Serum Levels of Interleukin-6 and Tumor Necrosis Factor Alpha in Children With Attention-Deficit Hyperactivity Disorder.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a common disorder in children, but its etiology and pathogenesis are still unclear. AIMS: The aims of this study were to measure the level of serum interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) as markers of immune system involvement in children with ADHD, and to study their correlation with symptoms severity of ADHD. MATERIALS AND METHODS: The study was conducted on 80 children diagnosed as ADHD based on the criteria adapted from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Eighty healthy children of matched age and sex served as a control group. All children enrolled in the study were subjected to history taking, clinical examination, and psychometric tests. Assay for serum IL-6 and TNF-α for all patients and controls was performed using enzyme-linked immunosorbent assay. RESULTS: The mean serum level of IL-6 was 26.11 ± 11.14 and 6.23 ± 2.52 in children with ADHD and controls, respectively. Children with ADHD showed significantly higher serum IL-6 levels than the control group (P = 0.001). Serum IL-6 showed no significant correlation with the intelligence quotient (IQ) or the Abbreviated Conners' Rating Scale scores for parents. However, TNF-α showed no significant differences between the two groups and no significant correlation with the IQ or the Abbreviated Conners' Rating Scale scores for parents. CONCLUSION: Serum IL-6 levels were significantly higher in children with ADHD compared to controls; however, the IL-6 levels did not correlate with ADHD symptoms severity. Increased IL-6 levels may contribute to the etiology of ADHD.

The value of serum procalcitonin in acute meningitis in children.

Early diagnosis and initial therapy are important to reduce the complications of bacterial meningitis. We aimed to evaluate the diagnostic value of serum procalcitonin in children with acute meningitis. We included 40 children (4 months-14 years) suspected to have acute meningitis in our study. Based on the clinical scenario, physical examination and complete analysis of cerebrospinal fluid, patients were assigned into two groups: bacterial meningitis group (24 patients) and aseptic meningitis group (16 patients). Twenty-five apparently healthy children of matched age and sex served as a control group. Procalcitonin, C-reactive protein, and leukocyte count were measured initially at the time of admission and again after 72 h. Initially, patients with bacterial meningitis showed statistically significant higher values of serum procalcitonin than both patients with aseptic meningitis and the control groups (p < 0.001). After 72 h of treatment, patients of bacterial meningitis group showed statistically significant lower values of serum procalcitonin than their initial values (P < 0.05). The cutoff point of procalcitonin needed for early diagnosis of bacterial meningitis was >10 ng/ml at the time of admission. However, values of procalcitonin >2 ng/ml had 100% sensitivity. Whereas, the specificity, negative predictive value and positive predictive value of procalcitonin were 63%, 100%, and 67% respectively. Serum Procalcitonin can be used as an early diagnostic marker of acute bacterial meningitis and its differentiation from aseptic meningitis. In acute bacterial meningitis, it can be used to follow the response to antibiotic therapy.