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Review
. 2022 Dec;36(4):735-748.
doi: 10.1016/j.idc.2022.07.001.

Cytokine Release Syndrome and Sepsis: Analogous Clinical Syndromes with Distinct Causes and Challenges in Management

Janhavi Athale  1 , Lindsay M Busch  2 , Naomi P O'Grady  3
Affiliations
Review

Cytokine Release Syndrome and Sepsis: Analogous Clinical Syndromes with Distinct Causes and Challenges in Management

Janhavi Athale et al. Infect Dis Clin North Am. 2022 Dec.

Abstract

Both cytokine release syndrome (CRS) and sepsis are clinical syndromes rather than distinct diseases and share considerable overlap. It can often be challenging to distinguish between the two, but it is important given the availability of targeted treatment options. In addition, several other clinical syndromes overlap with CRS and sepsis, further making it difficult to differentiate them. This has particularly been highlighted in the recent coronavirus disease-2019 pandemic. As we start to understand the differences in the inflammatory markers and presentations in these syndromes, hopefully we will be able to enhance treatment and improve outcomes.

Keywords: COVID-19; Cytokine release syndtome; Inflammatory clinical syndromes; Sepsis; Tocilizumab.

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Conflict of interest statement

Disclosure Dr. O'Grady: This article has been partially funded by the Intramural Program at the National Institutes of Health.

Figures

FIGURE 1:
FIGURE 1:
Overlap between Cytokine Release Syndrome (CRS) and Sepsis with the inclusion of other diseases and clinical syndromes. Abbreviations: CLS: Capillary Leak Syndrome; CPI: Checkpoint Inhibitor; IRAE: Immune-Related Adverse Events; HSCT: hematopoietic stem cell transplant; IRIS: Immune Reconstitution Inflammatory Syndrome; MAS: Macrophage Activation Syndrome; HLH: Hemophagocytic Lymphohistiocytosis; CAR-T: Chimeric Antigen Receptor T cell
See this image and copyright information in PMC

References

    1. Fajgenbaum DC, June CH. Cytokine Storm. N Engl J Med. 2020;383(23):2255–2273. - PMC - PubMed
    1. Ferrara JL, Abhyankar S, Gilliland DG. Cytokine storm of graft-versus-host disease: a critical effector role for interleukin-1. Transplant Proc. 1993;25(1 Pt 2):1216–1217. - PubMed
    1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Jama. 2016;315(8):801–810. - PMC - PubMed
    1. Morgan RA, Yang JC, Kitano M, Dudley ME, Laurencot CM, Rosenberg SA. Case report of a serious adverse event following the administration of T cells transduced with a chimeric antigen receptor recognizing ERBB2. Mol Ther. 2010;18(4):843–851. - PMC - PubMed
    1. Lee DW, Santomasso BD, Locke FL, et al. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. Biol Blood Marrow Transplant. 2019;25(4):625–638. - PubMed

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