Sadullah TOPRAK, Murat ARI, Hatice Feray ARI, İsmail KOYUNCU
Meandros Medical and Dental Journal - 2026;27(2):328-338
Objective: Pediatric sepsis remains a leading cause of critical illness and mortality among children admitted to pediatric intensive care units (PICU). Early and accurate diagnosis is essential for timely intervention and improved clinical outcomes. Recent evidence suggests that inflammasome-related biomarkers, including NOD-like receptor family pyrin domain-containing 3 (NLRP3), caspase-1, and interleukin-18 (IL-18), may play important roles in the pathophysiology of sepsis. This study aimed to evaluate the diagnostic utility of NLRP-3 caspase-1, and IL-18 levels in pediatric sepsis. Materials and Methods: This prospective case-control study included 60 pediatric patients admitted to the PICU between November 2022 and January 2023, including 30 with sepsis and 30 non-septic controls. Serum NLRP3, caspase-1, and IL-18 levels were measured by ELISA within 48 hours of diagnosis. Demographic, clinical, laboratory, and PRISM III data were collected and compared between groups. Results: NLRP3, caspase-1, and IL-18 levels were significantly higher in the sepsis group compared to controls (p < 0.001). Among these biomarkers, IL-18 demonstrated the highest diagnostic accuracy, with a sensitivity and specificity of 93.3%. The mean PRISM III score was also significantly elevated in the sepsis group (32.12 +/- 32.56 vs. 12.14 +/- 12.11; p < 0.01). Conclusion: NLRP3, caspase-1, and IL-18 were significantly increased in children with sepsis, highlighting the potential diagnostic relevance of inflammasome activation in pediatric sepsis. Of these biomarkers, IL-18 showed the best diagnostic performance, suggesting that it may be a valuable candidate for clinical use.
