Urine catecholamines in children with severe Enterovirus A71 infection: comparison with paediatric septic shock. (3rd April 2019)

• Record Type: Journal Article
• Authors: Jan, Sheng-Ling; Lin, Ming-Chih; Chan, Sheng-Ching; Lee, Hsiu-Fen; Chen, Po-Yen; Huang, Fang-Liang
• Is Part Of: Biomarkers. Volume 24:Number 3(2019)
• Page Start: 277
• Page End: 285
• Publication Date: 2019-04-03
• Subjects: Biomarkers -- children -- enterovirus A71 -- septic shock -- urine catecholamines; Biochemical markers -- Periodicals; 610.28
• DOI: 10.1080/1354750X.2018.1556339
• Languages: English
• ISSNs: 1354-750X

Abstract

Abstract: Purpose: Hypercatecholaminemia-related heart failure has been proposed as the main cause of enterovirus A71-related (EV-A71) early mortality. The purpose of this study was to measure urine catecholamine concentrations in severe EV-A71-infected children. Methods: A total of 35 children, aged 2.5 ± 2.1 years, were divided into three groups. Group I: 15 septic shock patients, group II: 17 EV-A71-stage-2 patients, and group III: 3 EV-A71-stage-4 patients. The laboratory results, cardiac biomarkers and urine catecholamine concentrations were statistically analysed. Results: Group I had the highest C-reactive protein (CRP) levels and group II had the lowest B-type natriuretic peptide (BNP) and its N-terminal prohormone among the groups ( p = 0.039, <0.01 and <0.01, respectively). Group III patients had significantly higher urine catecholamine and troponin-I values among the groups. If urine epinephrine (Epi) >134 ug/gCr, norepinephrine (NE) >176 ug/gCr and vanillylmandelic acid (VMA) >11.7 mg/gCr were used as the cutoff points to differentiate groups II and III, the sensitivities and specificity were all 100%. Conclusions: The significantly elevated urine catecholamine concentrations in EV-A71-stage-4 patients support the hypothesis that hypercatecholaminemia-related heart failure is involved in severe EV-A71 infection. Urine catecholamines could be used as reliable biomarkers for differentiation of severe EV-A71 infection with or without heart failure and septic shock.