title: Endotoxin, cytokines and lipid peroxides in children with intussusception.
abstract: BACKGROUND
  Intussusception is a relatively common paediatric surgical emergency. The aim of this study was to investigate selected inflammatory mediators in children with acute intussusception and to identify potentially useful plasma markers of clinical outcome.
  
  
  METHODS
  Clinical, radiographic, operative and pathological details were recorded prospectively of all children presenting to a single institution with a confirmed diagnosis of acute intussusception during 1 year. Paired acute and convalescent venous blood samples were collected in a standard manner for blinded analysis of the following: malondialdehyde, C-reactive protein (CRP), interleukin (IL) 6, neopterin, tumour necrosis factor alpha, endotoxin, and immunoglobulin (Ig) G and IgM antiendotoxin core antibody (EndoCAb).
  
  
  RESULTS
  Thirty-two consecutive children (23 boys, nine girls) with a median age of 4 months were studied. Acute ileocolic intussusception was managed by air enema reduction (n = 19), operative reduction (n = 8) or surgical resection (n = 5). Peripheral blood cultures were sterile. Acute levels of plasma IL-6, neopterin and CRP were significantly raised in comparison to both normal laboratory ranges and convalescent samples (P < 0.001). Using stepwise discriminant analysis, CRP was identified as the best variable at distinguishing between the three treatment groups (P < 0.001). IgM EndoCAb concentrations were significantly greater in the convalescent sera of all the patients (P < 0.001).
  
  
  CONCLUSIONS
  Acute ileocolic intussusception in childhood is associated with endotoxinaemia and significantly raised levels of circulating inflammatory cytokines. Plasma CRP at diagnosis showed a statistically significant positive correlation with disease severity.
authors: Department of Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, UK.
authors: I E
authors: IE
authors: Willetts
authors: P
authors: P
authors: Kite
authors: G R
authors: GR
authors: Barclay
authors: R E
authors: RE
authors: Banks
authors: A
authors: A
authors: Rumley
authors: V
authors: V
authors: Allgar
authors: M D
authors: MD
authors: Stringer
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism*; D004731:Endotoxins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis*; D007075:Immunoglobulin M / Q000378:metabolism; D007223:Infant; D015850:Interleukin-6 / Q000378:metabolism; D007443:Intussusception / Q000175:diagnosis*; D008054:Lipid Peroxides / Q000378:metabolism*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D019798:Neopterin / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D015415:Biomarkers; D016207:Cytokines; D004731:Endotoxins; D007075:Immunoglobulin M; D015850:Interleukin-6; D008054:Lipid Peroxides; D014409:Tumor Necrosis Factor-alpha; D008315:Malondialdehyde; D019798:Neopterin; D002097:C-Reactive Protein