodothyronine (fT3) levels and antithyroid antibodies. We conducted a meta‐analysis to investigate whether thyroid dysfunction, that is, lower fT3 levels are associated with worsening clinical manifestations and prognosis in patients with AE. Methods Literature search of five electronic databases was performed till April 5, 2023. Inclusion criteria were as follows: Observational studies reporting patients with all subtypes of AE and assessing thyroid dysfunction categorized as low fT3 and non‐low fT3. Primary endpoints included modified Rankin scale (mRS) at admission, abnormal magnetic resonance imaging, length of stay, seizures, and consciousness declination. Results Comprehensive literature search resulted in 5127 studies. After duplicate removal and full‐text screening, six observational studies were included in this analysis. Patients with low fT3 were 2.95 times more likely to experience consciousness declination ( p = .0003), had higher mRS at admission ( p < .00001), had 3.14 times increased chances of having a tumor ( p = .003), were 3.88 times more likely to experience central hypoventilation, and were 2.36 times more likely to have positivity for antithyroid antibodies ( p = .009) as compared to patients with non‐low fT3. Conclusion The findings of our study suggest that low fT3 levels might be related to a more severe disease state, implying the significance of thyroid hormones in AE pathogenesis. This finding is crucial in not only improving the early diagnosis of severe AE but also in the efficient management of the disease.