Cytokines in childhood hemolytic uremic syndrome and thrombotic thrombocytopenic purpura.
Serum and urine cytokines were analyzed in children with hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP). Interleukin-6 (IL-6) was elevated in the serum of 33 of 35 children with HUS (94%) and in 2 of 2 children with recurrent TTP. Serum IL-6 was higher in children with HUS who developed anuria, extrarenal manifestations during the acute phase of illness and/or chronic renal sequelae. Tumor necrosis factor-alpha (TNF-alpha) was detected in the serum of 7 patients with HUS (20%) and 1 patient with TTP. IL-6 and TNF-alpha were elevated in the urine of 4 of 4 children with HUS and 2 of 2 children with TTP. Urinary levels were higher than serum levels, suggesting local production of cytokines in the urinary tract. Sequential serum and urine samples showed that IL-6 levels varied with disease activity. IL-6 and TNF-alpha were not detected in the serum (n = 25) and urine (n = 15) of healthy children. We conclude that IL-6 in urine may be used to monitor disease activity in HUS and TTP.
Karpman
D
D
Department of Pediatrics, Lund University, Sweden.
Andreasson
A
A
Thysell
H
H
Kaplan
B S
BS
Svanborg
C
C
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood* / Q000652:urine; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000097:blood / Q000652:urine; D008297:Male; D011697:Purpura, Thrombotic Thrombocytopenic / Q000276:immunology* / Q000628:therapy; D006435:Renal Dialysis; D012712:Serum Globulins / Q000652:urine; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D015850:Interleukin-6; D012712:Serum Globulins; D014409:Tumor Necrosis Factor-alpha