title: Cytokine and acute-phase reactant levels in serum of children with cancer admitted for fever and neutropenia.
abstract: Serum concentrations of tumor necrosis factor-alpha (TNF alpha), interleukin (IL)-1 beta, IL-6, and the acute-phase reactants C-reactive protein (CRP) and serum amyloid A (SAA) were measured on admission in 46 neutropenic children with cancer in 81 episodes of fever. The aim was to find out whether any of these variables would differentiate true bacteremia from fever due to other causes. In most episodes serum concentrations of TNF alpha and IL-1 beta were elevated. IL-6 was detectable in 68%, but the serum concentration was elevated in only 15%. SAA proved to be more sensitive than CRP for the early detection of bacteremia. However, not even SAA was sufficiently accurate at the individual level. We conclude that the cytokine and acute-phase protein levels found were related to the febrile response but did not correlate with documented bacterial etiology.
authors.affiliation: Children's Hospital, University of Helsinki, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Riikonen
authors.forename: U M
authors.initials: UM
authors.lastname: Saarinen
authors.forename: A M
authors.initials: AM
authors.lastname: Teppo
authors.forename: K
authors.initials: K
authors.lastname: Metsärinne
authors.forename: F
authors.initials: F
authors.lastname: Fyhrquist
authors.forename: H
authors.initials: H
authors.lastname: Jalanko
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis*; D000293:Adolescent; D016470:Bacteremia / Q000150:complications / Q000209:etiology; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007375:Interleukin-1 / Q000097:blood; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000209:etiology*; D011446:Prospective Studies; D000685:Serum Amyloid A Protein / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D000209:Acute-Phase Proteins; D016207:Cytokines; D007375:Interleukin-1; D000685:Serum Amyloid A Protein; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein