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.