Plasminogen activator inhibitor type-1 and interleukin-6 in haemolytic uraemic syndrome.
OBJECTIVE
Because haemolytic uraemic syndrome (HUS) is an important cause of renal dysfunction in children, the availability of prognostic markers of disease severity could assist in identifying those at risk of developing long-term sequelae. The aim of this study was to test the hypothesis that plasma levels of plasminogen activator inhibitor type-1 (PAI-1) and interleukin-6 (IL-6) in children at the time of diagnosis of HUS would predict renal function outcome in terms of glomerular filtration rate (GFR).


METHODS
Fourteen children suffering from diarrhoeal HUS were studied. Plasma samples were assayed for PAI-1 and IL-6, and GFR was measured at intervals after discharge from hospital. Twelve months following their recovery from HUS, the children were allocated to one of two outcome groups depending on whether GFR was above (Good Outcome, n = 9), or below (Poor Outcome, n = 5) 80 mL/min per 1.73 m2.


RESULTS
Elevated concentrations of PAI-1 were found in 4 of 5 Poor Outcome and 4 of 9 Good Outcome children. At the same time, increased concentrations of IL-6 were observed in 3 of 5 Poor Outcome and 3 of 9 Good Outcome children. Renal function continued to be compromised in four Poor Outcome children 36 months after diagnosis.


CONCLUSIONS
Our data show that PAI-1 and IL-6 are elevated in the plasma of some children at the time of diagnosis of HUS, but that neither is a definitive prognostic marker of poor outcome 3 years later.
Martin
A A
AA
Renal Unit and Pediatric Intensive Care Unit, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Woolven
B L
BL
Harris
S J
SJ
Keeley
S R
SR
Adams
L D
LD
Jureidini
K F
KF
Henning
P H
PH
D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006463:Hemolytic-Uremic Syndrome / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007677:Kidney Function Tests; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index
D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1