Low levels of unsaturated transferrin as a predictor of survival in pneumococcal pneumonia.

A study was conducted to evaluate factors which might influence the prognosis of persons with pneumonia owing to Streptococcus pneumoniae. Serum iron, total iron binding capacity and unbound iron binding capacity (UIBC), were evaluated in 35 such patients. Of the 10 patients with UIBC levels less than 130 micrograms per dl on admission to the hospital, six died, three had complications, and only one recovered uneventfully. Of the 25 surviving patients, 21 (84 percent) had UIBC greater than 130 micrograms per dl on admission. Positive blood cultures were also correlated with survival. However, the strongest prognostic indicator was the combination of UIBC and blood culture results. Only 14 percent of patients with abnormalities in both parameters survived, whereas 80 percent to 88 percent of those with negative blood culture and/or normal UIBC survived. This suggests that insufficient unsaturated transferrin may facilitate bacteremia and contribute to lethality of pneumococcal pneumonia.