Aseptic meningitis in children: Correlation between fever and interferon-gamma level

Abstract

We studied the correlation between interleukin-1 beta (IL-1 beta), tumour necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma) in cerebrospinal fluid (CSF) and clinical/laboratory findings in children with aseptic meningitis. In 19/27 patients (70%), the CSF IFN level was high at initial diagnosis, and reduced to a low or undetectable level during the convalescent phase (5-14 days later) of the disease. There were no differences in IL-1 beta and TNF-alpha levels between the acute and convalescent phase of the patients. The serum IFN-gamma levels in the patients, which were simultaneously examined were undetectable in the acute phase. When we compared the clinical/laboratory findings between the 29 patients with detectable CSF IFN-gamma level and the 21 patients with an undetectable CSF IFN-gamma level in the acute phase, the former demonstrated higher body temperature (P less than 0.01), and higher cell number and protein level in the CSF (P less than 0.05) than the latter. On the other hand, there were no significant differences in the duration of meningeal signs, the titre of C-reactive protein, and the peripheral leucocyte count between the two groups. By the Spearman's rank sum test, the CSF IFN-gamma levels correlated more definitively with the severity of febrile episode (maximal body temperature, duration of fever and body temperature at the first lumbar tap), and the cell number and protein level in the CSF. These results suggest that IFN-gamma produced in the inflamed intrathecal space may be associated with the pathogenesis of aseptic meningitis, especially the production of fever.

Relationship between Intracranial Granulomas and Cerebrospinal Fluid Levels of Gamma Interferon and Interleukin-10 in Patients with Tuberculous Meningitis

“…The CSF levels of IFN-␥ detected with our patients were similar to those described for patients with aseptic meningitis but far higher than those seen with children with bacterial meningitis (3,5,8,10). However, while IFN-␥ and IL-10 remained detectable in the CSF of patients with TBM for weeks, the cytokines were present for only days in patients with viral or bacterial meningitis (3,5,8,10). After 6 months of therapy, both IL-10 and IFN-␥ were undetectable in the CSF of 90% of our patients, in contrast to the results reported in the literature, according to which IFN-␥ was commonly detectable in the CSF at this time point (6,12).…”

“…The CSF levels of IFN-␥ detected with our patients were similar to those described for patients with aseptic meningitis but far higher than those seen with children with bacterial meningitis (3,5,8,10). However, while IFN-␥ and IL-10 remained detectable in the CSF of patients with TBM for weeks, the cytokines were present for only days in patients with viral or bacterial meningitis (3,5,8,10).…”

The Importance of Toxoplasma Gondii Infection in Diseases Presenting With Headaches. Headaches and Aseptic Meningitis May Be Manifestations of the Jarisch-Herxheimer Reaction

“…The percentages of total T cells are higher in the cerebrospinal fluid than in blood (Fryden, Kam-Hansen, Maller, & Link, 1980). Also IFN-γ levels are significantly elevated in cerebrospinal fluid of children with AM (Minamishima et al, 1991;Tang, Chen, Wu, Lee, & Chen, 1997). Minamishima et al (1991) suggested that this cytokine produced in the inflamed intrathecal space may be associated with the pathogenesis of AM.…”

The inflammatory cytokines in measles: Correlation between serum interferon-γ levels and lymphocyte subpopulations

“…IL-1 [3, TNF-ct and IFN-y levels were determined using an immunoradiometric assay (IL-1, TNF; IRE-Medgenix, Fleurus, Belgium, IFN-7; CENTOCORE, Inc, PA) as previously described [20]. The minimum detectable levels of IL-l[3 and TNF-a were 5 pg/ml, and that of ][FN-7 was 0.1 U/ml.…”