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Serum lipids and disease severity in children with severe meningococcal sepsis

Clementien L Vermont1, Marieke den Brinker, Nimet Kâkeci

  • 1Department of Pediatrics, Erasmus MC, Sophia, Rotterdam, the Netherlands.

Critical Care Medicine
|July 9, 2005
PubMed

Insights

Children with severe meningococcal sepsis exhibit extremely low cholesterol and lipoprotein levels, particularly LDL. Lower total cholesterol in non-survivors indicates its prognostic value in pediatric meningococcal disease.

Area of Science:

  • Pediatric Intensive Care
  • Infectious Diseases
  • Biochemistry

Background:

  • Severe meningococcal sepsis can lead to significant metabolic disturbances.
  • Cholesterol and lipoprotein levels may be altered during critical illness in children.

Purpose of the Study:

  • To investigate the role of cholesterol and lipoproteins in pediatric patients with severe meningococcal sepsis.
  • To assess the relationship between lipid levels and disease severity and outcomes.

Main Methods:

  • Retrospective observational study of 57 children with meningococcal sepsis or septic shock.
  • Measurement of total cholesterol, HDL, and LDL at multiple time points post-admission.
  • Calculation of standard deviation scores for age-related adjustments and assessment of disease severity using PRISM, SOFA, and DIC scores.

Main Results:

  • Patients presented with very low total cholesterol, HDL, and particularly LDL levels on admission.
  • Total cholesterol was significantly lower in non-survivors compared to survivors.
  • Lipoprotein levels correlated inversely with disease severity and cytokine levels, normalizing in survivors within 1-3 months.

Conclusions:

  • Severe meningococcal disease in children is characterized by profound hypocholesterolemia and low lipoprotein levels.
  • Low total cholesterol on admission is associated with increased mortality and disease severity.
  • Lipid profiles normalize over time in survivors, suggesting a dynamic metabolic response to sepsis.
Abstract

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