title: Relationship between Severity of Aseptic Meningitis and Cerebrospinal Fluid Cytokine Levels.
abstract: BACKGROUND
  Pediatricians sometimes see patients with severe aseptic meningitis and prolonged fever or severe headache, or both. This condition generally has a good prognosis and is usually treated with supportive therapy. However, there is neither guideline nor consensus for the treatment of patients with severe aseptic meningitis. Here, we investigated the relationship between disease severity and biomarkers.
  
  
  METHODS
  The subjects were 32 children aged 0 to 14 years, 23 of whom had aseptic meningitis and 9 of whom were meningitis-free controls. Aseptic meningitis was retrospectively categorized into two subgroups, namely mumps meningitis (MM) and viral meningitis excluding that caused by mumps (EM). We defined a novel aseptic meningitis severity score (AMSS) from the signs and symptoms of aseptic meningitis and thus evaluated disease severity. We analyzed the profiles of cytokines in the patients' cerebrospinal fluid (CSF).
  
  
  RESULTS
  The AMSS in MM was significantly higher than that in EM. IL-4, IL-6, IL-8, IL-10, and G-CSF levels in MM and EM CSF were higher than those in control CSF. IFN-γ levels were higher in MM than in controls (p<0.01). IL-10 and IFN-γ levels in MM were higher than those in EM.
  
  
  CONCLUSIONS
  MM was more severe than EM. One likely reason is the higher CSF cytokine levels in MM. IFN-γ may be a potentially strong biomarker of MM severity. Our findings would help further understanding
authors.forename: Norikatsu
authors.initials: N
authors.lastname: Hikita
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Seto
authors.forename: Kanako
authors.initials: K
authors.lastname: Yamashita
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Iritani
authors.forename: Minoru
authors.initials: M
authors.lastname: Aata
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ogura
authors.forename: Haruo
authors.initials: H
authors.lastname: Shintaku
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002555:Cerebrospinal Fluid / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000134:cerebrospinal fluid / Q000145:classification; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008582:Meningitis, Aseptic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D011379:Prognosis; D012107:Research Design; D012720:Severity of Illness Index; D013223:Statistics as Topic
chemical_list: D015415:Biomarkers; D016207:Cytokines