Urine catecholamines in children with severe Enterovirus A71 infection: comparison with paediatric septic shock.
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.
['Jan|Sheng-Ling|SL|', 'Lin|Ming-Chih|MC|', 'Chan|Sheng-Ching|SC|', 'Lee|Hsiu-Fen|HF|', 'Chen|Po-Yen|PY|', 'Huang|Fang-Liang|FL|']
D002395:Catecholamines D002648:Child D002675:Child, Preschool D029821:Enterovirus A, Human D004769:Enterovirus Infections D005260:Female D006801:Humans D007223:Infant D008297:Male D012772:Shock, Septic
urine catecholamines children enterovirus A71 septic shock Biomarkers