الفهرس 
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Abstract
Neonatal sepsis is one of the most challenging problems despite the ongoing progress in diagnosis and treatment.
For many years, a search has been ongoing to find predictors of neonatal sepsis that identify effectively patients who are at risk of infection.
It is very important that clinicians have the tools to recognize and diagnose sepsis promptly because early diagnosis and treatment may lead to improvement in both mortality and morbidity.
Neopterin is considered an activation marker of the monocyte / macrophage system in various inflammatory diseases.
The aim of our study is to evaluate the diagnostic value of serum neopterin level in neonatal sepsis.
This study was conducted on 88 neonates who were divided into three groups:
Group І included 38 neonate with confirmed sepsis , Group ІІ included 35 neonate with suspected sepsis and Group Ш included 15 healthy neonate with no clinical signs or laboratory evidence for sepsis serving as a control group.
Neonates with severe congenital anomalies, clinically apparent chromosomal abnormalities and inborn errors of metabolism were excluded.
For all neonates the Following were performed:
1- Histoty taking : (to detect risk factors for sepsis),
2- Thorough clinical examination.
3- Laboratory invegstigations including:-
* Complete Blood count with differential leucocytic count.
* CRP quantative assay.
* Erythrocyte sedimentation rate (ESR).
* Blood culture.
* Blood samples were withdrawn from all neonates by Venipuncture to determine Neopterin serum level by Enzyme linked immuno-sorbent assay (ELISA).
4- Statistical analysis of the results.
The Results of our study were:
The serum neopterin was significantly higher in confirmed sepsis and suspected sepsis groups compared to control group and show high sensitivity and specificity. So it acts as a diagnostic marker in neonatal sepsis.
Our study revealed that neopterin cut off level is 70.56 nmol/L with higher sensitivity 94.7% and Specificity 88.6% than CRP with cut off level 36 , sensitivity 65.8% and Specificity 60.0%
The serum neopterin increased significantly in non survived than survived patients so it acts as a prognostic marker in neonatal sepsis.
We found that neopterin correlated positively with HSS and CRP so combined use of neopterin and HSS or CRP enhance diagnostic accuracy of sepsis. So we found that neopterin is a promising marker in early diagnosis of neonatal sepsis and is more better than a lot of many diagnostic methods as it helps in prediction of the outcome of sepsis.