Serum Interleukin-6 Levels in the Differential Diagnosis of Sepsis and Transient Tachypnea of Newborn

Abstract

Objective: The aim of this study was to evaluate the role of serum interleukin-6 (IL-6) levels in the differentiation of neonatal bacterial sepsis and TTN. Material and Methods: The hospital records of 58 newborn infants with respiratory distress who were above 35 weeks of gestational age were investigated. Patients were divided into two groups. The infection group consisted of patients with proven sepsis and clinical sepsis and the other was the TTN group. Clinical findings and white blood cell count, serum C-reactive protein (CRP), IL-6 levels and the ratio of immature neutrophils to total neutrophils count (I/T) were recorded and compared between the two groups. Results: Serum CRP and IL-6 levels were found higher than the normal limits in both of the groups. However there was no significant difference between them. Duration of respiratory distress was longer and I/T ratio significantly higher in the infection group than the TTN group. The combination of IL-6 and I/T ratio yielded a sensitivity of 80%, a specificity of 48%, a positive predictive value of 44.7%, and a negative predictive value of 80% Conclusion: The I/T ratio and IL-6 may contribute to the early diagnosis of sepsis with respiratory symptoms in newborn infants but IL-6 alone cannot distinguish between TTN and sepsis. Turkish Başlık: Yenidoğanlarda Sepsis ve Yenidoğanın Geçici Takipnesinin Ayırıcı Tanısında Serum İnterlökin-6 Düzeyleri Anahtar Kelimeler: İnterlökin 6; sepsis; yenidoğan; yenidoğanın geçici takipnesi Amaç: Bu çalışmanın amacı yenidoğanlarda serum interlökin 6 düzeyinin bakteriyel sepsis ve yenidoğanın geçici takipnesinin ayrımında rolünün araştırılması. Gereç ve Yöntemler: Solunum sıkıntısı olan ve gestasyonel yaşı 35 haftadan büyük olan 58 yenidoğan çalışmaya alındı. Hastalar kanıtlanmış veya klinik sepsisi olanlar ve yenidoğanın geçici takipnesi olanlar olmak üzere iki gruba ayrıldı. Klinik bulgular beyaz küre sayısı, C reaktif protein, serum IL-6 düzeyi, periferik yaymada immature nötrofil sayısının toplam nötrofil sayısına oranı kaydedilerek gruplar arasında karşılaştırıldı. Bulgular: Her iki grupta da serum CRP ve IL-6 düzeyleri normal limitlerden yüksek bulunmasına rağmen iki grup arasında fark yoktu. Solunum sıkıntısının süresi ve I/T oranı kanıtlanmış veya klinik sepsisi olan grupta belirgin olarak fazla bulundu. IL-6 ve I/T oranı kombine olarak yenidoğan sepsisi erken tanısında birlikte kullanıldığında, duyarlılık %80, özgüllük ise %48 tespit edildi. Sonuç: IL-6 ve I/T oranı solunum sıkıntısı olan sepsisli yenidoğanların erken tanısı konusunda katkıda bulunurken IL-6 düzeyi tek başına yenidoğanlarda sepsis ve yenidoğanın geçici takipnesinde kullanılamaz.

Keywords

• Interleukin 6; sepsis; newborn; transient tachypnea

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