Myositis in children with meningococcal disease: a role for tumour necrosis factor-alpha and interleukin-8?

J Infect. 2002 Jan;44(1):17-21. doi: 10.1053/jinf.2001.0923.


Objectives: Myalgia is under-recognized in meningococcal disease (MCD). In septic shock, myositis is thought to be mediated by pro-inflammatory cytokines such as tumour necrosis factor-alpha (TNF-alpha), interleukin-8 (IL-8) and interleukin-6 (IL-6) but this has never previously been studied in MCD. We aimed to demonstrate whether muscle damage mediated via TNF-alpha and other pro-inflammatory cytokines occurs in MCD, as estimated by creatine kinase skeletal muscle isoenzyme (CK-MM) and cardiac isoenzyme (CK-MB) concentrations.

Methods: A total of 68 children, median age 2.7 years, with a diagnosis of MCD were prospectively studied. Severity of disease was measured using the Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS). Severe disease was defined as a GMSPS of > or =8. TNF-alpha, IL-8, IL-6 and IL-1Ra concentrations were determined on samples taken on admission.

Results: CK-MM correlated significantly with TNF-alpha, IL-8 and GMSPS. There was no significant correlation between CK-MB and TNF-alpha or IL-6, but CK-MB correlated with GMSPS and IL-8. Fifty-six percent of children with MCD had evidence of muscle damage as manifested by elevated CK-MM.

Conclusions: TNF-alpha and IL-8 may be potential mediators in the pathophysiology of skeletal muscle damage in MCD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Child
  • Child, Preschool
  • Creatine Kinase / blood
  • Creatine Kinase, MB Form
  • Creatine Kinase, MM Form
  • Female
  • Humans
  • Infant
  • Interleukin-8 / blood*
  • Isoenzymes / blood
  • Male
  • Meningococcal Infections / complications*
  • Meningococcal Infections / enzymology
  • Meningococcal Infections / metabolism*
  • Myositis / enzymology
  • Myositis / metabolism*
  • Myositis / microbiology*
  • Prospective Studies
  • Severity of Illness Index
  • Tumor Necrosis Factor-alpha / metabolism*


  • Biomarkers
  • Interleukin-8
  • Isoenzymes
  • Tumor Necrosis Factor-alpha
  • Creatine Kinase
  • Creatine Kinase, MB Form
  • Creatine Kinase, MM Form