High cytokine levels at admission are associated with fatal outcome in patients with necrotizing fasciitis.

نویسندگان

  • Kathrin Lungstras-Bufler
  • Philip Bufler
  • Rabiatu Abdullah
  • Christine Rutherford
  • Stefan Endres
  • Edward Abraham
  • Charles A Dinarello
  • Robert M Rodriguez
چکیده

We evaluated in a blinded fashion the cytokine profiles of patients with suspected necrotizing fasciitis. In 15 out of 20 patients, the diagnosis of necrotizing fasciitis was established; five patients had cellulitis. Eighteen of the 20 patients were i.v. drug users. Five of the 15 patients with necrotizing fasciitis died (33%). On admission, serum levels for interleukin-1beta (IL-1beta), IL-1-receptor antagonist (IL-1Ra), IL-18 and interferon-gamma (IFNgamma) as well as white blood cells (WBC) were significantly elevated in patients with fatal outcome compared to survivors with necrotizing fasciitis. IL-1Ra and WBC levels were also higher than in patients with cellulitis. No differences were observed between patients groups for IL-6 and IL-8. In summary, significantly elevated levels of proinflammatory cytokines and particularly IL-1Ra are associated with fatal outcome in patients with necrotizing fasciitis. The measurement of proinflammatory cytokines and IL-1Ra may help to establish early diagnosis of life-threatening necrotizing fasciitis and thus to initiate aggressive treatment.

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عنوان ژورنال:
  • European cytokine network

دوره 15 2  شماره 

صفحات  -

تاریخ انتشار 2004