Utility of Neutrophil Gelatinase-Associated Lipocalin and Emerging Lung Injury: Correspondence

We would like to share ideas on the publication “The Utility of Neutrophil Gelatinase-Associated Lipocalin in the Detection of Emerging Lung Injury due to Mechanical Ventilation in Children: A Preliminary Study.”¹ Kocaoğlu¹ concluded that “neutrophil gelatinase-associated lipocalin may be a useful biomarker for emerging lung injuries due to mechanical ventilation in critically ill children and deserves to be investigated.” We agree that the neutrophil gelatinase-associated lipocalin might be a useful biomarker. However, as Kocaoğlu already noted, further studies are required. We should be concerned with the possible effect of other conditions that might alter neutrophil gelatinase-associated lipocalin. For example, in an endemic area of hemoglobinopathy, including some areas of Turkey, the neutrophil gelatinase-associated lipocalin is altered in pediatric cases with underlying thalassemia.²

Funding Statement

The authors declared that this study has received no financial support.

Response

Çelebi Kocaoğlu

Pediatric Intensive Care Unit, University of Health Sciences, Konya City Hospital, Konya, Turkey

We would like to thank the esteemed authors for their interest and criticism of our article. Our study was not a sensitivity specificity study.¹ However, despite of NGAL is a sensitive biomarker, it can be speculated that its specificity is low due to increasing serum and urine NGAL levels in many cases such as liver insufficiency, severe chronic pulmonary disease, renal disease, cardiac pathologies, methabolic diseases. In the literature, it has been reported that there is an increase in NGAL level in many hemoglobinopathy, especially in thalassemia.^2-5 There was no participian with hemoglobinopathy among our patients. However, we also agree with Çetinkaya et al.² Hemoglobinopathies should be considered in the inclusion or exclusion criteria of the study.