ABSTRACT
AIM: To compare serum levels of interleukin-6, interleukin-8 and interleukin-10 in bacteremic and non-bacteremic episodes of febrile neutropenia in children with malignant diseases, and determine their changes and correlation with C-reactive protein (CRP). MATERIAL AND METHODS: Between January 2003 and June 2004, we examined 41 episodes of febrile neutropenia in 24 children with malignant diseases who were receiving polychemotherapy. C-reactive protein was measured at the onset of febrile episodes and on days 3 and 5 from beginning of therapy. The soluble interleukins-6, -8, and -10 were determined in the serum using enzyme bound immunosorbent analysis at the onset of fever and at 24 and 72 hours after initiation of an empiric antibiotic therapy. RESULTS: The CRP baseline levels differentiated the patients with unexplained fever from those with local infection but did not differentiate them from those with bacteremia. Interleukin-8 at 24 hours differentiated bacteremic from non-bacteremic episodes (P < 0.05) and at a cut-off value of 130 pg/ml it had a sensitivity of 72% and a specificity of 84% to differentiate bacteremia. Interleukin-10 at 24 hours yielded higher values in Gram (-) bacteremia in comparison with the non-bacteremic episodes (P < 0.001) and Gram (+) bacteremia (P < 0.05). Interleukin-6 at 24 hours had significantly higher values in febrile episodes of more than 3 days duration (P < 0.05). CONCLUSIONS: Interleukin-8 could differentiate in the first 24 hours bacteremic from non-bacteremic episodes in febrile neutropenia, while interleukin-10 is perhaps a more accurate marker for Gram (-) bacteremia.
Subject(s)
C-Reactive Protein/metabolism , Interleukin-10/blood , Interleukin-6/blood , Interleukin-8/blood , Neoplasms/blood , Neutropenia/blood , Adolescent , Adult , Analysis of Variance , Bacteremia/etiology , Biomarkers/blood , Child , Child, Preschool , Female , Fever/blood , Fever/complications , Gram-Negative Bacterial Infections/diagnosis , Gram-Positive Bacterial Infections/diagnosis , Humans , Infant , Male , Neoplasms/drug therapy , Neutropenia/complications , Statistics, NonparametricABSTRACT
UNLABELLED: Elevated plasma levels of homocysteine have been identified as an independent risk factor for atherosclerosis. AIM: The aim of this study was to determine the reference limits of plasma total homocysteine for Bulgarian population. MATERIALS AND METHODS: We investigated 153 healthy individuals without vitamin deficiency aged from 18 to 65 years. The reference group consisted of 74 males and 79 females with mean age respectively 37.80 +/- 1.36 and 39.32 +/- 1.33 years. Plasma total homocysteine was determined by high performance liquid-chromatography (HPLC) modified and validated in our laboratory. RESULTS: The reference intervals were 7.4-18.5 micromol/l for males and 5.5-14.5 micromol/ 1 for females. The mean levels of plasma homocysteine were significantly higher in males in comparison with females (11.86 +/- 0.33 micromol/l vs. 9.88 +/- 0.27 micromol/l; P < 0.001), without considerable correlation with age. Comparing the values of total homocysteine between the two groups of age - < or = 49 and > or = 50 years showed that the investigated individuals > or = 50 years had higher plasma concentration, and the difference was significant only for the group of females. Hyperhomocysteinemia according to ECAP cut-off value (> 12.1 micromol/l) was registered in 30.7% of healthy volunteers. CONCLUSIONS: The results of our study demonstrated that homocysteine levels depend on sex and, to a lesser degree, on age. We have determined plasma total homocysteine reference intervals for the Bulgarian population. This will help the interpretation of the results and contribute to adequate and efficient prevention of blood vessel diseases.
