Value of serum inflammatory factors in differential diagnosis of systemic juvenile idiopathic arthritis and sepsis in children

Abstract

Objective To evaluate the value of soluble interleukin 2 receptor (sIL-2R), interleukin (IL)-6, IL-10 and tumor necrosis factor-α (TNF-α) used in differential diagnosis of systemic juvenile idiopathic arthritis (sJIA) and sepsis in children. Methods Each of 41 children with sJIA and sepsis were enrolled and 41 healthy children were selected as the healthy control group at Children′s Hospital of Nanjing Medical University from January 2015 to July 2017.Levels of serum sIL-2R, IL-6, IL-10, TNF-α and peripheral blood levels of white blood cells (WBC), hemoglobin (Hb), platelets (PLT), high sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) and procalcitonin (PCT) were compared between the sJIA group and sepsis group before treatment and those of the healthy control group. Results Peripheral blood levels of WBC, Hb, PLT, CRP, ESR and PCT in the healthy control group were (8.43±2.35)×109/L, (124.46±8.76) g/L, (298.45±100.23)×109/L, (11.32±5.76) mg/L, (18.32±9.33) mm/1 h, (0.27±0.17) μg/L and the levels of serum sIL-2R, IL-6, IL-10, TNF-α were (483.24±255.33) kU/L, (7.38±4.02) ng/L, (5.45±3.06) ng/L, (8.23±3.03) ng/L, respectively.Peripheral blood levels of WBC, Hb, PLT, CRP, ESR and PCT in the sJIA group before treatment were (17.53±7.98)×109/L, (105.76±13.33) g/L, (389.43±176.34)×109/L, (88.32±43.21) mg/L, (55.32±34.23) mm/1 h, (0.53±0.24) μg/L and the levels of serum sIL-2R, IL-6, IL-10, TNF-α were (945.35±436.75) kU/L, (132.39±58.43) ng/L, (7.02±5.12) ng/L, (14.32±7.95) ng/L.Peripheral blood levels of WBC, Hb, PLT, CRP, ESR and PCT in sepsis group before treatment were (16.88±6.54)×109/L, (102.95±20.18) g/L, (302.87±124.45)×109/L, (60.41±33.24) mg/L, (53.75±28.43) mm/1 h, (2.84±1.76) μg/L and the levels of serum sIL-2R, IL-6, IL-10, TNF-α were (2 476.36±1 574.11) kU/L, (39.47±20.32) ng/L, (6.31±4.04) ng/L, (15.87±6.32) ng/L.Blood levels of WBC, CRP, ESR, PCT, sIL-2R, IL-6 and TNF-α in the sJIA and the sepsis group were significantly higher than those in healthy control group.Serum levels of sIL-2R and PCT in the sJIA group were obviously lower than those in the sepsis group, but the level of IL-6 was higher than that in the sepsis group. Conclusion Combined detection of blood sIL-2R, IL-6 and PCT can provide a reference and reduce mistaken diagnosis of sJIA and sepsis in the earlier clinical stage. Key words: Soluble interleukin 2 receptor; Interleukin-6; Interleukin-10; Tumor necrosis factor-α; Systemic juvenile idiopathic arthritis; Sepsis