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Predictive value of serum interleukin-6 level in influenza virus-associated encephalopathy.

AbstractOBJECTIVE:
In Japan, >200 children with influenza virus-associated encephalopathy were reported in 1999 and the mortality rate was high. The levels of tumor necrosis factor-alpha (TNFalpha) and interleukin-6 (IL-6) in both CSF and serum were significantly increased in severe cases. The authors found a correlation between elevated serum cytokine levels and mortality and neurologic morbidity.
METHODS:
TNFalpha, IL-6, soluble tumor necrosis factor receptor 1 (sTNF-R1), interferon-gamma (IFNgamma), and IL-2 were measured by the ELISA method in sera from six children with encephalopathy before and during therapy, and in six age-matched controls with influenza type A virus infection.
RESULTS:
The increases in the serum TNFalpha, IL-6, and sTNF-R1 levels were statistically significant at the onset of symptoms before therapy, but the IL-6 level was most useful for diagnosis. The serum IL-6 levels were >6,000 pg/mL in children with brain stem dysfunction, about 150 pg/mL in children without brain stem dysfunction, and <80 pg/mL in controls. The time course of the serum IL-6 level also reflected the clinical condition. Once the serum IL-6 level was increased to >15,000 pg/mL, none of the children survived. The lower the maximal serum IL-6 level, the milder the CNS sequelae.
CONCLUSION:
The serum IL-6 level may be the most useful indicator for the diagnosis and the clinical severity of influenza virus-associated encephalopathy.
AuthorsH Aiba, M Mochizuki, M Kimura, H Hojo
JournalNeurology (Neurology) Vol. 57 Issue 2 Pg. 295-9 (Jul 24 2001) ISSN: 0028-3878 [Print] United States
PMID11468315 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Cytokines
  • Interleukin-6
Topics
  • Brain Diseases (blood, etiology)
  • Child
  • Child, Preschool
  • Cytokines (blood, cerebrospinal fluid)
  • Female
  • Humans
  • Infant
  • Influenza, Human (complications)
  • Interleukin-6 (blood, cerebrospinal fluid)
  • Male
  • Predictive Value of Tests
  • Prognosis
  • Time Factors

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