Acute myocarditis (AM) is an inflammatory disease of the heart muscle that can progress to fulminant myocarditis (FM), a severe and life-threatening condition. The cytokine profile of myocarditis in children, especially in relation to fulminant myocarditis, is not well understood. This study aims to evaluate the cytokine profiles of acute and fulminant myocarditis in children. Pediatric patients diagnosed with myocarditis were included in the study. Cytokine levels were measured using a multiplexed fluorescent bead-based immunoassay. Statistical analysis was performed to compare patient characteristics and cytokine levels between FM, AM, and healthy control (HC) groups. Principal component analysis (PCA) was applied to cytokine groups that were independent among the FM, AM, and HC groups. The study included 22 patients with FM and 14 with AM patients. We identified four cytokines that were significantly higher in the FM group compared to the AM group: IL1-RA (p = 0.002), IL-8 (p = 0.005), IL-10 (p = 0.011), and IL-15 (p = 0.005). IL-4 was significantly higher in the AM group compared to FM and HC groups (p = 0.006 and 0.0015). PDGF-AA, and VEGF-A were significantly lower in the FM group than in the AM group (p = 0.013 and <0.001). Similar results were obtained in PCA. Cytokine profiles might be used to differentiate pediatric FM from AM, stratify severity, and predict prognosis. The targeted therapy that works individual cytokines might provide a potential treatment for reducing the onset of the FM and calming the condition, and further studies are needed.

急性心肌炎 (AM) 是一种心肌炎症性疾病，可发展为暴发性心肌炎 (FM)，这是一种严重且危及生命的疾病。儿童心肌炎的细胞因子谱，特别是与暴发性心肌炎相关的细胞因子谱，尚不清楚。本研究旨在评估儿童急性和暴发性心肌炎的细胞因子谱。该研究包括被诊断患有心肌炎的儿科患者。使用基于多重荧光珠的免疫测定法测量细胞因子水平。进行统计分析以比较 FM、AM 和健康对照 (HC) 组之间的患者特征和细胞因子水平。主成分分析（PCA）应用于 FM、AM 和 HC 组之间独立的细胞因子组。该研究包括 22 名 FM 患者和 14 名 AM 患者。我们发现 FM 组中的四种细胞因子显着高于 AM 组：IL1-RA ( p  = 0.002)、IL-8 ( p  = 0.005)、IL-10 ( p  = 0.011) 和 IL-15 ( p  = 0.005）。与 FM 和 HC 组相比，AM 组的 IL-4 显着升高（p  = 0.006 和 0.0015）。FM 组的 PDGF-AA 和 VEGF-A 显着低于 AM 组（p  = 0.013 和 <0.001）。PCA 中也得到了类似的结果。细胞因子谱可用于区分儿科 FM 和 AM、对严重程度进行分层并预测预后。作用于个体细胞因子的靶向治疗可能为减少 FM 的发作和缓解病情提供潜在的治疗方法，但还需要进一步的研究。