title: Tumour necrosis factor-alpha and adenosine in endotoxin shockleading related cardiovascular symptoms.
abstract: 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.
authors.affiliation: Third Department of Medicine University Mdical School Hungary.
authors.forename: S
authors.initials: S
authors.lastname: Sipka
authors.forename: T
authors.initials: T
authors.lastname: Seres
authors.forename: Z
authors.initials: Z
authors.lastname: Dinya
authors.forename: Z
authors.initials: Z
authors.lastname: Szekanecz
authors.forename: J
authors.initials: J
authors.lastname: Szentmiklósi
authors.forename: E
authors.initials: E
authors.lastname: Bodolay
authors.forename: G
authors.initials: G
authors.lastname: Szegedi