During the present study, thirty-eight children in Upper Egypt (less t
han 12 years old) were admitted to Pediatric Intensive Care Unit for s
corpion envenomation. They were compared with thirteen apparently heal
thy children of matching age as controls. The victims and controls wer
e subjected to complete clinical examination and full blood count. The
evaluations of the serum levels of interleukin-1 beta (IL-1 beta), in
terleukin-6 (IL-6), nitric oxide (NO) and alpha(1)-antitrypsin (alpha(
1)-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 vict
ims showed significantly higher mean values of IL-1 beta, IL-6, NO, al
pha(1)-AT and leucocytic count both on admission and on follow up when
compared with controls. Manifestations of mild envenomation were dete
cted among 28.9% of the victims, while 71.1% of the victims manifested
severe scorpion envenomation. The severely envenomated children showe
d significantly higher mean values of IL-I beta, IL-6, NO, alpha(1)-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-1 beta, IL-6 and leucocytic count both on admission and on follow
up in comparison to the survivors. Furthermore, those fatal cases show
ed a non-significant decline in the studied biochemical indices on fol
low up after 24 h, while the survivors showed a significant decline in
the serum levels of IL-6, IL-la, NO and alpha(1)-AT after 24 h of pos
t arrival to the hospital. In conclusion, these data revealed that cyt
okines are involved in the pathogenesis of scorpion envenomation and c
orrelated with the severity of envenomation. This may provide a ration
ale for anticytokine treatment. (C) 1998 Elsevier Science Ltd. All rig
hts reserved.