The association of interleukin 6 with clinical and laboratory parameters of acute pelvic inflammatory disease

OBJECTIVE: We sought (1) to determine whether interleukin 6 levels are incr eased in plasma and cervical secretions and endometrial tissue obtained fro m women with a clinical diagnosis of pelvic inflammatory disease, (2) to de termine whether interleukin 6 levels in these sample sites reflected the cl inical severity of acute infection, and (3) to determine whether interleuki n 6 levels in endometrial tissue obtained from these women were higher in t he presence or histologic endometritis. STUDY DESIGN: We performed a prospective pilot study on 20 women with a cli nical diagnosis of pelvic inflammatory disease (patients) and then compared them with 20 women presenting to the gynecology clinic without pelvic comp laints (control subjects). Interleukin 6 levels were measured by enzyme-lin ked immunologic testing in plasma, cervical secretions, and endometrial bio psy specimens. RESULTS: Cervical interleukin 6 levels were higher in patients than control subjects (median, 317 vs 111 pg/mL; P = .003). Among women with pelvic inf lammatory disease, statistically significant positive correlations were not ed between the clinical severity score and the erythrocyte sedimentation ra te (r = 0.45; P = .04), the clinical severity score and the white blood cel l count (r = 0.49; P = .03), the plasma interleukin 6 levels and the erythr ocyte sedimentation rate (r = 0.55; P = .02), and the plasma interleukin 6 levels and the white blood cell count (r = 0.54, P = .01). Endometrial tiss ue interleukin 6 levels were also higher in patients with versus those with out histologic endometritis (median, 427 vs 17 pg/mL; P = .004). CONCLUSION: In this pilot study interleukin 6 levels in cervical secretions were significantly higher in women with pelvic inflammatory disease Versus those without pelvic inflammatory disease. In women with pelvic inflammato ry disease, endometrial tissue samples with histologic evidence of endometr itis were observed to have higher levels of interleukin 6. Interleukin 6 ma y be a useful adjunct to the clinical diagnosis of pelvic inflammatory dise ase.