Serum interleukin-1beta, interleukin-6, nitric oxide and alpha1-antitrypsin in scorpion envenomed children

During the present study, thirty-eight children in Upper Egypt (less than 12years old) were admitted to Pediatric Intensive Care Unit for scorpion envenomation. They were compared with thirteen apparently healthy children of matching age as controls. The victims and controls were subjected to complete clinical examination and full blood count. The evaluations of the serum levels of interleukin-1beta (IL-1beta), interleukin-6 (IL-6), nitric oxide (NO) and alpha1-antitrypsin (alpha1-AT) were performed once for the controls and twice for the victims, the first sample on admission and the 2nd sample after 24 h. All victims showed significantly higher mean values of IL-1beta IL-6, NO, alpha1-AT and leucocytic count both on admission and on follow up when compared with controls. Manifestations of mild envenomation were detected among 28.9% of the victims, while 71.1% of the victims manifested severe scorpion envenomation. The severely envenomated children showed significantly higher mean values of IL-1beta, IL-6, NO, alpha1-AT and leucocytic count both on admission and on follow up when compared with mild cases. The case fatality rate in the current study was 7.8%. The non-surviving victims showed significantly higher mean values of IL-1beta, IL-6 and leucocytic count both on admission and on follow up in comparison to the survivors. Furthermore, those fatal cases showed a non-significant decline in the studied biochemical indices on follow up after 24 h, while the survivors showed a significant decline in the serum levels of IL-6, IL-1beta, NO and alpha1-AT after 24h of post arrival to the hospital. In conclusion, these data revealed that cytokines are involved in the pathogenesis of scorpion envenomation and correlated with the severity of envenomation. This may provide a rationale for anticytokine treatment.