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Arch Dis Child Fetal Neonatal Ed 2002;87:F34-F36 doi:10.1136/fn.87.1.F34
  • Original article

Procollagen I C-propeptide in the cerebrospinal fluid of neonates with posthaemorrhagic hydrocephalus

  1. A Heep1,
  2. B Stoffel-Wagner2,
  3. V Soditt3,
  4. C Aring3,
  5. P Groneck3,
  6. P Bartmann1
  1. 1Department of Neonatology, University of Bonn, Germany
  2. 2Department of Clinical Biochemistry, University of Bonn
  3. 3Childrens Hospital of Cologne, Germany
  1. Correspondence to:
    Dr A Heep, Universitaetsklinikum Bonn, Abteilung Neonatologie, Perinatalzentrum, Adenauerallee 119, D-53113 Bonn, Germany;
    a.heep{at}uni-bonn.de
  • Accepted 2 January 2002

Abstract

Background: The pathogenesis of posthaemorrhagic hydrocephalus (PHHC) following intraventricular haemorrhage (IVH) in premature infants includes a fibroproliferative reaction leading to arachnoidal fibrosis, ultimately causing malresorption of cerebrospinal fluid (CSF) at the arachnoid villi.

Aims: To determine whether an increased concentration of the carboxyterminal propeptide of type I procollagen (PICP) in the CSF of neonates after IVH reflects the activation of collagen synthesis preceding the manifestation of PHHC.

Methods: From 20 neonates with PHHC (median birth weight 740 g, median gestational age 25+1 weeks), 52 CSF samples were collected. CSF samples of four neonates (median birth weight 2170 g, median gestational age 32+4 weeks) with congenital non-haemorrhagic hydrocephalus served as controls. PICP was measured by radioimmunoassay.

Results: PICP in CSF taken at the start of external CSF drainage (median day 21, range 17–25 days postnatal age) was significantly increased (median 851.5, range 153.5–1944 μg/l) compared with controls (median 136.1, range 33.8–169.5 μg/l). CSF concentrations of PICP declined until permanent shunt placement (median day 70, range days 41–113).

Conclusion: In neonates who develop PHHC, significant elevation of PICP concentration in the CSF is present 3–4 weeks after IVH. It reflects the increase of local type I collagen turnover, thereby correlating with manifestation of PHHC.

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