ArticleTranslational pediatrics2026
Evaluating the risk of elevated IL-6 levels in pediatric patients: a stratified approach and evidence of interaction effects.
Article in Translational pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Distinguishing between an appropriate and a pathologically dysregulated elevation of interleukin-6 (IL-6) is challenging. This study aimed to explore how physiological function abnormalities could help identify subpopulations in whom IL-6 levels were associated with disease severity. Methods: This retrospective study included pediatric patients with serum IL-6 test results. After selecting laboratory parameters that effectively identify a subpopulation in which IL-6 levels can predict adverse clinical outcomes, the chosen parameters were categorized into function groups. Using IL-6 levels and the number of impaired functions as stratifying parameters, the risk of adverse outcomes for each stratum was calculated. To assess the interaction effect between functional impairment and IL-6 elevation on adverse outcomes, the relative excess risk due to interaction (RERI) was calculated. Results: A total of 56,170 pediatric patients were included. Fourteen laboratory parameters in pediatric patients could be used as stratifying parameters, where abnormal values suggest that IL-6 levels could be used as a prognostic marker [area under the receiver operating characteristic curves (AUCs) >0.7]. These parameters were categorized into five functional groups: immunological [white blood cell (WBC), neutrophils, monocytes], hepatic [aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bile acids], renal (creatinine, uric acid), coagulation [platelets, activated partial thromboplastin time (APTT), thrombin time], and myocardial enzymes [myoglobin, creatine kinase (CK), CK-MB]. For the rate of adverse outcomes, the rate difference (RD) between the IL-6 >85 Conclusions: The risk associated with elevated IL-6 levels increases as the number of impaired functions grows, with an intensified interaction effect between IL-6 elevation and functional impairment on clinical outcomes, offering a simple method for clinical risk stratification.
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