SERUM LEVELS OF TUMOR-NECROSIS-FACTOR-ALPHA, INTERLEUKIN-1, AND INTERLEUKIN-6 IN HEMORRHAGIC-FEVER WITH RENAL SYNDROME

Hemorrhagic fever with renal syndrome is an acute viral disease caused by hantavirus. On the basis of clinical observation, the illness is d ivided into five sequential stages: febrile, hypotensive, oliguric, di uretic, and convalescent. Because interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6) are mediators resp onsible for fever, septic shock, and acute phase protein induction, we examined, using ELISA, the presence of these three cytokines in 276 s era collected during the Korean Conflict from 110 patients. Detectable levels (>20 pg/ml) of TNF-alpha, IL-1 beta, and IL-6 occurred in 14, 14, and 33% of these samples, respectively. There was a significant co rrelation between serum levels of IL-1 beta and TNF-alpha (r = 0.66, p <0.001), IL-1 beta and IL-6 (r = 0.59, p <0.001), and IL-6 and TNF-al pha (r = 0.71, p <0.001). The pathophysiologic processes of HFRS do no t have clear or consistent correlations with alterations in the levels of the cytokines studied.