Serum interleukin-6 level as a diagnostic test in children with sepsis.
BACKGROUND
This study was performed to determine the serum concentrations of interleukin-6 (IL-6) during the early course of bacterial infections disease in children, and to evaluate the usefulness of IL-6 as a diagnostic test alone and in combination with C-reactive protein (CRP).


METHODS
We measured serum IL-6 values in 3 groups of children on their first day of admission, from January 2001 to December 2001: group 1, patients with clinical and microbiological evidence of sepsis (n = 13); group 2, patients with clinical and chest radiographical evidence of pneumonia (n = 18); and group 3, patients with no signs of infection (control group) (n = 16). Kruskal-Wallis tests were used to compare the difference of IL-6 values between groups and control subjects.


RESULTS
IL-6 values were significantly higher in groups 1 and 2 compared with those in the control group (p < 0.001). No significant differences were found between the groups 1 and 2. As a diagnostic test, IL-6 (> or = 20 pg/mL) alone yielded a sensitivity of 68%, a specificity of 88%, a positive predictive value of 71%, and a negative predictive value of 58%. A combined parameter of IL-6 (> or = 20 pg/mL) and CRP (> or = 1 mg/dL) yielded a sensitivity of 94%, a specificity of 63%, a positive predictive value of 79%, and a negative predictive value of 87%.


CONCLUSIONS
IL-6 levels increase in children with sepsis. In combination with CRP, IL-6 seems to be a valuable parameter in the early diagnosis of pediatric infections.
Huang
Shi-Ying
SY
Department of Pediatrics, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, ROC.
Tang
Ren-Bin
RB
Chen
Shu-Jen
SJ
Chung
Ruey-Lung
RL
D001424:Bacterial Infections / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis*
D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein