July - September 2013, Volume 9, Issue 3

Ardeleanu I, Caragheorgheopol A

The Value of Cortisol Measurement in Prolonged Fever because of Low Respiratory Tract Infection in Children

Acta Endo (Buc) 2013, 9 (3): 397-404
doi: 10.4183/aeb.2013.397

Context. The role of cortisol in modulating the inflammatory response upon an immune challenge is well documented. Objectives. We aim to assess cortisol levels related to inflammatory status in children with persistent fever and low respiratory tract infection (LRTI). Patients and methods. Thirty five children hospitalised with fever above 38oC for more than 10 days and clinical features of LRTI were enrolled. Immunoglobulins, C-reactive protein (CRP) and cortisol were measured at the admission and after 12 days. Results. From 35 patients, 29 had a satisfactory evolution and 7 had a complicated course of disease. In patients with a satisfactory outcome, the mean value of cortisol at the admission was at the upper limit of the reference range, CRP and immunoglobulin G (IgG) are significantly higher versus reference limit (p<0.05). Children with a severe evolution had a significantly lower cortisol level than those with good evolution, at the lower limit of reference range (p<0.001), and correlated with low levels of CRP and immunoglobulins; cortisol and CRP showed a slight increase after 12 days corresponding with a prolonged course of disease.Conclusions. Cortisol measurement might aid value in early identification of patients requiring initiation of antibiotherapy, corticotherapy or other intensive management strategies.

Keywords: cortisol, prolonged fever, respiratory infection.

Correspondence: Andra Caragheorgheopol PhD, “C.I.Parhon” Institute of Endocrinology, Aviatorilor 34-36, Bucharest, 011863, Romania, Email:andracaragheor@yahoo.com