This article discusses cytokine storm syndrome, including its symptoms, diagnosis, and treatment.
The heart may not pump as well as it normally would.
As a result, cytokine storm can affect multiple organ systems.
Justin Paget / Getty Images
In cytokine storm syndrome, respiratory symptoms may worsen to becomeacute respiratory distress syndrome (ARDS).
It might require mechanical ventilation to help a person receive enough oxygen.
It is also sometimes called cytokine release syndrome, CRS, or just cytokine storm.
The immune system has many different components that help you handle infections.
It includes many different types of cells that communicate with each other using signaling molecules.
These molecules are known ascytokines.
Many different cytokines perform many kinds of functions.
Some help recruit other immune cells, and some help with antibody production or pain signaling.
Some make the blood clot more easily.
Some help produce inflammation.
This can make blood vessels more leaky than normal.
Another group of cytokines helps tamp down the bodys inflammatory response.
Thats an important balance.
This is because too much inflammation causes its own problems.
The problem is that sometimes the bodys inflammatory response can get out of control.
This causes more harm than good.
Sometimes the body produces too many inflammatory cytokines and not enough cytokines that control inflammation.
The inflammatory cytokines start storming out of control, without enough feedback from the anti-inflammatory cytokines.
Most people with COVID-19 do not develop cytokine storm and its symptoms.
At this point, this is not known for sure.
Several different types of underlying health issues may cause it.
Genetic Syndromes
People with certain genetic syndromes are more likely to experience cytokine storm.
For example, this applies to people with a condition called familial hemophagocytic lymphohistiocytosis (HLH).
These genetic defects lead to specific problems in certain immune system cells.
This usually happens within the first few months of life.
This is the virus that causes the common flu.
Severe types of influenza infections may be more likely to cause cytokine storm.
Epstein-Barr virus andcytomegalovirusare some other common infectious causes.
Autoimmune disease
People with certain autoimmune syndromes have a higher risk of getting cytokine storm syndrome.
This pop in of cytokine storm might occur when a persons underlying disease is flaring up.
And it can also happen when the person is also experiencing some kind of infection.
Other Causes
Cytokine storm can also sometimes be a side effect of specific medical therapies.
Certain types of cancers may also cause a cytokine storm syndrome.
Conditions that affect the immune system, like AIDS, can also cause it.
Cytokine Storm Syndrome Diagnosis
Doctors consider the underlying medical condition when diagnosing cytokine storm.
This underlying problem might be already known, or it may require its own diagnosis.
Medical history and a physical exam provide diagnostic starting points.
Your clinician will want to know about your past medical issues and recent symptoms.
The clinician will also thoroughly examine you for signs that might indicate cytokine storm.
This is important because cytokine storm can affect so many different systems of the body.
Laboratory abnormalities, like may be seen in basic blood tests, can provide clues.
People with cytokine storm might have abnormalities like the following:
Medical imaging can also provide clues.
For example, a chest X-ray might display lung involvement from cytokine storm related to COVID-19.
It isnt always diagnosed or mentioned specifically.
You might just learn that someone is having severe symptoms from influenza, COVID-19, or another condition.
Tests to verify that cytokines are elevated might not be helpful or necessary.
Researchers are working hard to understand what cytokine storm means in the context of COVID-19.
However, this is not yet clear.
Cytokine Storm Treatment
Supportive care is a critical part of treatment for cytokine storm.
Sometimes an individual is experiencing severe symptoms, like difficulty breathing.
They may need care in an intensive care unit.
For example, if cytokine storm is triggered by a bacterial infection, an antibiotic may be helpful.
But it is very complicated, in part because the immune system has so many different parts.
The best options may depend somewhat on the specific underlying cause of the cytokine storm.
There may also be a lot of variability in how people respond to such therapies.
In the past, some treatments have been tried for cytokine storm with some mixed success.
It blocks the activity of a specific cytokine known as interleukin 1 (IL-1).
It has sometimes been helpful for people with cytokine storm from autoimmune conditions.
Researchers are currently studying whether this therapy might help critically ill people with cytokine storm syndrome from COVID-19.
This therapy blocks the activity of another cytokine, interleukin 6 (IL-6).
Scientists are currently investigating these therapies, as well as many other potential interventions.
Summary
Cytokine storm happens when the immune system produces too many inflammatory signals.
This can can cause serious symptoms that in some cases can lead to organ failure and death.
Symptoms of cytokine storm can include confusion, shortness of breath, lethargy, and more.
Its scary and frustrating to learn that someone you care about is battling such a problem.
However, know that you arent alone.
Medical professionals will do everything possible to see to it your loved one receives the best possible care.
Frequently Asked Questions
Hypercytokinemia is the medical term for cytokine storm.
It refers to the overproduction ofcytokines, certain proteins that send messages between cells.
It does require immediate treatment, however.
2017;3(1):3348. doi:10.1007/s40674-017-0059-x
Treatment of COVID-19 patients with anti-interleukin drugs.
ClinicalTrials.gov identifier: NCT04330638.
SinoBiological (SB).Cytokine storm.
