Department of Pediatrics, Division of Emergency Medicine, Ege University School of Medicine, Izmir, Turkey.
Department of Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey.
J Paediatr Child Health. 2022 Jun;58(6):1022-1027. doi: 10.1111/jpc.15894. Epub 2022 Feb 7.
To investigate the association of benign acute childhood myositis (BACM) with respiratory viruses. Also, we aimed to assess the effect of antiviral treatment on the improvement and complications.
This study was conducted at an urban-academic emergency department during four influenza-seasons (2016-2019), retrospectively. Demographics, clinical findings, laboratories, metabolic disease analyses and serological features were extracted from the medical records. Treatments, complications and outcomes were also recorded.
A total of 114 children were included. The median age was 7.0 (min 1.25-max 17) years and 78.9% were male. The most common symptoms were leg pain (91.2%), anorexia (54.4%), fever (45.6%), sore throat (42.1%) and walking difficulty (32.5%). On admission, the median creatine phosphokinase level was 3332 IU/L (range, 1634-50 185), median aspartate aminotransferase 107 U/L (range, 38-1798). In the multiplex polymerase chain reaction analysis, 40.4% influenza B, 36.8% influenza A, 7.8% adenovirus, 7.8% parainfluenza virus, 5.3% rhinovirus, 5.3% respiratory syncytial virus and 1.8% Mycoplasma pneumoniae were detected. Rhabdomyolysis was developed in 6.7% and acute renal failure was seen in two patients. Oseltamivir was given in 44 (38.6%) patients who had influenza A/B. Metabolic disease screening tests were performed in 33.3% of patients and metabolic diseases were detected in 4 (3.5%) patients. The median recovery time was lower in patients with oseltamivir treatment (4 (min 2-max 5) - 5 (min 3-max 10) days) (P < 0.001).
Rhabdomyolysis is more common in BACM due to the influenza A virus. The early use of oseltamivir treatment was significantly associated with a shorter recovery time.
研究良性急性儿童肌炎（BACM）与呼吸道病毒的关系。我们还旨在评估抗病毒治疗对改善和并发症的影响。
本研究在四个流感季节（2016-2019 年）期间在城市学术急诊室进行，回顾性研究。从病历中提取人口统计学、临床发现、实验室、代谢性疾病分析和血清学特征。还记录了治疗、并发症和结局。
共纳入 114 例儿童。中位年龄为 7.0 岁（最小 1.25-最大 17 岁），78.9%为男性。最常见的症状是腿痛（91.2%）、食欲不振（54.4%）、发热（45.6%）、咽痛（42.1%）和行走困难（32.5%）。入院时，肌酸磷酸激酶中位数为 3332IU/L（范围 1634-50185），天门冬氨酸氨基转移酶中位数为 107U/L（范围 38-1798）。在多重聚合酶链反应分析中，检测到 40.4%的乙型流感、36.8%的甲型流感、7.8%的腺病毒、7.8%的副流感病毒、5.3%的鼻病毒、5.3%的呼吸道合胞病毒和 1.8%的肺炎支原体。6.7%发生横纹肌溶解症，2 例发生急性肾衰竭。给予奥司他韦治疗 44 例（38.6%）流感 A/B 患者。对 33.3%的患者进行代谢性疾病筛查试验，发现 4 例（3.5%）患者存在代谢性疾病。奥司他韦治疗组的中位恢复时间较低（4（min 2-max 5）-5（min 3-max 10）天）（P<0.001）。
流感 A 病毒导致 BACM 更常发生横纹肌溶解症。早期使用奥司他韦治疗与恢复时间缩短显著相关。
