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Serum and CSF S100B, neuron specific enolase,
and tau protein in acute encephalopathy with
biphasic seizures and late reduced diffusion
Takashi Shiihara , Mio Watanabe , Keiko Kamayachi , Noriko Sawaura
1 1 2 2
Gunma Children’s Medical Center, Gunma, Japan ; Gunma University
Graduate School of Medicine, Gunma, Japan 2
In the early stages of the disease, The levels of all biomarkers were
acute encephalopathy with biphasic significantly higher in AESD than
seizures and late reduced diffusion those of FS patients (table 1).
(AESD) could resemble its far more
When only days 0 to 2 samples Table 1: Clinical characteristics and
prevalent and benign counterpart,
from AESD patients were used, the biomarkers in FS and AESD. AESD patients
febrile seizure (FS), but often are shown as the all patients and the patients
levels of all the measured
results in some neurological with day 0-2 samples available.
biomarkers, except serum NSE,
were still significantly higher in
Biomarkers, such as S100B, patients with AESD than those in
neuron-specific enolase (NSE), and FS. Conclusions
tau protein, have been regarded
CSF S100B (cut-off value, 100 AESD may be associated with
as damage marker of astrocytes,
pg/ml) and CSF tau protein (cut-off damage to astrocytes, neurons
neurons, and axons, respectively.
value, 100 pg/ml) were better and axons, even in the early
predictors of AESD compared to stages of the disease. CSF S100B
other biomarkers (fig. 1). and tau levels can be helpful for
Aim early diagnosis.
To assess whether serum and Combining both CSF S100B and
cerebrospinal fluid (CSF) S100B, CSF tau levels maximized the
NSE, and tau protein are altered in sensitivity (71.4%) plus
AESD and to evaluate their specificity (94.7%) of the test to References
diagnostic validity. distinguish AESD from FS. The
positive predictive value for Takanashi J, et al. Neurology
AESD was 83.3% (fig. 2). 2006;66:1304-9.
Methods Tanuma N, et al. Brain Dev
We measured and compared
serum and CSF S100B, NSE,
and tau protein levels in 43
patients with FS and 18 patients Acknowledgements
with AESD, using sandwich
enzyme-linked immunosorbent This study was supported by the
assays, at any point during their Medical Research Program of
Fig. 1: ROC curves for serum (left) and CSF
illness. Ethics approval was (right) biomarkers (solid line: S100B; dashed
Gunma Prefectural Government,
obtained from the institutional line: NSE; dotted line: tau protein). AUCs Japan. We are deeply grateful to all
review board. are noted along the line. the patients, their parents, and the
Fig. 2: Scatter plot doctors who participated in this
To assess early diagnostic showing the study.
validity, we analyzed these relationships between
biomarkers in 43 FS patients and CSF S100B and tau Apart from this study, we Japan are
8 AESD patients, for whom day 0
protein in AESD still struggling after the disaster
(closed circle) and FS
to 2 samples were available. (open circle). Vertical-
March 11, 2011. We are grateful
and horizontal-dashed for the world help. Arigatou!!
We used the receiver operating lines denote cut-off
characteristic (ROC) curve with values for AESD, CSF
S100B and tau protein
the area under curve (AUC) to (all 100 pg/ml).
evaluate the diagnostic values of