Adrenocorticotropic Hormone and Cortisol Levels in Relation to Inflammatory Response and Disease Severity in Children with Meningococcal Disease | Zendy

Job B. M. van Woensel | Zendy; Maarten H. Biezeveld | Zendy; Anne Marie Biesterbos Alders | Zendy; Ank J. M. Eerenberg | Zendy; Erik Endert | Zendy; Erik Hack | Zendy; Inès A. von Rosenstiel | Zendy; Taco W. Kuijpers | Zendy

Open Access

Adrenocorticotropic Hormone and Cortisol Levels in Relation to Inflammatory Response and Disease Severity in Children with Meningococcal Disease

Author(s) -

Job B. M. van Woensel,

Maarten H. Biezeveld,

Anne Marie Biesterbos Alders,

Ank J. M. Eerenberg,

Erik Endert,

Erik Hack,

Inès A. von Rosenstiel,

Taco W. Kuijpers

Publication year - 2001

Publication title -

the journal of infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 2.69

H-Index - 252

eISSN - 1537-6613

pISSN - 0022-1899

DOI - 10.1086/324673

Subject(s) - meningococcal disease , adrenocorticotropic hormone , medicine , fulminant , hypothalamic–pituitary–adrenal axis , endocrinology , c reactive protein , hydrocortisone , meningitis , prospective cohort study , septic shock , hormone , immunology , sepsis , inflammation , biology , surgery , neisseria meningitidis , bacteria , genetics

This prospective observational study investigated the relationship of the hypothalamic-pituitary-adrenal axis to inflammatory markers and to disease severity in children with meningococcal disease. In total, 32 children were studied: 10 with distinct meningococcal meningitis (MM), 10 with MM and septic shock, and 12 with fulminant meningococcal septicemia (FMS). Levels of adrenocorticotropic hormone (ACTH) and interleukin (IL)-6, IL-8, and IL-10 were lowest in the MM group and dramatically elevated in the FMS group. Cortisol and C-reactive protein levels were highest in the MM group and relatively low in the FMS group. Levels of ACTH and inflammatory markers decreased within the first 24 h of admission, but cortisol levels did not fluctuate. Cortisol was significantly inversely correlated with IL-6, IL-8, and IL-10 (P < or =.04). These results suggest that the adrenal reserve in children is insufficient to handle the extreme conditions and stress associated with severe meningococcal disease.

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