title: Temporal Relationship between Serum Levels of Interleukin-6 and C-Reactive Protein in Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy.
abstract: ObjectiveC-reactive protein (CRP) is a useful marker of neonatal infection. Recent studies have shown that neonatal therapeutic hypothermia delays an elevation of CRP in infants with hypoxic-ischemic encephalopathy (HIE). This study investigated the time difference of peak levels of serum CRP and other inflammatory responses during therapeutic hypothermia.Study designWe prospectively studied the serial serum data of CRP, interleukin-6 (IL-6), procalcitonin (PCT), and complete blood counts during the first week of life in HIE infants receiving therapeutic hypothermia.ResultsWe identified 22 infants who received therapeutic hypothermia between August 2013 and July 2015. No infants developed clinically overt infections. The peak of serum levels of IL-6, PCT, and CRP were postnatal days 1, 2, and 4, respectively. White blood cells, neutrophils, and platelet counts gradually decreased from days 1 to 7. Early postnatal serum levels of IL-6 correlated with CRP on day 4 (IL-6 on day 2;r= 0.78,p< 0.001).ConclusionThe peak value of CRP on day 4 might reflect the early production and secretion of IL-6 rather than an actual infection. Serial measurement of IL-6 might help avoid invasive sepsis workup and unnecessary change of antibiotics in infants.
authors.affiliation: Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Saito
authors.affiliation: Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Shibasaki
authors.affiliation: Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Shimokaze
authors.affiliation: Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kishigami
authors.affiliation: Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Ohyama
authors.affiliation: Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
authors.forename: Rikuo
authors.initials: R
authors.lastname: Hoshino
authors.affiliation: Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Toyoshima
authors.affiliation: Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Itani
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000628:therapy*; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood*; D007564:Japan; D007958:Leukocyte Count; D008297:Male; D009504:Neutrophils / Q000378:metabolism*; D010976:Platelet Count; D011446:Prospective Studies; D018805:Sepsis / Q000188:drug therapy; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D002116:Calcitonin; D002097:C-Reactive Protein