Fulminant meningococcal septicemia: dissociation between plasma thrombopoietin levels and platelet counts.
Thrombopoietin (TPO), interleukin (IL)-6, and platelets were measured serially in 9 patients with fulminant meningococcal septicemia and consumption coagulopathy. The results were compared with those of patients with meningococcal meningitis and mild meningococcemia (n=10) and with those of healthy control subjects (n=19). TPO levels in control subjects were below the detection limit (<63 pg/mL). In patients with fulminant meningococcal septicemia, the median TPO level on admission was 193 pg/mL (range, 133-401 pg/mL), and the level peaked within 3-7 days (median, 488 pg/mL; range, 239-1334 pg/mL). Platelet counts remained low, despite the elevated TPO levels. In patients with meningitis or meningococcemia, the median TPO level on admission was 112 pg/mL (range, <63-695 pg/mL), and the TPO level was not detectable within 48 h. Platelet counts for these patients remained within normal limits. Maximum IL-6 levels in patients with septicemia were observed on admission (median, 5317 pg/mL; range, 188-651,000 pg/mL) and increased earlier than TPO levels. In patients with fulminant septicemia, TPO level increases significantly whereas the level of circulating platelets does not.
Bjerre
A
A
Department of Pediatrics and the Research and Development Group, Ullevål University Hospital, Oslo, Norway. a.k.bjerre@ioks.uio.no
Ovstebø
R
R
Kierulf
P
P
Halvorsen
S
S
Brandtzaeg
P
P
D000328:Adult; D016470:Bacteremia / Q000097:blood* / Q000378:metabolism / Q000382:microbiology; D002648:Child; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008589:Meningococcal Infections / Q000097:blood* / Q000378:metabolism / Q000382:microbiology; D009345:Neisseria meningitidis; D010976:Platelet Count; D013926:Thrombopoietin / Q000097:blood*
D015850:Interleukin-6; D013926:Thrombopoietin