Yamaguchi H, Nishiyama M, Tokumoto S, et al. - Researchers intended to define the characteristics of hemorrhagic shock and encephalopathy syndrome (HSES) by assessing alterations in serum biomarker concentrations over time. This analysis involved six patients with HSES. In the first 24 h, cytokine and chemokine levels were the highest and reduced thereafter. A markedly high level of growth and differentiation factor 15 (GDF-15) was detected. Except for IL(interleukin)-2 and IL-4, patients with HSES exhibited significantly higher cytokine, chemokine, and GDF-15 levels in the first 24 h, compared with controls. High inflammatory cytokine and chemokine concentrations, an elevated GDF-15 level in the first 24 h, and raised lactate levels, all were found in patients with HSES. This work affords not only new insights on the pathophysiology of HSES, but also an in-depth clinical picture of cases with HSES, as well as potential biomarkers.