Plasma concentrations of granulocytic elastase-alpha 1-proteinase inhibitor complex in patients with severe head injury, multiple trauma or cerebral bleeding.

In patients with severe head injury or multiple trauma a multitude of inflammatory mediators are released. As in cerebral bleeding, elevations of body temperature can be observed even in the absence of bacterial infections. In order to evaluate the diagnostic significance of plasma elastase levels for the exclusion or early detection of infections in the course of the above diseases, quantitative estimations of granulocytic elastase in complex with alpha 1-proteinase inhibitor were carried out in 11 patients using an enzyme-linked immunoassay over a period from 3 to 47 days. Additionally, leukocyte counts were made and body temperatures measured. In all but two cases, elastase levels were elevated at the beginning of the disease and usually decreased over the period of study. In contrast to leukocyte counts and body temperature, the values correlated with the severity of the clinical symptoms. It is concluded that plasma elastase determinations are useful in the differential diagnosis of infection from other causes of elevated body temperatures.