Abstract
Summary Background: Episodic fever syndromes are commonly seen in pediatric practice. Episodic fever of unknown origin (FUO) lasts for a few days or weeks and is followed by a fever-free period with a sense of well-being. In this condition, activated neutrophils and monocytes intensively generate reactive oxidative species that may further damage various mole- cules. The aim of the study was to evaluate oxidative stress biomarkers, lipid peroxidation in erythrocytes and plasma, and advanced oxidation protein products (AOPP) in children with episodic FUO. Methods: The study enrolled 25 children with episodic FUO in afebrile phase and 25 healthy children as controls. Lipid peroxidation was evaluated by measuring malondialdehyde (MDA) production with the thiobarbituric-acid-reactive sub- stances (TBARS) assay in erythrocytes and plasma. Oxidative modification of proteins was measured spectrophotometri- cally by the determination of AOPP in plasma. Results: Mean duration of episodic fevers was 3.96±2.8 years. Erythrocyte MDA levels were higher in children with FUO than in controls (86.26± 10.75 vs. 78.0±3.21 nmol/g hemoglobin), although not significantly (p=0.202). The MDA plasma concentrations were similar (2.42±0.35 vs. 2.41 ±0.39 (xmol/L) between the groups (p=0.732). Unexpectedly, levels of AOPP were significantly lower in chil- dren with FUO than in healthy controls (18.8±5.04 vs. 25.1 ±3.35 nmol/L, p=0.047). Conclusions: Episodic fevers of unknown origin with an aver- age duration of 3.96±2.8 years do not cause significant oxidative modifications of lipids and proteins in children.
Highlights
Fever is one of the most common signs in pediatric practice
Sometimes the origin of fever remains unknown, and if the diagnosis is uncertain after 1 week of intensive evaluation, the fever is designated as a fever of unknown origin (FUO)
The study group comprised 25 eligible children with episodic FUO referred to the Department of Pediatric Rheumatology, Clinical Center in Ni{, Serbia
Summary
Fever is one of the most common signs in pediatric practice. Children, especially in the first years of life, have about 10 self-limited viral illnesses accompanied with fever. FUO may occur as a single illness, where fever ≥38.0 °C lasts at least 3 weeks. Recurrent or episodic FUOs are defined as three or more fevers ≥38.0 °C, that last for a few days to a few weeks, with a fever-free period and a sense of well-being [1,2,3]. These syndromes represent a diagnostic challenge and usually the right diagnosis is delayed. Other causes of episodic FUO are more commonly hereditary, autoinflammatory and sometimes autoimmune diseases [2,3,4]
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