Document Detail


Selectively high levels of serum interleukin 17 in a newborn infant with progressive severe cholestasis.
MedLine Citation:
PMID:  20547643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We present here the unusual case of a male newborn infant who showed progressive severe cholestasis. The infant's gestational age was 37 weeks, and his birth weight was 2134 g. His serum level of direct bilirubin gradually increased from the 6th day of life and reached 257.5 micromol/L on the 22nd day of life. We could not find any cause for his cholestasis, but his serum level of ferritin was extremely elevated at 9211.0 ng/mL. Because we felt that his clinical condition might be related to hypercytokinemia caused by an immunologic reaction, steroid pulse therapy and cyclosporine were administered. His condition improved, and his direct bilirubin and ferritin levels declined. From the investigation of his cytokine profile, we found a preferentially elevated level of serum interleukin 17 (IL-17) (96.1 pg/mL) and high level of chemokines IL-8 and macrophage inflammatory protein 1beta. The IL-17 level gradually decreased to 7.5 pg/mL by the 124th day of life. The infant was successfully discharged from the children's hospital but later developed epilepsy at 11 months and asthma at 1 year, 2 months of age. Although we have not yet reached a definitive diagnosis, this case may be the first to show a relationship between cholestasis and an elevated serum IL-17 level in the neonatal period.
Authors:
Maho Ichikawa; Naoto Takahashi; Yukari Yada; Yasunori Koike; Ryou Kawamata; Yumi Kono; Yoko Honma; Shigeru Yotsumoto; Mariko Y Momoi
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-06-14
Journal Detail:
Title:  Pediatrics     Volume:  126     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e247-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Cholestasis / blood*,  diagnosis*,  drug therapy
Cyclosporine / therapeutic use
Disease Progression
Drug Therapy, Combination
Follow-Up Studies
Humans
Infant, Newborn
Interleukin-17 / blood*
Interleukin-8 / blood
Macrophage Inflammatory Proteins / blood
Male
Risk Assessment
Severity of Illness Index
Steroids / therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Interleukin-17; 0/Interleukin-8; 0/Macrophage Inflammatory Proteins; 0/Steroids; 59865-13-3/Cyclosporine

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