The relationship between S100B protein serum levels, injury severity and Glasgow Outcome Scale values in children with CNS injuries
Abstract
The S100B protein subgroup is a thermolabile acidic calcium-binding protein, which was first described in association with the central nervous system. Destruction of nerve tissue results in S100B protein release from astrocytes and elevation of its levels in cerebrospinal fluid.
If the blood-brain barrier is also damaged, S100B can pass into the systemic circulation and elevated blood levels of S100B can be detected. High S100B serum levels in patients with head injuries are predictive of possible development of secondary brain injury and may be related to the extent of permanent injury to the CNS.
The authors present results obtained from a group of 39 children aged 0 (newborns) to 17 years with an isolated craniocerebral injury. RESULTS: In our group of 39 children (aged 0-17 years) we observed excellent GOS group (GOS - Glasgow Outcome Scale 4 or 5) in 33 patients at the time of transfer from our intensive care unit to the neurological department.
There were no deaths and only 6 children were in the poor GOS group (GOS 2 or 3). A second GOS evaluation was performed 6 months later: at this time 36 children were in the excellent GOS group and only 3 children remained in the poor GOS group.
CONCLUSIONS: Due to high variability in S100B protein serum levels in children (dependent on age and gender) no correlation between initial S100B levels and GOS was observed for our group of patients. Our results indicate that the rate of decrease of S100B protein levels back to normal values is more meaningful than its absolute value.