Plasminogen activator inhibitor type-1 and interleukin-6 in haemolytic uraemic syndrome

Objective: Because haemolytic uraemic syndrome (HUS) is an important cause of renal dysfunction in children, the availability of prognostic markers of disease severity could assist in identifying those at risk of developing l ong-term sequelae. The aim of this study was to test the hypothesis that pl asma levels of plasminogen activator inhibitor type-1 (PAI-1) and interleuk in-6 (IL-6) in children at the time of diagnosis of HUS would predict renal function outcome in terms of glomerular filtration rate (GFR). Methodology: Fourteen children suffering from diarrhoeal HUS were studied. Plasma samples were assayed for PAI-1 and IL-6, and GFR was measured at int ervals after discharge from hospital. Twelve months following their recover y from HUS, the children were allocated to one of two outcome groups depend ing on whether GFR was above (Good Outcome, n = 9), or below (Poor Outcome, n = 5) 80 mL/min per 1.73 m(2). Results: Elevated concentrations of PAI-1 were found in 4 of 5 Poor Outcome and 4 of 9 Good Outcome children. At the same time, increased concentratio ns of IL-6 were observed in 3 of 5 Poor Outcome and 3 of 9 Good Outcome chi ldren. Renal function continued to be compromised in four Poor Outcome chil dren 36 months after diagnosis. Conclusions: Our data show that PAI-1 and IL-6 are elevated in the plasma o f some children at the time of diagnosis of HUS, but that neither is a defi nitive prognostic marker of poor outcome 3 years later.