The diagnostic value of neurogranin in patients with carbon monoxide poisoning: Can it show early neurological damage?

• Published in: The American journal of emergency medicine 2021-12, Vol.50, p.191-195
• Main Authors: Yeşilyurt, Ömer, Cömertpay, Ertan, Vural, Sevilay, Eroğlu, Oğuz, Badem, Nermin Dindar, Çankaya, İmran, Bilgili, Yasemin Karadeniz
• Format: Article
• Language: English
• Subjects: Biomarkers; Biomarkers - blood; Carbon; Carbon monoxide; Carbon monoxide poisoning; Carbon Monoxide Poisoning - diagnosis; Carbon Monoxide Poisoning - diagnostic imaging; Case-Control Studies; Chronic illnesses; Correlation analysis; Diffusion Magnetic Resonance Imaging; Diffusion weighted magnetic resonance imaging; Emergency medical care; Emergency Service, Hospital; Female; Glasgow Coma Scale; Humans; Kinases; Magnetic resonance imaging; Male; Medical diagnosis; Middle Aged; Neurogranin; Neurogranin - blood; Neuroimaging; Neurological complications; Poisoning; Prospective Studies; Traumatic brain injury
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2021.07.052

Carbon monoxide poisoning is a toxicological emergency that causes neurological complications. High serum neurogranin can be detected in acute or chronic conditions where brain tissue is damaged. This study aimed to investigate the diagnostic value of serum neurogranin level and its role in demonstrating neurological damage in patients admitted to the emergency department with carbon monoxide poisoning. The study was conducted prospectively on patients with carbon monoxide poisoning (patient group) and healthy volunteers (control group). Demographic characteristics and serum neurogranin level of all participants and symptoms at admission, neurological examination findings, laboratory results, and Diffusion-Weighted Magnetic Resonance Imaging results of the patient group were recorded. We used an independent sample t-test to compare neurogranin levels and bivariate correlation analysis to compare the relationship between serum neurogranin levels and data belonging to the patient group. Sixty eight participants (patient group, n = 36; control group, n = 32) were included in the study. Serum neurogranin level was significantly higher in patients with carbon monoxide poisoning (0.31 ± 0.16 ng/ml) compared to control group (0.22 ± 0.10 ng/ml) (p = 0.015). The mean Glasgow Coma Scale of the patients with carbon monoxide poisoning was 14.59 ± 0.23, and of Diffusion Weighted Magnetic Resonance Imaging results were completely normal in 94.4% (n = 34). There was no correlation between serum neurogranin level and Diffusion Weighted Magnetic Resonance Imaging results (r = −0.011; p = 0.953). Serum neurogranin level may be a new diagnostic biomarker in patients admitted to the emergency department with carbon monoxide poisoning. The high serum neurogranin levels detected in patients with normal diffusion-weighted imaging after carbon monoxide poisoning suggest that there is neurological damage in these patients, even if imaging methods cannot detect it.