Tumour necrosis factor-alpha and adenosine in endotoxin shockleading related cardiovascular symptoms.
We have observed uncontrollable cardiogenic shock as a cardiovascular manifestation of systemic inflammatory response syndrome (SIRS) leading to death in a 62-year-old woman. The diagnosis of SIRS was based on the demonstration of endotoxinaemia, and highly elevated plasma levels of tumour necrosis factor (TNF)-alpha, and interleukin (IL)-10. We suggest that these cytokines may contribute to the terminal SIRS-related arrythmias, impaired myocardial contractility, as well as increased vascular permeability. In addition, the increased production of adenosine, a counter-regulatory mediator of inflammation, may also play a role in cardiodepression. We suggest a relationship between the action of TNF-alpha , IL-10 and adenosine in the pathogenesis of circulatory symptoms described above.
Sipka
S
S
Third Department of Medicine University Mdical School Hungary.
Seres
T
T
Dinya
Z
Z
Szekanecz
Z
Z
Szentmiklósi
J
J
Bodolay
E
E
Szegedi
G
G