The aim of the study: To determine the clinical and immunological characteristics and elucidate the role of cytokine dysregulation in the development of DIC syndrome in children aged 1–3 years with severe pneumonia in order to improve early diagnosis and prognosis of complications.

Materials and methods. The study was conducted in 2024–2025 at the Intensive Care and Pediatric Pulmonology Department of the Multidisciplinary Clinic of TSMU. Thirty-nine children aged 1–3 years diagnosed with severe pneumonia were observed. To elucidate the role of cytokine dysregulation in the development of DIC syndrome, the patients were divided into two groups. The first group consisted of 17 children (43.6%) who developed DIC syndrome against a background of severe pneumonia. Among them, there were 10 boys (58.8%) and 7 girls (41.2%). The second group consisted of 22 children (56.4%) who did not have hemostasis disorders. Of these, 12 were boys (54.5%) and 10 were girls (45.5%).

Results and discussion. The analysis of the examined children revealed significant differences in clinical and laboratory parameters between the group with DIC and patients without coagulopathic complications. Already at admission, children with DIC demonstrated a more pronounced inflammatory response: their C-reactive protein levels averaged 118.4 mg/L (95% CI: 103–132 mg/L), which was statistically significantly higher than those in the second group, where the average values were 62.7 mg/L (95% CI: 52–73 mg/L; p < 0.01).

Conclusions. In children aged 1–3 years with severe pneumonia, the development of DIC syndrome is accompanied by more pronounced systemic inflammation, as evidenced by significantly elevated levels of C-reactive protein and procalcitonin compared to patients without DIC. The development of DIC is associated with pronounced cytokine dysregulation: IL-6 concentrations in children with DIC were more than twice as high, while IL-10 levels were significantly lower, indicating an insufficient anti-inflammatory response.

Children, severe pneumonia, DIC syndrome

Evdokimova T. A., Ogorodova L. M. Impact of chronic opisthorchiasis infestation on the clinical course and immune response in pneumonia in children // Pediatrics. Speransky Journal. - 2025. - Vol. 84. - No. 6. - Pp. 12-17.

Makatsaria A. D. et al. Thrombotic storm, hemostatic disorders, and thromboinflammation in the context of COVID-19 // Obstetrics, Gynecology, and Reproduction. - 2021. - Vol. 15. - No. 5. - Pp. 499-514.

Skripchenko N. V. et al. Hemostasis system factors as biomarkers of severe acute viral infections // S. S. Korsakov Journal of Neurology and Psychiatry. – 2024. – Vol. 124. – No. 3. – P. 63-74.

Tashmatova G. A., Khalmatova B. T. The state of the digestive system of children suffering from bronchial asthma // Experimental and Clinical Gastroenterology. – 2020. – No. 1 (173). – P. 84-86.

Chang J., Liu W., Yin C. Clinical application of C-reactive protein, leukocyte and immunoglobulin in the diagnosis and treatment of infantile pneumonia at the acute stage // Signa Vitae. – 2023. – Vol. 19. – No. 5.

Hirata N. et al. Recombinant human thrombomodulin for pneumonia-induced severe ARDS complicated by DIC in children: A preliminary study // Journal of anesthesia. – 2021. – T. 35. – No. 5. – pp. 638-645.

Kumari M. V. et al. Gastric motility and pulmonary function in children with functional abdominal pain disorders and asthma: A pathophysiological study //Plos one. – 2022. – T. 17. – No. 1. – P. e0262086.

Profir I., Popescu C. M., Nechita A. Fatal Influenza B–MRSA Coinfection in a Healthy Adolescent: Necrotizing Pneumonia, Cytokine Storm, and Multi-Organ Failure //Children. – 2025. – T. 12. – No. 6. – P. 766.

Tashmatova G. A. Influence of coronavirus infection covid-19 on the frequency of exacerbations of bronchial asthma in children //American journal of education and learning. – 2024. – T. 2. – No. 4. – pp. 643-649.

Totapally B. R., Totapally A., Martinez P. A. Thrombocytopenia in Critically Ill Children: A Review for Practicing Clinicians //Children. – 2025. – T. 12. – No. 1. – P. 83.