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Urine catecholamines in children with severe Enterovirus A71 infection: comparison with paediatric septic shock

Sheng-Ling Jan1,2,3, Ming-Chih Lin1,2, Sheng-Ching Chan4

  • 1a Department of Paediatrics, Children's Medical Center , Taichung Veterans General Hospital , Taichung , Taiwan , ROC.

Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
|December 7, 2018
PubMed

Insights

Elevated urine catecholamines in severe enterovirus A71 (EV-A71) infection indicate hypercatecholaminemia-related heart failure. These biomarkers can distinguish EV-A71 stages and associated heart conditions.

Area of Science:

  • Pediatric Infectious Diseases
  • Cardiology
  • Biomarker Discovery

Background:

  • Enterovirus A71 (EV-A71) infection can lead to severe outcomes, with hypercatecholaminemia-related heart failure proposed as a cause of early mortality.
  • Understanding the physiological markers of severe EV-A71 infection is crucial for timely diagnosis and management.

Purpose of the Study:

  • To measure and analyze urine catecholamine concentrations in children with severe EV-A71 infection.
  • To investigate the potential role of urine catecholamines as biomarkers for differentiating EV-A71 severity and associated cardiac complications.

Main Methods:

  • A cohort of 35 children was studied, divided into three groups: septic shock, EV-A71 stage-2, and EV-A71 stage-4.
  • Urine catecholamine levels (epinephrine, norepinephrine, vanillylmandelic acid), cardiac biomarkers (troponin-I, B-type natriuretic peptide), and C-reactive protein were measured and statistically analyzed.

Main Results:

  • Children with EV-A71 stage-4 exhibited significantly higher urine catecholamine and troponin-I levels compared to other groups.
  • Specific cutoff values for urine epinephrine, norepinephrine, and vanillylmandelic acid demonstrated 100% sensitivity and specificity in differentiating EV-A71 stages.
  • Septic shock patients had the highest C-reactive protein, while EV-A71 stage-2 patients had the lowest B-type natriuretic peptide levels.

Conclusions:

  • Elevated urine catecholamine concentrations in severe EV-A71 infection support the hypothesis of hypercatecholaminemia-related heart failure.
  • Urine catecholamines serve as reliable biomarkers for distinguishing severe EV-A71 infection, particularly in identifying associated heart failure and differentiating from septic shock.

Keywords:
Biomarkerschildrenenterovirus A71septic shockurine catecholamines

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