Evaluation of IL-11 levels in cases of thrombocytopenia secondary to neonatal sepsis and the relationship between platelet count and IL-11 levels

8-SUMMARYThrombocytopenia is one of the most commonly seen haematologyc problems inNeonatal Intensive Care Unit (NICU). It is evident in one out of three newborns in NICU.The incidence of changes between %18-50 is higher in premature mewborns companed tomature newborns. Various fetomaternal and perinatal factors cause thrombocytopenia in fetusand newborn. The cause of onset early thrombocytopenia is fetal and maternal factors. Thecause of late onset thrombocytopenia is almost septicemia and Necrotizan enterocolitis.IL-11 is produced by various tissues which have many fonctions. IL-11, a pleotropicmollecule, is an important regulator of hematopoiesis. IL-11 also stimulatesmegakaryopoiesis by stimulating progenitor cell proliferation and maturation. There arelimited studies concerning thrombocytopenia and IL-11 relationship which have conflicts.The aim of this study was to determine the relationship between platelet count and IL-11levels in cases of thrombocytopenia secondary to neonatal sepsis and to determine levels ofIL-11 healthy preterm/term newborns.Three study groups were constructed to determine IL-11 levels. In group I 30preterm/term newborn with thrombocytopenia secondary to neonatal sepsis, in group II, III 30healthy preterm and term newborns with no risk for trombocytopenia or septicemia weretaken. In group I, blood serum samples were obtained for complete blood count and IL-11levels, when septicemia was suspected. In group II and III, blood samples were taken within72 hours, postnatally. IL-11 levels were measured by the ELISA method (RayBio Human IL-11 ELISA kit).Mean gestationel ages in group I.was 34.9 ± 3.81 week, in group II 33,6 ± 1.47 week, ingroup III 38.6 ± 0.90 week. Mean birth weights in group I, II and III were also determined as2188,60 ± 14.85 gr, 1973,27 ± 432.99 gr. and 3408,28 ± 451.55 gr. respectively. MeaningfullStatistical differences were found for gestational age and birth weight in all groups.Fiftyseven percent of the newborns (n=17) were males, rest (%43) were females. Sixtythreepercent of the newborns (n=19) were preterm and rest (%37) were term newborns. For theneonatal septicemia premature birth is the fetal risk factor and premature rupture of81membrane is the obstetrical risk factor. Late onset thrombocytopenia developed in %83 of thenewborns. In group I, patients total mortaliti rate was %60, early onset septicemia rate was%80, late onset septicemia rate was %56. The mean IL-11 levels in group I were found higherthan group II and group III, which was statistically meaningful. The mean IL-11 levels ingroup I and II was not statistically meaningful. When we concidered all newborn participartstotaly, IL-11 levels and thrombocyte counts were correlated negatively. Also this study wasdetermine the relationship between CRP and IL-11 levels. IL-11 levels and CRP levels werepositively correlated.In our study, IL-11 levels in newborns with thrombocytopenia secondary to septicemiawere found higher than healthy newborns who have not thrombocytopenia. Higher levels ofIL-11, were found to be associated with elevated levelf of CRP and inflammatory cytokinesin infection. That finding of our study was supported by possitive correlation between IL-11and CRP levels. It was thought that thrombocytopenic newborns which was secondary tosepticemia, diminished absolute neutrophil count and thrombocytopenia caused increased IL-11 expression in bone marrow stromal cells. IL-11 levels were found similar in preterm andterm newborns.82