Serum levels of tumor necrosis factor-alpha, interleukin-1, and interleukin-6 in hemorrhagic fever with renal syndrome

Hemorrhagic fever with renal syndrome is an acute viral disease caused by hantavirus. On the basis of clinical observation, the illness is divided into five sequential stages: febrile, hypotensive, oliguric, diuretic, and convalescent. Because interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6) are mediators responsible for fever, septic shock, and acute phase protein induction, we examined, using ELISA, the presence of these three cytokines in 276 sera collected during the Korean Conflict from 110 patients. Detectable levels (>20 pg/ml) of TNF-alpha, IL-1 beta, and IL-6 occurred in 14, 14, and 33% of these samples, respectively. There was a significant correlation between serum levels of IL-1 beta and TNF-alpha (r = 0.66, p <0.001), IL-1 beta and IL-6 (r = 0.59, p <0.001), and IL-6 and TNF-alpha (r = 0.71, p <0.001). The pathophysiologic processes of HFRS do not have clear or consistent correlations with alterations in the levels of the cytokines studied.