الفهرس 
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Abstract
Pneumonia constitutes a major proportion of the global burden
of childhood disease, being responsible for around 20% of childhood
deaths, the majority of which occur in developing countries
.Childhood community-acquired pneumonia accounts for between
30% and 40% of hospital admissions with associated case fatality
rates of between 15% and 28%.
The World Health Organization (WHO) estimates there are 156
million cases of pneumonia each year in children younger than five
years, with as many as 20 million cases severe enough to require
hospital admission.
Pneumonia is a condition typically associated with fever,
respiratory symptoms, and evidence of parenchymal involvement,
either by physical examination or by the presence of infiltrates on
chest radiography.
Our study included 90 children years admitted to Menofyia
University Hospitals from December 2015 to April 2016. 60 of
patients were included as cases aging from 5 month to 5 years. They
were admitted patients suffering from pneumonia and for treatment of
community acquired pneumonia.Patients were diagnosed based on
clinical, laboratory and radiological findings and 30 apparently
healthy children within same age ,sex and socioeconomic status .All
were exposed to the same clinical assessment and laboratory
investigations.
The aim of the this study is to determine the levels of
proadrenomedullin in a group of hospitalized children with pneumonia, and studying the relation between ProADM level and
severity and complication of pneumonia.
All cases were subjected to a complete clinical study (thorough
history and physical examination) upon study inclusion, with
emphasis on symptoms and signs of pneumonia.
The following investigations were performed: chest x- ray
complete blood counts (CBC), HB, WBCs, quantitative C-reactive
protein (CRP), and serum Proadrenomedullin by a commercial
enzyme linked immunosorbent assay (ELISA) kit.
The study reached the following:
Serum Proadrenomedullin level is significantly higher in
pneumonic children compared to healthy controls.
Serum Proadrenomedullin level is significantly higher in
complicated children with pneumonia compared to
noncomplicated cases.
Serum Proadrenomedullin level is significantly higher in pleural
effusion in complicated pneumonic children compared to
patient without pleural effusion.
Serum Proadrenomedullin level is significantly higher in severe
pneumonic children compared to mild and moderate pneumonic
cases.
Serum Proadrenomedullin significantly more accurate than total
leukocytic countand CRP in pneumonic children
Serum Proadrenomedullin is more prognostic than diagnostic
marker in pediatric pneumonia