Exp Clin Endocrinol Diabetes 2009; 117(2): 57-59
DOI: 10.1055/s-2008-1076717
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Cytokines as a Common Components of Two Different Disorders: Metabolic Syndrome and Hemophagocytic Lymphohystiositosis

Z. Şıklar 1 , M. Berberoğlu 1 , Z. Uysal 2 , F. E. Çıtak 2 , P. Bilir 1 , M. Ertem 2 , Ö. Engiz 1 , G. Öçal 1
  • 1Department of Pediatric Endocrinology, School of Medicine, Ankara University, Ankara, Türkiye
  • 2Department of Pediatric Haematology, School of Medicine, Ankara University, Ankara, Türkiye
Further Information

Publication History

received 03.11.2007 first decision 11.04.2008

accepted 11.04.2008

Publication Date:
03 June 2008 (online)

Abstract

Increased cytokines secretion occurs in several different disorders. Hemophagocytic lymphohystiositosis (HLH) and metabolic syndrome (MS) are consist two of them. Hemophagocytic lymphohystiositosis results from uncontrolled macrophage activation and huge amounts of cytokine secretion. The metabolic syndrome is a multicomponent condition characterized by insulin resistance, dyslipidemia, abdominal obesity, hypertension, and increased level of proinflammatory cytokines. It was presented a 6.8 years old girl, diagnosed as HLH. Because she was morbid obese, endocrinological investigation had been done and metabolic syndrome, thyroid hormone dysfunction, and hypercortisolemia with disturbances of diurnal rhythm were detected. During follow-up of patient, metabolic syndrome components disappear gradually while haemophagocytosis was recovered. Endocrine system can be affect during HLH attack, and MS can be developed. Cytokines seems to act central role of pathological changes for both diseases.

References

  • 1 Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation.  Diab Med. 1998;  15 539-553
  • 2 Arico M, Janka G, Fischer A, Henter JI, Blanche S, Elinder G, Martinetti M, Rusca MP. Hemophagocytic lymphohistiocytosis. Report of 122 children from the International Registry. FHL Study Group of the Histiocyte Society.  Leukemia. 1996 Feb;  10 ((2)) 197-203
  • 3 Atabek ME, Pirgon Ö, Kurtoglu S. Prevalence of metabolic syndrome in obese Turkish children and adolescents.  Diab Res Clin Prac. 2006;  72 ((3)) 315-321
  • 4 Berghe G, Zegher F, Bouillon R. Acute and Prolonged Critical Illness as Different Neuroendocrine Paradigms.  JCEM. 1998;  83 ((6)) 1827-1834
  • 5 Biliau AD, Roskams T, Damme-Lombaerts R Van, Matthys P, Wounters C. Macrophage activation syndrome: characteristic findings on liver biopsy illustrating the key role of activated, IFN γ-producing lymphocytes and IL-6 and TNF α producing macrophages.  Blood. 2005;  105 ((4)) 1648-1651
  • 6 Bitsori M, Kafatos A. Dysmetabolic syndrome in childhood and adolescence.  Acta Pædiatrica. 2005;  94 995-1005
  • 7 Chopra IJ, Huang TS, Beredo A, Solomon DH, Chua Teco GN, Mead JF. Evidence for an inhibitor of extrathyroidal conversion of thyroxine to 3,5,39- triiodothyronine in sera of patients with non-thyroidal illness.  J Clin Endocrinol Metab. 1985;  60 666-672
  • 8 Coppack SW. Fat cells and cytokines.  Topical Endocrinol. 2004;  24 13-16
  • 9 Fronzo RA De. Insulin resistance syndrome.  Diabetes Care. 1991;  14 173-194
  • 10 Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Jane W. Prevalence of the metabolic syndrome in American adolescents findings from the Third National Health and Nutrition Examination Survey.  Circulation. 2004;  110 2494-2497
  • 11 Henter JI, Horne AC, Arico M, Egeler RM, Filipovich AH, Imashuku S, Ladisch S, MacClain K, Webb D, Winiarski J, Janka R. HLH-2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis.  Pediatr Blood Cancer. 2007;  48 124-131
  • 12 Hristova M, Aloe L. Metabolic syndrome-neurotrophic hypothesis.  Med Hypothes. 2006;  66 545-549
  • 13 Grimble RF. Inflammatory status and insuln resistance.  Curr Opin Clin Nutr Metab Care. 2002;  5 551-559
  • 14 Kakucska I, Romero LI, Clark BD, Rondeel JM, Alex S, Emerson CH, Lechan RM. Suppression of thyrotropin-releasing hormone gene expression by interleukin-1-beta in the rat: implications for nonthyroidal illness.  Neuroendocrinology. 1994;  59 129-137
  • 15 Larroche C, Mouthon L. Pathogenesis of hemophagocytic syndrome (HPS).  Autoimmunity Reviews. 2004;  3 69-75
  • 16 Matsuzawa Y. The metabolic syndrome and adipokines.  FEBS Lett. 2006;  580 ((12)) 2917-2921
  • 17 Moller DE, Kaufman KD. Metabolic syndrome: a clinical and metabolic perspective.  Annu Rev med. 2004;  56 45-62
  • 18 Third Report of the National Cholesterol Education Program (NCEP) .Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Final Report. Bethesda, Md: National Heart, Lung, and Blood Institute 2002 http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf
  • 19 Shintani F, Nakaki T, Kanba S, Kato R, Asai M. Role of interleukin-1 in stress responses. A putative neurotransmitter.  Mol Neurobiol. 1995;  10 ((1)) 47-71
  • 20 Stouthard JML, Poll T van der, Endert E. Effects of acute and chronic interleukin-6 administration on the thyroid hormone metabolism in humans.  J Clin Endocrinol Metab. 1994;  79 1342-1346
  • 21 Tomlinson JW, Stewart PM. Cortisol metabolism and the role of 11betahydroxysteroid dehydrogenase.  Best Pract Res Clin Endocrinol Metab. 2001;  15 61-78
  • 22 Wartofski L, Burman KD. Alterations in thyroid function in patients with systemic illness: the “euthyroid sick syndrome”.  Endocr Rev. 1982;  3 164-167

Correspondence

Dr. Z. Şıklar

Orman Fidanlık Lojmanları 23/4

Söğütözü

Ankara

Türkiye

Phone: +90/312/595 67 91

Fax: +90/312/319 14 40

Email: zeynepsklr@hotmail.com

Email: zeynepsklr@gmail.com

    >