Assuntos
Infecções por Bacillaceae/imunologia , Bacillus cereus , Citocinas/sangue , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Doenças do Prematuro/imunologia , Infecções Oportunistas/imunologia , Infecções por Bacillaceae/diagnóstico , Evolução Fatal , Proteínas Hemolisinas/sangue , Humanos , Recém-Nascido , Doenças do Prematuro/diagnóstico , Masculino , Infecções Oportunistas/diagnóstico , Fosfolipases/sangue , Valores de ReferênciaRESUMO
BACKGROUND: Very low birth weight (VLBW) infants sometimes develop abdominal distension and poor weight gain. The influence of thyroid function on these symptoms in VLBW infants has not been reported. METHODS: In a retrospective study, 18 VLBW infants whose abdominal distension and poor weight gain did not improve with standard treatment were enrolled as subjects. Serum levels of free thyroxin (fT(4)) and thyroid stimulating hormone (TSH) were measured. Subjects with serum fT(4) levels less than 1.3 ng/dl received thyroxin supplementation. Another 18 VLBW infants were recruited as age- and weight-matched controls. We compared degree of intestinal dilation on X-ray, weight gain, and quantity of milk tolerated before and after starting thyroxin supplementation in the subjects and the controls. RESULTS: All subjects had serum fT(4) levels less than 1.3 ng/dl (mean, 0.72 ng/dl). TSH values varied widely and were less than 8 microU/ml in 12 subjects. Therefore, all subjects received thyroxin supplementation; after starting this, mean serum fT(4) level increased significantly to 1.31 ng/dl. In parallel with fT(4) increase, intestinal dilation improved in 16 of 18 subjects (mean grade of dilation decreased from 2.8 to 1.6). Weight gain and quantity of tolerated milk were significantly increased with thyroxin supplementation in all and 17 of the 18 subjects, respectively. CONCLUSIONS: Thyroxin supplementation was effective in improving abdominal symptoms in VLBW infants whose serum fT(4) level was less than 1.3 ng/dl.
Assuntos
Abdome/patologia , Insuficiência de Crescimento , Recém-Nascido de muito Baixo Peso , Tiroxina/administração & dosagem , Tiroxina/sangue , Aumento de Peso , Humanos , Recém-Nascido , Estudos Retrospectivos , Glândula Tireoide/fisiopatologia , Tireotropina/sangueRESUMO
Neonatal toxic shock syndrome (TSS)-like exanthematous disease (NTED) is an emerging neonatal infectious disease caused by TSS toxin-1 (TSST-1). Although NTED and TSS are caused by the same superantigenic exotoxin, NTED is less severe than TSS. The mechanism of this reduced severity in NTED has not been elucidated. Thirteen patients with NTED were enrolled in the study. We investigated serum cytokine profile using a cytometric bead array system with a cytokine panel. Expression of Vbeta2 and CD45RO in CD4(+) T cells was investigated in mononuclear cells by using flowcytometry. Ten patients with other bacterial infections and eight patients without any infections were also enrolled as control groups. The mean serum level of IL-10 was 1209.9 pg/mL in patients with NTED at the time of admission into the study. The other inhibitory cytokine, IL-4, exhibited a minimum level. The high level of IL-10 rapidly decreased within 3-9 days of the onset of NTED. The cytokine profile of NTED, with its high IL-10 level, was clearly different from that of the other bacterial infections. The increased level of IL-10 seems to be related to the reduced severity of NTED. Th2 shift is not thought to be the cause of this IL-10 excretion.
