Diagnostic and prognostic value of neuron-specific enolase and S-100 protein in pediatric viral encephalitis

Abstract

Objective – to study the dynamics of the level of neuron-specific enolase (NSE) and S-100 protein in blood serum and cerebrospinal fluid in children with various features of viral encephalitis course and outcome and to define their role in diagnostics and prognosis.Material and methods. 48 children aged from 1 month to 15 years were examined. Analysis of the level of NSE and S-100 protein was performed by the method of hardphase immune-enzyme analysis.Results. A reliable increase of the level of S-100 protein in blood serum was identified in comparison with the control group in both acute and reconvalescence periods. During acute period higher values of NSE in blood serum were found in children with herpesvirus encephalitis of various etiologies in comparison with varicella zoster encephalitis, and during reconvalescence period – higher values of S-100 protein. In case of the most severe course of the disease the level of NSE in cerebrospinal fluid was reliably higher in comparison with patients in severe condition. Children with convulsive syndrome demonstrated higher concentration of NSE in cerebrospinal fluid than patients without convulsions. In case of formation of stable neurologic deficiency during the disease outcome there was identified an increase of NSE concentration in blood serum in comparison with the recovered patients. It was also identified that if the values of NSE were >7.0 ng/ml, it was possible to predict unfavourable outcome of viral encephalitis with sensitivity of 61.54% and specificity of 71.43%. The highest values of neuron-specific proteins in blood serum were found in the dead patient with herpes encephalitis.Conclusion. Analysis of NSE and S-100 protein in pediatric viral encephalitis is characterized by diagnostic and prognostic significance, demonstrates their role in pathogenesis and can be used for therapy correction.