To investigate the relationship between the changes in the serum levels of astrocyte derived protein (S100B), neuron specific enolase (NSE) and the change of brain magnetic resonance imaging (MRI) in children with severe hand-foot-mouth disease (HFMD) induced by human enterovirus 71 (EV71) infection. 

Sixty children with EV71 infected HFMD admitted to Department of Pediatrics of Affiliated Hospital of Youjiang Medical University for Nationalities were enrolled, and they were divided into severe group (n = 24) and mild group (n = 36) according to disease severity. Serum levels of S100B and NSE at 6, 24, 48 and 72 hours after hospital admission were determined, and MRI was administrated at 24 hours after hospital admission. Thirty healthy children with the same age were served as healthy control group. 

The serum levels of S100B and NSE at 6, 24, 48 and 72 hours in the severe group were significantly higher than those of mild group and healthy control group [S100B (μg/L): 1.29±0.13 vs. 0.15±0.03, 0.13±0.02 at 6 hours, 1.56±0.16 vs. 0.13±0.02, 0.13±0.02 at 24 hours, 1.66±0.15 vs. 0.16±0.02, 0.13±0.02 at 48 hours, 1.60±0.16 vs. 0.16±0.02, 0.13±0.02 at 72 hours; NSE (μg/L): 42.36±5.48 vs. 5.95±0.14, 5.61±0.20 at 6 hours, 50.13±5.58 vs. 6.16±0.15, 5.61±0.20 at 24 hours, 59.36±5.94 vs. 6.07±0.14, 5.61±0.20 at 48 hours, 56.78±5.07 vs. 5.86±0.16, 5.61±0.20 at 72 hours, all P < 0.01]. There was no statistically significant difference between the mild group and the control group at each time point (all P > 0.05). Brain parenchyma damages in MRI were presented with single brain parenchyma damage (6 cases) and multiple brain parenchyma damage (6 cases) in 50% of children in the severe group. The basal ganglia, thalamus and brainstem were the common locations of damage, and the serum levels of S100B and NES were significantly higher than those without brain parenchyma damage [S100B (μg/L): 1.64±0.15, 1.72±0.14 vs. 1.49±0.16, NES (μg/L): 52.14±5.08, 54.50±4.85 vs. 47.14±4.65, all P < 0.05].  

The serum levels of S100B and NES increased significantly in the children with severe HFMD, furthermore, the serum levels of S100B and NES were higher in the children with brain parenchyma damage.

Hand-foot-mouth disease;  Astrocyte derived protein;  Neuron specific enolase;  Magnetic resonance imaging