Evaluation of IL-6 and High Sensitive C Reactive Protein Value in CSF and Serum Children Suspected Meningitis Referred to Pediatric Emergency Room

Abdolkarim Hamedi,Alireza Ataee Nakhaee,Hosain Ayatollahi

doi:10.5812/ircmj.4726

Abdolkarim Hamedi, Alireza Ataee Nakhaee + Show 1 more

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https://doi.org/10.5812/ircmj.4726

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Abstract

BackgroundAcute bacterial meningitis which is a pediatric emergency with high mortality and morbidity must be diagnosed and treat promptly. Often diagnosis of bacterial meningitis from viral meningitis is difficult after some days. Determination of some inflammatory mediators’ example IL-6 and HS-CRP were useful in differential diagnosis of bacterial and viral meningitis.ObjectivesThis study attempted to Determining HS-CRP and IL6 in serum and CSF in children suspected meningitis and Comparing value HS-CRP and IL6 in bacterial/viral meningitis.Patients and MethodsOf children that hospitalized in pediatric emergency ward (Ghaem Hospital Mashhad university of medical science, in duration 01 Dec 2010-01 Dec 2011) and for they performed lumbar puncture, 1cc serum and CSF of they were taken to laboratory and have measured IL-6 with Elisa method and HS-CRP with immunoturbidometry method, patients were followed up and finally we compared levels of this two mediators.ResultsFinally, this study performed on 81 children and infants. From 81 cases, 27 cases (33.3%) had bacterial meningitis 27 cases (33.3%) viral meningitis and 27 cases (33.3%) had normal CSF. IL-6 concentration in the CSF and serum were significantly raised in cases of bacterial meningitis (P = 0.001, P = 0.01) but HS-CRP concentration in the CSF and serum were not significantly raised in cases of bacterial meningitis (P = 0.46, P = 0.29). Mean IL-6 concentration in the CSF in bacterial meningitis was (180.74) and in viral meningitis was (39.08) .Mean HS-CRP in CSF in bacterial meningitis was (2.22) and viral meningitis was (1.29). Mean HS-CRP in serum in bacterial meningitis was (8.23) and viral meningitis was (6.36).ConclusionsThe measurement of IL-6 in the CSF and serum in potentially a very useful diagnostic tool for differential diagnosis of bacterial and viral meningitis.

Highlights

Acute bacterial meningitis which is a pediatric emergency with high mortality and morbidity must be diagnosed and treat promptly
There are some inflammatory mediators in cerebrospinal fluid (CSF) or serum that help to differential diagnosis of bacterial and viral meningitis such as IL6, CRP, Pre- calcitonin, TNF, IL8
We measured two inflammatory mediators, IL6 and HS-CRP, in CSF and serum of children who were admitted to pediatric emergency room and the level of these two mediators in three groups of patients were compared: Bacterial meningitis, viral meningitis, and normal CSF patients

Summary

Introduction

Acute bacterial meningitis which is a pediatric emergency with high mortality and morbidity must be diagnosed and treat promptly. Determination of some inflammatory mediators’ example IL-6 and HS-CRP were useful in differential diagnosis of bacterial and viral meningitis. Objectives: This study attempted to Determining HS-CRP and IL6 in serum and CSF in children suspected meningitis and Comparing value HS-CRP and IL6 in bacterial/viral meningitis. Conclusions: The measurement of IL-6 in the CSF and serum in potentially a very useful diagnostic tool for differential diagnosis of bacterial and viral meningitis. Acute bacterial meningitis which is a pediatric emergency with high mortality and morbidity must be diagnosed and treated promptly, to prevent severe complications. Acute phase reactant protein like serum procalcitonin is useful as a screening test for bacterial meningitis [4]. Pro-Inflammatory mediators such as TNF-α, IL-1, IL-6 are majority these

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