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[良性急性儿童肌炎(BACM)——病例报告]

[Benign acute childhood myositis (BACM)--cases report].

作者信息

Hozyasz Kamil K, Gryglicka Halina, Radomyska Barbara

机构信息

Institute of Mother and Child in Warsaw, Department of Pediatrics, Poland.

出版信息

Pol Merkur Lekarski. 2009 Aug;27(158):129-31.

Abstract

Benign acute childhood myositis (BACM) is characterised by sudden calf pain and inability to walk. We analyzed the characteristics of seven boys and two girls with BACM treated in the Pediatric Department from April 2005 to March 2009. The mean age at onset of symptoms was 7 +/- 2 years. Two boys were hospitalized twice for BACM. All cases occurred in winter or spring. 7 out of all admissions were clustered together in one week long periods. Patients demonstrated prodromal symptoms of flu-like illness followed by the sudden onset of difficulty in walking. One girl additionally complained of a painful right hip. Four patients received inosine pranobex for prodromal viral infection before the clinical onset of myositis. In all cases, creatine phosphokinase (CPK; the highest value at 8988 U/l) and aspartate aminotransferase (AST; the highest value at 329 U/l) values were elevated. The serum concentration of myoglobin was elevated in five out of six tested patients (the highest value at 2172 microg/l). The following haematological abnormalities were detected: leucocytopenia (the lowest WBC 1.35 x 10(3)/microl), neutropenia, and trombocytopenia. All patients made a rapid recovery within 1 to 5 days. Pediatricians and emergency medicine specialists must be aware that BACM is a self-limiting disorder with the acute onset of inability to walk, elevated CPK and AST levels, and transient haematological abnormalities. There is no sufficient data from clinical reports on immunostimulant use before the onset of BACM.

摘要

良性急性儿童肌炎(BACM)的特征是突发小腿疼痛和无法行走。我们分析了2005年4月至2009年3月在儿科接受治疗的7名男孩和2名女孩的BACM特征。症状发作时的平均年龄为7±2岁。两名男孩因BACM住院两次。所有病例均发生在冬季或春季。所有入院病例中有7例集中在为期一周的时间内。患者表现出流感样疾病的前驱症状,随后突然出现行走困难。一名女孩还抱怨右髋疼痛。4名患者在肌炎临床发作前因前驱病毒感染接受了异丙肌苷治疗。在所有病例中,肌酸磷酸激酶(CPK;最高值为8988 U/l)和天冬氨酸转氨酶(AST;最高值为329 U/l)值均升高。6名接受检测的患者中有5名肌红蛋白血清浓度升高(最高值为2172μg/l)。检测到以下血液学异常:白细胞减少(最低白细胞计数为1.35×10³/μl)、中性粒细胞减少和血小板减少。所有患者在1至5天内迅速康复。儿科医生和急诊医学专家必须意识到,BACM是一种自限性疾病,其急性发作表现为无法行走、CPK和AST水平升高以及短暂的血液学异常。在BACM发作前使用免疫刺激剂的临床报告数据不足。

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