Increased Levels of S100A8/A9 in Patients with Peritonsillar Abscess: A New Promising Diagnostic Marker to Differentiate between Peritonsillar Abscess and Peritonsillitis

Dis Markers. 2017:2017:9126560. doi: 10.1155/2017/9126560. Epub 2017 Oct 17.

Abstract

Peritonsillar abscess (PTA) is a very frequent reason for urgent outpatient consultation and otolaryngological hospital admission. Early, correct diagnosis and therapy of peritonsillar abscess are important to prevent possible life-threatening complications. Based on physical examinations, a reliable differentiation between peritonsillar cellulitis and peritonsillar abscess is restricted. A heterodimeric complex called calprotectin consists of the S100 proteins A8 and A9 (S100A8/A9) and is predominantly expressed not only in monocytes and neutrophils but also in epithelial cells. Due to its release by activated phagocytes at local sites of inflammation, we assumed S100A8/A9 to be a potential biomarker for peritonsillar abscess. We examined serum and saliva of patients with peritonsillitis, acute tonsillitis, peritonsillar abscess, and healthy controls and found significantly increased levels of S100A8/A9 in patients with PTA. Furthermore, we could identify halitosis, trismus, uvula edema, and unilateral swelling of the arched palate to be characteristic symptoms for PTA. Using a combination of these characteristic symptoms and S100A8/A9 levels, we developed a PTA score as an objective and appropriate tool to differentiate between peritonsillitis and peritonsillar abscess with a sensitivity of 92% and specificity of 93%.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Biomarkers / metabolism
  • Calgranulin A / blood*
  • Calgranulin A / metabolism
  • Calgranulin B / blood*
  • Calgranulin B / metabolism
  • Case-Control Studies
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Peritonsillar Abscess / blood*
  • Peritonsillar Abscess / metabolism
  • Peritonsillar Abscess / pathology
  • Saliva / metabolism

Substances

  • Biomarkers
  • Calgranulin A
  • Calgranulin B