RESUMO
Background: cytokines are involved in a wide spectrum of immune and non-immune biological events causing neonatal respiratory distress, as early onset neonatal sepsis, hyaline membrane disease [HMD] and transient tachypnea of newborn [TIIV]
Objectives: to investigate if early detection of serum level of interleukin-6 [IL-6] ,total leucocyte count [TLC], immature to total neutrophils ratio [I/T] and platelet count ,could distinguish early onset sepsis from other causes of respiratory distress in the newborn as HMD or TTN
Subjects: this cross sectional case-control study included 60 infants, classified according to physical examination and laboratory work into 4 groups: group A ,included 15 newborn with sepsis, 9 males and 6 females, their mean gestational age was 38.13 +/- 1.64week, and their mean weight was 3.806 +/- 1.16kg. Group B, included 15 newborns with TTN, 11 males and 4 females, their mean gestational age was 39.1 +/- 1.2week and their mean weight was 3.81 +/- 0.12 kg. Group C included 15 preterm with HMD, 7 males and 8 females, their mean gestational age was 32.6 +/- 1.92 week and their mean weight was 1.65 +/- 0.36kg .Also, 15 full term neonates, 5 males and 10 females, their mean gestational age was 39.6 +/- 0.84week, and their mean weight was 3.614 0.23, served as a control group
Methods: all cases were subjected to the following: Complete blood Count, C reactive protein, serum level of IL-6 and chest X ray
Results: the results of this study showed a highly significant increase in the mean serum level of IL-6 in the septic and TTN groups when compared with control group [P<0.01]. A highly significant increase in serum level of lL-6 in the septic group when compared to TTN group [P<0.01], while in HMD group, no significant difference was found in the mean serum IL-6 value when compared to septic group [P>0.05] , but there was a significant increase when compared to TTN group [P<0.05].A significant correlation was found between IL-6 and TLC [r = 0.583, P<0.05], I/T ratio [r = 0.61 1, P<0.05] and platelet count [r = 0.565, P<0.05] in the septic group. As regards HMD group, a highly sign9cant correlation was found between IL-6 and TLC only [r = 0.722, P<0.0l], while no significant correlation was found between IL-6 and I/T ratio or platelet count .TTN group showed no significant correlation at all between IL-6 and the three parameters
Conclusion: serum level of lL-6 could be used as a helpful tool to differentiate early onset sepsis from TTN but did not differentiate between septic cases and newborns with HMD. Serum level of lL-6 is considered as an earlier marker for sepsis than the hematological indices .Also TLC and platelet count were the least useful indices of neonatal sepsis, while I/T ratio was considered a useful indicator of infection