Patients with hemorrhagic shock and encephalopathy syndrome (HSES) have a high early mortality rate, which may be caused by a 'cytokine storm'. However, there is little information on how cytokines and chemokines change over time in these patients. We aimed to describe the characteristics of HSES by examining changes in serum biomarker levels over time. Six patients with HSES were included. We retrospectively evaluated their clinical course and imaging/laboratory data. We measured serum levels of multiple cytokines [interleukin 1β (IL-1β), IL-2, IL-4, IL-6, IL-10, IL-17, interferon-gamma, and tumor necrosis factor alpha], chemokines (IL-8, monocyte chemoattractant protein-1, interferon-inducible protein-10), and growth and differentiation factor (GDF)-15. The highest cytokine and chemokine levels were noted in the first 24 h, and decreased thereafter. The GDF-15 level was markedly high. Cytokine, chemokine, and GDF-15 levels were significantly higher in patients with HSES than in controls in the first 24 h, except for IL-2 and IL-4. Patients with HSES have high inflammatory cytokine and chemokine levels, a high GDF-15 level in the first 24 h, and high lactate levels. Our study provides new insights on the pathophysiology of HSES, a detailed clinical picture of patients with HSES, and potential biomarkers.

中文翻译：

---

出血性休克和脑病综合征中细胞因子、趋化因子和生长和分化因子 15 水平升高：一项回顾性观察研究

失血性休克和脑病综合征 (HSES) 患者的早期死亡率很高，这可能是由“细胞因子风暴”引起的。然而，关于这些患者的细胞因子和趋化因子如何随时间变化的信息很少。我们旨在通过检查血清生物标志物水平随时间的变化来描述 HSES 的特征。包括 6 名 HSES 患者。我们回顾性评估了他们的临床过程和影像/实验室数据。我们测量了多种细胞因子 [白介素 1β (IL-1β)、IL-2、IL-4、IL-6、IL-10、IL-17、干扰素-γ 和肿瘤坏死因子 α]、趋化因子 (IL -8，单核细胞趋化蛋白-1，干扰素诱导蛋白-10）和生长和分化因子（GDF）-15。在最初的 24 小时内注意到最高的细胞因子和趋化因子水平，并随后下降。GDF-15 水平明显高。除 IL-2 和 IL-4 外，HSES 患者的细胞因子、趋化因子和 GDF-15 水平在前 24 小时内显着高于对照组。HSES 患者的炎症细胞因子和趋化因子水平较高，前 24 小时 GDF-15 水平较高，乳酸水平较高。我们的研究为 HSES 的病理生理学、HSES 患者的详细临床图片和潜在的生物标志物提供了新的见解。