Inflammatory and immunological parameters in children with haemolytic uremic syndrome (HUS) and gastroenteritis-pathophysiological and diagnostic clues.
The objective of this study was to identify parameters indicating a risk for developing typical haemolytic uremic syndrome (D+HUS) during the prodromal phase of diarrhea caused by enterohaemorrhagic Escherichia coli (EHEC). Forty-eight children were studied prospectively with regard to inflammatory serum factors on admission to hospital. Ten patients developed D+HUS (group I), 15 suffered from viral-gastroenteritis (group IIa) and 23 from other types of bacterial gastroenteritis (group IIb). Mean levels of IL-8 tended to be elevated in group I compared to groups IIa and IIb. Neopterin and IL-10 levels particularly were significantly decreased in HUS in comparison to both gastroenteritis groups. Low IL-10 levels indicate a substantial disregulation of the immune response in HUS, as IL-10 downregulates the pro-inflammatory response and suppresses pro-coagulant activity in experimental endotoxemia. Our results suggest low neopterin, high IL-8 and especially low IL-10 levels are indicators of a high risk for developing HUS.
Westerholt
S
S
Children's Hospital of the Technical University of Munich, Munich, Germany. Soeren.Westerholt@lrz.tum.de
Hartung
T
T
Tollens
M
M
Güstrau
A
A
Oberhoffer
M
M
Karch
H
H
Klare
B
B
Pfeffer
K
K
Emmrich
P
P
Oberhoffer
R
R
D001424:Bacterial Infections / Q000150:complications; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D005759:Gastroenteritis / Q000097:blood* / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D006463:Hemolytic-Uremic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D007249:Inflammation; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D012016:Reference Values; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014777:Virus Diseases / Q000150:complications
D015415:Biomarkers; D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D002097:C-Reactive Protein