ABSTRACT
Pro- and anti inflammatory cytokines regulate the febrile response during infection. Febrile convulsions [FCs] conversely are associated with rapid onset of high fever. Activation of the cytokine network has been shown in previous studies of FCs and cytokines. In this study, the association between cytokines and FCs was further investigated. lnterleukin-1 beta [IL-1 beta], interleukin-1 receptor antagonist [IL-1RA], and tumor necrosis factor-a [TNF-a] plasma levels were measured with enzyme-linked immunosorbent assay in 40 children with FCs and in 20 age-matched febrile controls immediately on arrival at the emergency room or pediatric clinic. Cerebrospinal fluid [C.S.F.] level of these cytokines also, was measured in 7 FC children. The plasma IL-1 beta level was lower in FC children when compared with controls [mean +/- SD, 19.5 +/- 7.72 pg/ml vs. 57.2 +/- 10.43 pg/ml; p = 0.1], but the difference was not statistically significant. FC patients had significantly higher plasma IL-1RA levels [mean +/- SD, 15357 +/- 4870 pg/ml vs. 3963 +/- 2950 pg/ml; p = 0.0005]. The plasma IL-1RA/IL-1p ratio was significantly higher in FC patients compared with controls [mean, 7875 vs. 69.283; p < 0.0001]. There was no significant difference in plasma TNF-alpha level between FC patients and controls [mean +/- SD, 7.42 +/- 3.12 pg/ml vs. 6.71 +/- 4.8; p = 0.63]. In C.S.F, IL-1RA was detectable in 5, IL-1beta in one and TNF-alpha was undetectable in the 7 studied FC patients. Logistic regression analysis was used to find the most significant predisposing factors for FCs. In this analysis, the high plasma IL-1RA/IL-1beta ratio was the most significant factor connected to FCs [OR, 41.5; 95% CI, 4.9-352.8]. Present results support the hypothesis that the cytokine network is activated and could have a role in the pathogenesis of FCs