Elevated Interleukin-6 Levels as a Potential Marker of Neonatal Morbidity in Full-term Infants With Polycythemia: A Prospective Study.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Author(s): Tamer R;Tamer R; Ünal ŞSO; Ünal ŞSO; Yozgat CY; Yozgat CY
  • Source:
    Journal of pediatric hematology/oncology [J Pediatr Hematol Oncol] 2025 Jan 01; Vol. 47 (1), pp. e15-e18. Date of Electronic Publication: 2024 Nov 08.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9505928 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-3678 (Electronic) Linking ISSN: 10774114 NLM ISO Abbreviation: J Pediatr Hematol Oncol Subsets: MEDLINE
    • Publication Information:
      Publication: 1998- : Hagerstown, MD : Lippincott Williams & Wilkins
      Original Publication: New York, NY : Raven Press, c1995-
    • Subject Terms:
    • Abstract:
      Objective: To research and show that interleukin-6 (IL-6) and c-reactive protein (CRP), which can be used as infection markers, are also higher among newborns with polycythemia. The study took place in the neonatal intensive care unit of Zekai Tahir Burak Maternity Teaching and Research Hospital.
      Patients and Methods: Infants with a gestational age of >37 weeks were included in the study. Infants with chorioamnionitis, perinatal asphyxia, and positive blood culture were excluded from the study. Blood samples were obtained six hours after the delivery from the peripheral vein of the infants for measurements of central hematocrit, blood culture, IL-6, and CRP. Infants with a venous hematocrit value of >65% were grouped as the "polycythemia group," and the ones with a venous hematocrit value of <65% were designated as the "control group." Observation of significantly higher levels of CRP and IL-6 among newborns admitted to the neonatal intensive care unit due to different causes (such as respiratory distress, hypoglycemia, and feeding intolerance), but significantly higher IL-6 levels in newborns with polycythemia.
      Results: Thirty-five newborns (18 infants in the polycythemia group and 17 infants in the control group) were enrolled in the study. The IL-6 values for the polycythemia group were higher than the upper normal limits (mean ± 2SD, 37.6 ± 55 vs 12 ± 5 pg/dL, respectively; P = 0.00). The IL-6 values of the polycythemia group were found to be higher than the IL-6 values of the control group, with a mean ± 2SD of 37.6 ± 55 vs 6.3 ± 3.4 pg/dL, respectively; this was significant ( P = 0.00). Although the CRP values of the polycythemia group were found to be slightly higher than those of the control group (a mean ± 2SD of 3.06 ± 4.07 vs 1.54 ± 2.21 mg/dL, respectively, P > 0.05), this was not significant.
      Conclusions: This study found a significant and robust statistical correlation between IL-6 and v. Hct values ( P = 0.01, rs = 0.641). Contrary to IL-6 levels, however, a meaningful relationship was not found between CRP and v.htc values ( P = 0.286; rs = 0.184).
      Competing Interests: The authors declare no conflict of interest.
      (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
    • References:
      Blanchette V, Dror Y, Chan A. Hematology. In: MacDonald MG, Seshia MMK, Mullet MD eds. Avery’s Neonatology Pathophysiology & Management of the Newborn 6th edn. Philadelphia: LWW; 2005:1169–1234.
      Oski FA. Neonatal hematology. In: Nathan DG, Oski FA eds. Hematology of Infancy and Childhood 4th edn. Philadelphia: W.B. Saunders; 1993:17–154.
      Gordon EA. Polycythemia and hyperviscosity of the newborn. J Perinat Neonatal Nurs. 2003;17:209–221.
      Alsafadi TR, Hashmi SM, Youssef HA, et al. Polycythemia in neonatal intensive care unit, risk factors, symptoms, pattern, and management controversy. J Clin Neonatol. 2014;3:93–98.
      Deorari AK, Paul VK. Symposium on AIIMS protocols in neonatology. Editorial. Indian J Pediatr. 2008;75:55.
      Wong GG, Witek-Giannotti JS, Temple PA, et al. Stimulation of murine hemopoietic colony formation by human IL-6. J Immunol. 1988;140:3040–3044.
      Clark SC. The lymphohematopoietic cytokines. In: Nathan DG, Oski FA eds. Hematology of Infancy and Childhood 4th edn. Philadelphia: WB Saunders; 1993:1078–1095.
      Wu YQ, Shen J, Zhou QL, et al. Interleukin-6 and interleukin-8 in diagnosing neonatal septicemia. J Biol Regul Homeost Agents. 2016;30:1107–1113.
      Ozdemir A, Oygür N, Gültekin M, et al. Neonatal tumor necrosis factor, interleukin-1 alpha, interleukin-1 beta, and interleukin-6 response to infection. Am J Perinatol. 1994;11:282–285.
      Bhartiya D, Kapadia C, Sanghvi K, et al. Preliminary studies on IL-6 levels in healthy and septic Indian neonates. Indian Pediatr. 2000;37:1361–1367.
      Verbeek L, Slaghekke F, Sueters M, et al. Hematological disorders at birth in complicated monochorionic twins. Expert Rev Hematol. 2017;10:525–532.
      Rossi AC, Prefumo F. Perinatal outcomes of twin anemia-polycythemia sequence: a systematic review. J Obstet Gynaecol Can. 2014;36:701–707.
      Lucewicz A, Fisher K, Henry A, et al. Review of the correlation between blood flow velocity and polycythemia in the fetus, neonate, and adult: appropriate diagnostic levels need to be determined for twin anemia-polycythemia sequence. Ultrasound Obstet Gynecol. 2016;47:152–157.
      Messinezy M, Pearson TC. The classification and diagnostic criteria of the erythrocytoses (polycythaemias). Clin Lab Haematol. 1999;21:309–316.
      McMullin MF. The classification and diagnosis of erythrocytosis. Int J Lab Hematol. 2008;30:447–459.
      Erdem A, Erdem M, Arslan M, et al. The effect of maternal anemia and iron deficiency on fetal erythropoiesis: comparison between serum erythropoietin, hemoglobin and ferritin levels in mothers and newborns. J Matern Fetal Neonatal Med. 2002;11:329–332.
      Athanasiou-Metaxa M, Economou M, Tsantali C, et al. Congenital erythrocytosis with increased erythropoietin level. J Pediatr Hematol Oncol. 2002;24:234–236.
      Gordeuk VR, Stockton DW, Prchal JT. Congenital polycythemias/erythrocytoses. Haematologica. 2005;90:109–116.
      Ishii T, Zhao Y, Shi J, et al. T cells from patients with polycythemia vera elaborate growth factors which contribute to endogenous erythroid and megakaryocyte colony formation. Leukemia. 2007;21:2433–2441.
      Corre-Buscail I, Pineau D, Boissinot M, et al. Erythropoietin-independent erythroid colony formation by bone marrow progenitors exposed to interleukin-11 and interleukin-8. Exp Hematol. 2005;33:1299–1308.
      Maran J, Prchal J. Polycythemia and oxygen sensing. Pathol Biol. 2004;52:280–284.
      Sui X, Tsuji K, Tajima S, et al. Erythropoietin-independent erythrocyte production: signals through gp130 and c-kit dramatically promote erythropoiesis from human CD34 + cells. J Exp Med. 1996;183:837–845.
      Chiesa C, Pacifico L, Natale F, et al. Fetal and early neonatal interleukin-6 response. Cytokine. 2015;76:1–12.
      Weitkamp JH, Aschner JL. Diagnostic use of C-reactive protein (CRP) in the assessment of neonatal sepsis. Neo Review. 2005;6:508–515.
      Bhandari V. Effective biomarkers for diagnosis of neonatal sepsis. J Pediatric Infect Dis Soc. 2014;3:234–245.
      Jauréguy M, Choukroun G. Factors affecting the response to erythropoiesis-stimulating agents. Nephrol Ther. 2006;2(suppl 4):S274–S282.
      Macdougall IC, Cooper AC. Hyporesponsiveness to erythropoietic therapy due to chronic inflammation. Eur J Clin Invest. 2005;35(suppl 3):32–35.
      Cooper AC, Mikhail A, Lethbridge MW, et al. Increased expression of erythropoiesis inhibiting cytokines (IFN-gamma, TNF-alpha, IL-10, and IL-13) by T cells in patients exhibiting a poor response to erythropoietin therapy. J Am Soc Nephrol. 2003;14:1776–1784.
      Morceau F, Dicato M, Diederich M. Pro-inflammatory cytokine-mediated anemia: regarding molecular mechanisms of erythropoiesis. Mediators Inflamm. 2009;2009:405016.
      Akdag A, Dilli D, Erdeve O, et al. Does polycythemia affect interleukin-6 response patterns in early postnatal period? J Clin Lab Anal. 2010;24:340–347.
      Sennikov SV, Injelevskaya TV, Krysov SV, et al. Production of hemo- and immunoregulatory cytokines by erythroblast antigen+ and glycophorin A+ cells from human bone marrow. BMC Cell Biol. 2004;5:39.
    • Accession Number:
      0 (Interleukin-6)
      0 (Biomarkers)
      9007-41-4 (C-Reactive Protein)
      0 (IL6 protein, human)
    • Publication Date:
      Date Created: 20241112 Date Completed: 20241231 Latest Revision: 20241231
    • Publication Date:
      20241231
    • Accession Number:
      10.1097/MPH.0000000000002968
    • Accession Number:
      39530770