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Intravenous Endotoxin Challenge in Healthy Humans: An Experimental Platform to Investigate and Modulate Systemic Inflammation
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Intravenous Endotoxin Challenge in Healthy Humans: An Experimental Platform to Investigate and Modulate Systemic Inflammation

Published on: May 16, 2016

Endotoxin levels in immunocompromised children with fever

A Hass, M I Rossberg, H L Hodes

    The Journal of Pediatrics
    |August 1, 1986
    PubMed

    Insights

    Unexplained fevers in immunocompromised children may be caused by endotoxemia. This study found elevated endotoxin levels in some children without infection, suggesting endotoxemia as a potential cause of febrile episodes.

    Area of Science:

    • Pediatrics
    • Immunology
    • Infectious Diseases

    Background:

    • Febrile episodes without a clear cause are frequent in immunocompromised children.
    • Circulating endotoxin, a pyrogen, is a potential contributor to unexplained fevers.
    • A sensitive Limulus amebocyte lysate assay with a chromogenic substrate was developed.

    Purpose of the Study:

    • To investigate the role of plasma endotoxin in unexplained febrile episodes in immunocompromised children.
    • To establish normal plasma endotoxin levels in children.

    Main Methods:

    • Plasma endotoxin levels were measured using an enhanced Limulus amebocyte lysate assay.
    • Assays were performed on 36 immunocompromised children with fever, including convalescent samples.
    • Normal endotoxin levels in healthy children were also determined.

    Main Results:

    • The upper limit of normal plasma endotoxin level in children was determined to be 35 pg (0.10 EU)/ml.
    • Five children (14%) exhibited elevated endotoxin levels during febrile episodes without documented infection or bacteremia.
    • Endotoxin levels normalized in these children during convalescence.

    Conclusions:

    • Endotoxemia is a potential cause or contributing factor for unexplained fevers in immunocompromised children.
    • The developed assay provides a sensitive and objective method for endotoxin detection.
    • Further research is warranted to understand the clinical implications of endotoxemia in this population.

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