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S-100B in serum and urine after traumatic head injury in children
Magnus Hallén1, Mathias Karlsson, Rickard Carlhed
1Department of Surgery, Central Hospital, Karlstad, Sweden.
Insights
Serum S-100B levels can help identify children with head trauma who have intracranial injuries. This protein marker may aid emergency departments in diagnosing head injuries in pediatric patients.
Area of Science:
- Pediatric Emergency Medicine
- Neurotrauma Biomarkers
- Clinical Diagnostics
Background:
- Head trauma is common in children, posing diagnostic challenges in emergency settings.
- S-100B protein, a marker for brain damage in adults, has limited study in pediatric head injury.
- There is a need for improved diagnostic tools for pediatric head trauma.
Purpose of the Study:
- To investigate the utility of serum S-100B levels as a diagnostic marker in children with head trauma.
- To compare S-100B levels in children with and without intracranial pathology after head injury.
Main Methods:
- 111 children with head trauma had blood and urine samples collected at presentation and 6 hours later.
- Serum and urine S-100B levels were analyzed.
- Patients were grouped based on computed tomography (CT) scan findings: no intracranial pathology (n=105) vs. intracranial pathology (n=6).
Main Results:
- Serum S-100B levels were significantly higher in children with intracranial pathology compared to those without (median 0.282 microg/L vs. 0.111 microg/L, p < 0.01).
- S-100B levels at both time points showed significant differences between the groups.
- Urine S-100B levels did not significantly differ between the groups.
Conclusions:
- Serum S-100B is a promising biomarker for detecting intracranial pathology in children following head trauma.
- Elevated S-100B levels within 6 hours of injury can help identify high-risk pediatric patients.
- S-100B may serve as a valuable adjunct diagnostic tool in emergency departments for pediatric head injury.
Background:
Children with head trauma are frequently seen in many emergency units. The clinical evaluation of these patients is difficult for a number of reasons and improved diagnostic tools are needed. S-100B, a protein found in glial cells, has previously been shown to be a sensible marker for brain damage after head injury in adults, but few studies have focused on its use in children.
Methods:
In this study, 111 children with head trauma were included and venous blood and urine samples were taken at arrival (S1 and U1) and 6 hours later (S2 and U2). S-100B levels were analyzed. Clinical and radiologic evaluations were performed according to hospital routine. Two groups were identified- group 1: no computed tomography (CT) scan performed ora CT scan without any sign of trauma-related intracranial pathology (n = 105). Group 2: A CT scan with signs of trauma-related intracranial pathology (n = 6).
Results:
In group 1, the median (inter quartile range) serum S-100B value in S1-samples was 0.111 microg/L (0.086-0.153), and in group 2, it was 0.282 microg/L (0.195-1.44) (p < 0.01). Also, S2 values significantly differed between the two groups. Urine values were, however, not significantly differing between the groups.
Conclusions:
Serum S-100B values within 6 hours after head trauma in children were significantly higher in patients with intracranial pathology compared with those without intracranial complications. Identification of these high-risk patients already in the emergency department is of major importance, and we suggest that S-100B could be a valuable diagnostic tool in addition to those used in clinical practice today.
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