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Evaluation of usefulness of myeloperoxidase index (MPXI) for differential diagnosis of systemic inflammatory response syndrome (SIRS) in the emergency department
  1. Yong Sung Cha,
  2. Jeong Min Yoon,
  3. Woo Jin Jung,
  4. Yong Won Kim,
  5. Tae Hoon Kim,
  6. Oh Hyun Kim,
  7. Kyoung Chul Cha,
  8. Hyun Kim,
  9. Sung Oh Hwang,
  10. Kang Hyun Lee
  1. Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea
  1. Correspondence to Dr Kang Hyun Lee, Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, 162 Ilsandong, Wonju 220-701, Republic of Korea; ed119{at}


Background The myeloperoxidase index (MPXI) is elevated in infection. We ascertained whether MPXI might be useful in differentiation of sepsis versus non-infectious systemic inflammatory response syndrome (SIRS) in emergency department (ED).

Methods After exclusion of patients with an age of <18 years, trauma, haematological disease and on anticancer chemotherapy, 444 consecutive cases with SIRS (sepsis: 224, 50.3%; and non-infectious SIRS: 220, 49.7%) diagnosed and treated at the ED of The Wonju Severance Christian Hospital from May 2012 to June 2012 were retrospectively reviewed.

Results Median MPXI was higher in sepsis versus non-infectious SIRS (0.1 (IQR: −3.1 to 2.5) vs −1.2 (−4.1 to 1.6), respectively, p=0.020). Median white cell count, neutrophil percentage, C reactive protein level and δ neutrophil index were also higher. However, MPXI resulted as not statistically useful for differential diagnostic parameter in analysis.

Conclusions MPXI is higher in sepsis than in non-infectious SIRS. However, there is currently no evidence that the MPXI adds any additional benefit to differentiate sepsis from non-infectious SIRS in the ED. Therefore, further study will be needed.

  • Diagnosis
  • Infection
  • Haematology

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