The value of serum level of S100B protein in predicting brain edema in children with diabetes ketoacidosis

Background and Objective: The S100B protein has recently been considered as an important marker for predicting severe brain damage; however there has been very little evidence of increasing this marker in cerebral edema due to metabolic disorders such as diabetes ketoacidosis (DKA). This study was designed and performed to evaluate the prognostic role of S100B protein in predicting brain edema in children with DKA. Methods: This case-control study was performed on children aged 22 months to 13 years who suffering moderate to severe DKA that were admitted to intensive care unit. A venous blood sample was taken from the patients during the first 6 hours of admission to the intensive care units. Based on the evidences of brain edema requiring manitol infusion, the patients were divided into 2 groups including the patients with brain edema as the cases and those without this problem as the controls. The serum level of S100B protein was measured by ELISA technique in both groups.  Results: The mean serum level of S100B in the groups with and without brain edema was 1.07 ± 1.15 and 0.67 ± 0.99 respectively with no difference (p = 0.437). Based on the multivariable linear regression modeling, the presence of brain edema was not associated with the level of S100B. According to the ROC curve analysis S100B (AUC = 0.506, P = 0.967) could not predict the occurrence of brain edema children with DKA. Conclusion: the increase in the serum level of S100B may not predict the likelihood of brain edema in children with DKA.