title: Thymic involution as a predictor of early-onset neonatal sepsis.
abstract: BACKGROUND
  Diagnosis of early-onset neonatal sepsis (EONS) is often difficult because of vague clinical signs and non-specific laboratory parameters.
  
  
  OBJECTIVE
  To assess the statistical validity of thymic size estimation as a diagnostic marker of EONS compared with cord blood interleukin-6 (IL-6) concentrations.
  
  
  METHODS
  Thirty-two neonates delivered in hospital and admitted to the neonatal unit with EONS comprised the study group. EONS was diagnosed on the basis of development of clinical signs and symptoms of sepsis within 72 hours of birth in the presence of antenatal risk factors for chorio-amnionitis and a positive blood culture. Thirty-two gestational age- and gender-matched healthy neonates served as controls. Cord blood IL-6 concentrations were estimated by ELISA. Thymic size was assessed by sonological measurement of thymic dimensions (longitudinal and transverse diameters, thymic volume and thymic index) within 24 hours of birth in the study infants and the controls. Data were analyzed by SPSS 16.0.
  
  
  RESULTS
  Thymic size was significantly smaller whereas cord blood IL-6 concentrations were significantly higher (P<0.001) in the sepsis group than in the controls. Sensitivity and specificity of thymic dimensions were comparable to IL-6 concentrations for diagnosing EONS. Significant correlation was noted between reduction in thymic size and a rise in IL-6 concentrations.
  
  
  CONCLUSIONS
  Thymic involution can be used as a reliable diagnostic marker for EONS.
authors: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. drsriparnabasu@rediffmail.com
authors: Sriparna
authors: S
authors: Basu
authors: Shashikant
authors: S
authors: Dewangan
authors: Ram Chandra
authors: RC
authors: Shukla
authors: Shampa
authors: S
authors: Anupurva
authors: Ashok
authors: A
authors: Kumar
mesh_terms: D015510:Clinical Medicine / Q000379:methods*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009929:Organ Size; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis* / Q000276:immunology; D013950:Thymus Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D015850:Interleukin-6