INFLAMMATORY AND IMMUNOLOGICAL PARAMETERS IN CHILDREN WITH HAEMOLYTIC UREMIC SYNDROME (HUS) AND GASTROENTERITIS—PATHOPHYSIOLOGICAL AND DIAGNOSTIC CLUES

The objective of this study was to identify parameters indicating a risk for developing typical haemolytic uremic syndrome (D+HUS) during the prodromal phase of diarrhea caused by enterohaemorrhagic Escherichia coli (EHEC). Forty-eight children were studied prospectively with regard to inflammatory...

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Bibliographic Details
Published in:Cytokine (Philadelphia, Pa.) Pa.), 2000-06, Vol.12 (6), p.822-827
Main Authors: Westerholt, Sören, Hartung, Thomas, Tollens, Martin, Güstrau, Andrea, Oberhoffer, Mathias, Karch, Helge, Klare, Bernd, Pfeffer, Klaus, Emmrich, Peter, Oberhoffer, Renate
Format: Article
Language:English
Subjects:
Bacterial Infections - complications
Biomarkers - blood
C-Reactive Protein - analysis
Child
Child, Preschool
Cytokines - blood
Gastroenteritis - blood
Gastroenteritis - diagnosis
Gastroenteritis - immunology
Gastroenteritis - physiopathology
haemolytic uremic syndrome/interleukin-10/interleukin 8/neopterin/enterohaemorrhagic E. coli
Hemolytic-Uremic Syndrome - blood
Hemolytic-Uremic Syndrome - diagnosis
Hemolytic-Uremic Syndrome - immunology
Hemolytic-Uremic Syndrome - physiopathology
Humans
Inflammation
Interleukin-10 - blood
Interleukin-6 - blood
Interleukin-8 - blood
Reference Values
Risk Factors
Tumor Necrosis Factor-alpha - analysis
Virus Diseases - complications
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Summary:The objective of this study was to identify parameters indicating a risk for developing typical haemolytic uremic syndrome (D+HUS) during the prodromal phase of diarrhea caused by enterohaemorrhagic Escherichia coli (EHEC). Forty-eight children were studied prospectively with regard to inflammatory serum factors on admission to hospital. Ten patients developed D+HUS (group I), 15 suffered from viral-gastroenteritis (group IIa) and 23 from other types of bacterial gastroenteritis (group IIb). Mean levels of IL-8 tended to be elevated in group I compared to groups IIa and IIb. Neopterin and IL-10 levels particularly were significantly decreased in HUS in comparison to both gastroenteritis groups. Low IL-10 levels indicate a substantial disregulation of the immune response in HUS, as IL-10 downregulates the pro-inflammatory response and suppresses pro-coagulant activity in experimental endotoxemia. Our results suggest low neopterin, high IL-8 and especially low IL-10 levels are indicators of a high risk for developing HUS.
ISSN:1043-4666
1096-0023
DOI:10.1006/cyto.1999.0624