ISSN:
1432-198X
Keywords:
Haemolytic uraemic syndrome
;
Endothelium
;
Soluble vascular cell adhesion molecule-1
;
Soluble intercellular adhesion molecule-1
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Plasma concentrations of soluble vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin) and intercellular adhesion molecule-1 (sICAM-1) were measured by enzyme-linked immunosorbent assay in four groups of children. Group 1 consisted of 20 patients with acute diarrhoea-associated haemolytic uraemic syndrome (D+HUS), the aetiology of HUS being verocytotoxin-producingEscherichia coli infection in each case. Controls consisted of 11 patients who had previously had D+HUS (group 2), 12 with chronic renal failure (group 3) and 8 healthy controls (group 4). When compared with healthy controls, the acute D+HUS group had higher sVCAM-1 (median 1,875 ng/ml, range 1,200–6,450 ng/ml vs. 1,200 ng/ml, range 975–2,125 ng/ml), von Willebrand factor antigen, (1.9 U/ml, range 0.85–5.1 U/ml vs. 0.55 U/ml, range 0.3–1.57 U/ml), white cell count (WBC, 14.5×109/l, range 7.8–43.1 109/l vs. 8.9 109/l, range 5.7–10.8 109/l) and neutrophil count (PMN, 10.1×109/l, range 4.3–26.5 109/l vs. 4.3 109/l, range 3.7–6.6 109/l), allP〈0.005, and sICAM-1 was reduced (230 ng/ml, range 130–340 ng/ml vs. 400 ng/ml, range 260–690 ng/ml),P〈0.05. Within the acute D+HUS group there was a significant correlation between sICAM-1 and PMN (r=0.56,P〈0.01). There was no correlation between any adhesion molecule and plasma creatinine or von Willebrand factor. Comparing the acute HUS group with children with chronic renal failure, WBC (P〈0.001), PMN (P〈0.01) and sVCAM-1 (P〈0.01) were significantly elevated, but there was no difference between the von Willebrand factor (P=0.08) or the sICAM-1 (P〉0.1). sVCAM-1 is elevated and sICAM-1 decreased in acute D+HUS. This pattern of altered adhesion molecule concentration is unlike that in adults with vasculitis and suggests that different endothelial regulatory factors are at play.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00860938
Permalink
