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J Child Neurol. 2016 Nov;31(13):1450-1456. Epub 2016 Jun 6.

Cytokine and Chemokine Expression in CSF May Differentiate Viral and Autoimmune NMDAR Encephalitis in Children.

Author information

1
Institution for Women's and Children's Health, Unit of Clinical Pediatrics, Karolinska Institutet, Stockholm, Sweden.
2
Institution for Women's and Children's Health, Neuropediatric Unit, Karolinska Institutet, Stockholm, Sweden.
3
Institution for Women's and Children's Health, Neuropediatric Unit, Karolinska Institutet, Stockholm, Sweden ronny.wickstrom@ki.se.

Abstract

Childhood encephalitis is a potentially devastating condition with significant morbidity and mortality. Researchers currently lack biomarkers for differentiating infectious encephalitis from those with autoimmune causes which may delay adequate treatment. The authors studied the possibility of using cerebrospinal fluid cytokine and chemokine levels for this purpose. Children admitted to hospital care fulfilling criteria for encephalitis were prospectively included. Children who underwent lumbar puncture but were not classified as central nervous system infections served as controls. Cytokine and chemokine levels in the cerebrospinal fluid obtained upon initial presentation were analyzed using Luminex technology. In children with infectious encephalitis (n = 13), the cerebrospinal fluid displayed markedly elevated mean levels of IL6, IL7, and IL13 as compared to N-methyl-D-aspartate receptor (NMDAR) encephalitis (n = 4) and controls (n = 13). The expression of IL6 appeared to precede that of IL13. Analysis of selected cerebrospinal fluid cytokines may thus allow differential diagnosis of infectious and NMDAR encephalitis already at the initial lumbar puncture and enable immediate therapy.

KEYWORDS:

central nervous system; childhood; immunomodulation; pediatric

PMID:
27270468
DOI:
10.1177/0883073816653780
[Indexed for MEDLINE]

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