INTRODUCTION
Febrile episodes are common in children with sickle cell disease (SCD),
often with challenging etiological diagnosis. These patients are at risk
of severe bacterial infections (SBI), although they have become less
frequent in high-income countries in recent years1–5. Therefore, it would be important to find
biomarkers that could help distinguish the etiology of these febrile
episodes early in order to guide antimicrobial therapy. Several
biomarkers [white blood count (WBC), neutrophils, C-reactive protein
(CRP) and procalcitonin, among others] have been studied in SCD
patients with bacteremia and other bacterial infections with variable
results1,6–9. Serum cytokines have also been studied
in steady-state SCD patients and those with vaso-occlusive crisis
(VOC)10–15, but they have not been well studied in
SCD patients with an infection.
The aim of this study was to analyze the pattern of inflammatory
biomarkers, including pro-inflammatory cytokines, in SCD children with
fever of different etiologies, in order to find useful parameters to
discriminate the patients at risk of SBI. Since SBI has become less
frequent in well-controled SCD children in recent years, this could help
to guide the management of these patients, reducing unnecessary
antibiotic treatments and hospital admissions.