Archives of Disease in Childhood 2006;91:469-472
ORIGINAL ARTICLE
Prognostic predictive values of serum cytochrome c, cytokines, and other laboratory measurements in acute encephalopathy with multiple organ failure
1 Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
2 Eisai Co. Ltd, Japan
3 Department of Pediatrics, Miyazaki Medical College, University of Miyazaki, Japan
Correspondence to:
Dr M Hosoya
Dept of Pediatrics, Fukushima Medical University School of Medicine, Hikarigaoka-1, Fukushima 960-1295, Japan; mhosoya{at}fmu.ac.jp
Aims: To evaluate the prognostic predictive values of cytochrome c, cytokines, and other laboratory measurements in serum collected during neurological onset in acute encephalopathy with multiple organ failure.
Methods: In addition to general laboratory examinations, the concentrations of cytochrome c (apoptosis marker) and cytokines (inflammatory markers) were measured in serum samples collected at the initial phase in 29 patients with acute encephalopathy. The obtained values were evaluated as predictors for the development of severe encephalopathy.
Results: Cytochrome c, tumour necrosis factor 
(TNF-), interleukin 6 (IL-6), soluble TNF-receptor 1 (sTNF-R1), and aspartate aminotransferase (AST) concentrations at the initial phase were high and correlated well with patient outcome. High concentrations of serum cytochrome c (>45 ng/ml), sTNF-R1 (>2000 pg/ml), AST (>58 IU/dl), IL-6 (>60 pg/ml), and TNF- (>15 pg/ml) predicted an unfavourable prognosis (sequelae and death) at 93%, 79%, 82%, 77%, and 60%, respectively. The specificity of those markers was 100%, 89%, 83%, 100%, and 100%, respectively.
Conclusions: Serum cytochrome c is the most sensitive and specific predictor for the development of severe encephalopathy at the initial phase. Results suggest that this marker might be used to guide decisions regarding the start of the initial treatment and further intensive care.
Keywords: acute encephalopathy; cytochrome c; multiple organ failure; prognostic predictive marker
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Arch. Dis. Child. 2006 91: 455-456.
Arch. Dis. Child. 2006 91: 455.
This article has been cited by other articles:
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Surtees, R, DeSousa, C
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91: 455-456
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