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Elevated Serum Levels of Tumor Necrosis Factor Are Associated With Progressive Encephalopathy in Children With Acquired Immunodeficiency Syndrome
Mark Mintz, MD;
Robert Rapaport, MD;
James M. Oleske, MD;
Edward M. Connor, MD;
M. Richard Koenigsberger, MD;
Tom Denny;
Leon G. Epstein, MD
Am J Dis Child. 1989;143(7):771-774.
Abstract
• The cytokine tumor necrosis factor (TNF) was assayed in the sera (n = 31) and cerebrospinal fluid (n=26) of children with acquired immunodeficiency syndrome, using a competitive radioimmunoassay. Elevated serum levels of TNF were found in 15 (79%) of 19 patients with progressive encephalopathy (PE), compared with 1 (8%) of 12 patients without neurologic involvement. There was a significant association of PE with elevated serum TNF levels. Conversely, of 16 patients with elevated serum TNF levels, 15 (94%) were found to have PE, and of 8 patients with serum TNF levels greater than 100 pg/mL, all 8(100%) had PE. No association was found between cerebrospinal fluid levels of TNF and PE. Neither serum nor cerebrospinal fluid TNF levels correlated with the degree of cachexia. These data suggest that circulating TNF may be responsible for the myelin damage that occurs in human immunodeficiency virus type 1-associated PE.
(AJDC. 1989;143:771-774)
Author Affiliations
From the Department of Neurosciences, Division of Pediatric Neurology (Drs Mintz, Koenigsberger, and Epstein), and the Department of Pediatrics (Drs Rapaport, Oleske, Connor, Koenigsberger, and Epstein and Mr Denny), University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark; and Children's Hospital AIDS Program, Children's Hospital of New Jersey, Newark (Drs Mintz, Oleske, Connor, and Epstein and Mr Denny).
Footnotes
Accepted for publication March 18, 1989.
Reprint requests to Department of Neurology, PO Box 673, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642 (Dr Epstein).
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