Document Detail


Sepsis associated encephalopathy studied by MRI and cerebral spinal fluid S100B measurement.
MedLine Citation:
PMID:  19132530     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The pathogenesis of sepsis associated encephalopathy (SAE) is not yet clear: the blood-brain barrier (BBB) disruption has been indicated among the possible causative mechanisms. S100B, a calcium binding protein, originates in the central nervous system but it can be also produced by extra-cerebral sources; it is passively released from damaged glial cells and neurons; it has limited passage through the BBB. We aimed to demonstrate BBB damage as part of the pathogenesis of SAE by cerebral spinal fluid (CSF) and serum S100B measurements and by magnetic resonance imaging (MRI). This paper describes four septic patients in whom SAE was clinically evident, who underwent MRI and S100B measurement. We have not found any evidence of CSF-S100B increase. Serum S100B increase was found in three out of four patients. MRI did not identify images attributable to BBB disruption but vasogenic edema, probably caused by an alteration of autoregulation, was diagnosed. S100B does not increase in CSF of septic patients; S100B increase in serum may be due to extracerebral sources and does not prove any injury of BBB. MRI can exclude other cerebral pathologies causing brain dysfunction but is not specific of SAE. BBB damage may be numbered among the contributors of SAE, which aetiology is certainly multifactorial: an interplay between the toxic mediators involved in sepsis and the indirect effects of hyperthermia, hypossia and hypoperfusion.
Authors:
Ornella Piazza; Simona Cotena; Edoardo De Robertis; Ferdinando Caranci; Rosalba Tufano
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-01-09
Journal Detail:
Title:  Neurochemical research     Volume:  34     ISSN:  1573-6903     ISO Abbreviation:  Neurochem. Res.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-05-20     Completed Date:  2009-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7613461     Medline TA:  Neurochem Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1289-92     Citation Subset:  IM    
Affiliation:
Dipartimento di Scienze Chirurgiche Anestesiologiche Rianimatorie e dell'Emergenza, Università degli Studi di Napoli Federico II, via Pansini 5, 80131, Naples, Italy. orpiazza@unina.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood-Brain Barrier / physiology
Brain Diseases / cerebrospinal fluid,  etiology
Fatal Outcome
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Nerve Growth Factors / cerebrospinal fluid*
S100 Proteins / cerebrospinal fluid*
Sepsis / cerebrospinal fluid*,  complications,  metabolism*
Shock, Septic / complications
Chemical
Reg. No./Substance:
0/Nerve Growth Factors; 0/S-100 calcium-binding protein beta subunit; 0/S100 Proteins

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