Synovial-type (group II) phospholipase A2 in serum of febrile patients with haematological malignancy.

Elevated concentrations of synovial-type (group II) phospholipase A2 (PLA2-II) in serum are associated with septic bacterial infections. We measured the concentrations of PLA2-II in serum in 24 fever episodes involving patients suffering from haematological malignancies and having fever after cytotoxic treatment. We applied a novel time-resolved fluoroimmunoassay using a polyclonal antibody raised against recombinant human synovial-type PLA2. The concentrations of PLA2-II in serum were 194.7 +/- 204.4 micrograms/l (mean +/- SD, median 141.9, range 4.6-931.5 micrograms/l). The concentrations of PLA2-II correlated well to the concentrations of C-reactive protein (CRP) in serum (r = 0.688, p < 0.001). The PLA2-II concentrations increased faster than the corresponding CRP values and began to decrease 12 hours after the beginning of antimicrobial treatment. Inverse correlations were found between the concentrations of PLA2-II and blood neutrophil and platelet counts. No correlation was found between the concentrations of PLA2-II and the duration of the time interval from the onset of preceding cytotoxic and corticosteroid treatment to the first blood sample. The concentration of pancreatic PLA2 was within the reference interval in all samples. The present results indicate that PLA2-II resembles an acute-phase protein and is not of blood cell or pancreatic origin.