Correlation analysis of serum inflammatory cytokine levels and immune markers in children with severe hand, foot and mouth disease

OBJECTIVE: To identify the correlation between serum inflammatory cytokines and immune markers in children with severe hand, foot and mouth disease (HFMD). METHODS: Paediatric patients with severe or mild HFMD from Linping Campus, the Second Affiliated Hospital of Zhejiang University, were included in this retrospective study. Data comprising demographic characteristics, clinical symptoms and signs, laboratory findings and other factors were collected. Serum interleukin (IL)-1, IL-6, IL-10, tumour necrosis factor (TNF)-α, and interferon (IFN)-γ levels were measured by enzyme-linked immunosorbent assay at 1, 3, and 5 days after admission. Risk factors were screened using multivariate logistic regression analysis. RESULTS: A total of 200 patients with HFMD (120 severe and 80 mild cases) were included. Younger age and longer fever duration were associated with severe HFMD, as were increased white blood cell, neutrophil and platelet counts, blood glucose, immunoglobulin (Ig)M and IgG. IL-6 and IL-10 levels were higher in patients with severe versus mild HFMD on days 1, 3 and 5. TNF-α was higher in the severe group on day 3. Increased white blood cell and neutrophil counts, IL-6, IL-10, and IgG levels, age, fever duration, and blood glucose level were found to be risk factors associated with the occurrence of severe HFMD. CONCLUSIONS: Inflammatory cytokines and immune indexes may be related to the occurrence of severe HFMD.