The Turkish Journal of Pediatrics 2017 , Vol 59 , Num 3
Are cytokines and cortisol important predictors for the severity of pediatric croup: A case control study
Özlem Üzüm 1 ,Aykut Çağlar 2 ,Tuncay Küme 3 ,Arzu Sayıner 4 ,Anıl Er 2 ,Fatma Akgül 2 ,Emel Ulusoy 2 ,Durgül Yılmaz 2 ,Murat Duman 2
1 Department of Pediatrics, and Departments of Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
2 Division of Pediatric Emergency Care, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
3 Department of Medical Biochemistry, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
4 Department of Medical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
DOI : 10.24953/turkjped.2017.03.008 Üzüm Ö, Çağlar A, Küme T, Sayıner A, Er A, Akgül F, Ulusoy E, Yılmaz D, Duman M. Are cytokines and cortisol important predictors for the severity of pediatric croup: A case control study. Turk J Pediatr 2017; 59: 281-287.

The aim of this study is to investigate the role of cytokines (TNF-α, IL-6, IL-10, and PAF), cortisol, and IgE in the pathogenesis of croup and the factors determining its clinical severity. Patients diagnosed with croup at the Pediatric Emergency Department were included and thirty healthy children were included as a control group. Patients` demographic characteristics, clinical findings, recurrent croup history, and patient-family atopy history were recorded. Patients were grouped according to the Westley croup scoring system. Blood samples were taken from the control group and the patients for cytokines and cortisol. Respiratory pathogens were studied with PCR. Sixty-nine pediatric cases who were diagnosed as croup were included in the study (34 mild, 31 moderate, 4 severe). Group comparisons were made in terms of mild and moderate/severe groups. In the moderate/severe group, IL-10 and cortisol levels were higher than the mild group. The moderate/severe cortisol levels between 12:00 am-6:00 pm were found to be higher. PAF and TNF-alpha levels were detected to be higher in patients with a history of atopy. Viral agents were isolated in 45 patients; rhinovirus PCR tests were positive in 22 patients.

In this study, rhinovirus was the most common etiology for croup. Increased levels of IL-10 and cortisol in the moderate/severe group indicate that different systemic and local mechanisms may play a role in the pathogenesis of croup. Keywords : children, croup, cytokines, cortisol

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