Chen Hui, Chen Yong, Zhong Jian Min
Department of Neurology, Children's Hospital of Jiangxi Province, Nanchang, China.
Medicine (Baltimore). 2020 Nov 25;99(48):e23439. doi: 10.1097/MD.0000000000023439.
Benign convulsions with mild gastroenteritis (CwG) and febrile seizures (FS) associated with mild gastroenteritis are 2 different diseases in the spectrum of seizures associated with mild gastroenteritis. However, specific and useful indicators for the identification of the 2 diseases are lacking. A retrospective analysis was performed to compare the serum neuronal-specific enolase (NSE) and S100B protein levels between patients with these 2 diseases to evaluate the value of NSE and S100B for differential diagnosis between these 2 diseases.The clinical data and NSE and S100B protein levels of 81 children with seizure-associated mild gastroenteritis were collected. According to the axillary temperature at the time of convulsions, all patients were classified into an afebrile seizure (AFS) group, hereafter called the CwG group (n = 46), and a febrile seizure group (FS group, n = 35).The serum NSE level was higher in the CwG group than in the FS group (14.046 (11.095, 19.266) pg/ml and 9.034 (7.158, 12.165) pg/ml, respectively, P < .001); however, the serum S100B protein levels in the CwG and the FS group were not significantly different (P > .05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for NSE was 0.806, P = .000, which was statistically significant. The Youden index was largest (0.605) for a serum NSE cut-off value of 10.460 pg/ml, which yielded a sensitivity and specificity of 89% and 71%, respectively, for prediction of a CwG diagnosis.NSE may contribute to the differential diagnosis of CwG and FS associated with mild gastroenteritis.
伴有轻度胃肠炎的良性惊厥（CwG）以及与轻度胃肠炎相关的热性惊厥（FS）是轻度胃肠炎相关惊厥谱中的两种不同疾病。然而，缺乏用于鉴别这两种疾病的特异性且有用的指标。进行了一项回顾性分析，以比较这两种疾病患者血清神经元特异性烯醇化酶（NSE）和S100B蛋白水平，评估NSE和S100B在这两种疾病鉴别诊断中的价值。收集了81例与惊厥相关的轻度胃肠炎患儿的临床资料以及NSE和S100B蛋白水平。根据惊厥时的腋温，将所有患者分为无热惊厥（AFS）组，以下称为CwG组（n = 46）和热性惊厥组（FS组，n = 35）。CwG组血清NSE水平高于FS组（分别为14.046（11.095，19.266）pg/ml和9.034（7.158，12.165）pg/ml，P <.001）；然而，CwG组和FS组的血清S100B蛋白水平无显著差异（P >.05）。受试者工作特征（ROC）曲线分析显示，NSE的曲线下面积（AUC）为0.806，P =.000，具有统计学意义。血清NSE临界值为10.460 pg/ml时约登指数最大（0.605），预测CwG诊断的敏感性和特异性分别为89%和71%。NSE可能有助于轻度胃肠炎相关CwG和FS的鉴别诊断。
