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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
                                                       1

                    Graduate School of Medicine, Gunma, Japan  2




Introduction                          Results
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,
sequelae.
                                      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
                                                                                            2010;32:435-9.
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
  these markers.

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CSF S100B and tau protein help diagnose AESD early

  • 1. 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 1 Graduate School of Medicine, Gunma, Japan 2 Introduction Results 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, sequelae. 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 2010;32:435-9. 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 these markers.