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. 2024 Jan 30;62(6):1109-1117.
doi: 10.1515/cclm-2023-1471. Print 2024 May 27.

Elevated S100B urine levels predict seizures in infants complicated by perinatal asphyxia and undergoing therapeutic hypothermia

Iliana Bersani  1 , Giuseppe Lapergola  2 , Roberta Patacchiola  2 , Ebe D'Adamo  2 , Liborio Stuppia  3 , Vincenzo de Laurenzi  3 , Verena Damiani  3 , Ivana Cataldo  4 , Katia Clemente  4 , Adele Primavera  2 , Rita Salomone  2 , Elisabetta Barbante  2 , Francesca Campi  1 , Immacolata Savarese  1 , Sara Ronci  1 , Andrea Dotta  1 , Annabella Braguglia  1 , Daniela Longo  1 , Danilo A W Gavilanes  5 , Francesca Gazzolo  6 , Laura Serpero  7 , Maria Chiara Strozzi  8 , Antonio Maconi  9 , Maurizio Cassinari  10 , Roberta Libener  10 , Diego Gazzolo  2
Affiliations

Elevated S100B urine levels predict seizures in infants complicated by perinatal asphyxia and undergoing therapeutic hypothermia

Iliana Bersani et al. Clin Chem Lab Med. .

Abstract

Objectives: Seizures (SZ) are one of the main complications occurring in infants undergoing therapeutic hypothermia (TH) due to perinatal asphyxia (PA) and hypoxic ischemic encephalopathy (HIE). Phenobarbital (PB) is the first-line therapeutic strategy, although data on its potential side-effects need elucidation. We investigated whether: i) PB administration in PA-HIE TH-treated infants affects S100B urine levels, and ii) S100B could be a reliable early predictor of SZ.

Methods: We performed a prospective case-control study in 88 PA-HIE TH infants, complicated (n=44) or not (n=44) by SZ requiring PB treatment. S100B urine levels were measured at 11 predetermined monitoring time-points from first void up to 96-h from birth. Standard-of-care monitoring parameters were also recorded.

Results: S100B significantly increased in the first 24-h independently from HIE severity in the cases who later developed SZ and requested PB treatment. ROC curve analysis showed that S100B, as SZ predictor, at a cut-off of 2.78 μg/L achieved a sensitivity/specificity of 63 and 84 %, positive/negative predictive values of 83 and 64 %.

Conclusions: The present results offer additional support to the usefulness of S100B as a trustable diagnostic tool in the clinical daily monitoring of therapeutic and pharmacological procedures in infants complicated by PA-HIE.

Keywords: S100B; hypothermia; perinatal asphyxia; phenobarbital; seizures.

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References

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