Pediatrik akut enfeksiyöz miyozitlerin klinik ve laboratuvar özellikleri: 26 hastanın değerlendirilmesi
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Date
2020-01-09
Authors
Danış, Ayşegül
Köken, Özlem Yayıcı
Kayılıoğlu, Hülya
Aksoy, Ayşe
Yüksel, Deniz
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Enfeksiyöz ve idiopatik olarak iki ana grupta incelenen, inflamatuvar miyopatiler içinde etken ajanın tespit edilebildiği enfeksiyöz miyozitler; çocuklarda genellikle viral üst solunum yolu enfeksiyonlarını takiben 1-5 günlük dönemde ortaya çıkan, yaygın kas ağrısı, yürümede güçlük ile karakterize, çoğunlukla kendiliğinden düzelen selim tablolardır. Bu çalışmada amaç çocukluk çağı akut enfeksiyöz miyoziti tanısı ile takip edilen hastalarımızın klinik ve laboratuvar özelliklerini incelemektir. YÖNTEM ve GEREÇLER: Sağlık Bilimleri Üniversitesi Ankara Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk Nöroloji Polikliniğine son beş yılda başvuran ve akut enfeksiyöz ve idiopatik miyozit tanısı alan hastalar retrospektif olarak dosya bilgileri ile incelendi. BULGULAR: Ani başlayan yaygın kas ağrısı, yürümede güçlük şikayeti ile başvuran ortalama yaşları 79.6 ay ve %57. 7’ si erkek (n=15) toplamda 26 hastanın; %73.1’ inde (n:19) yakın zamanda geçirilmiş üst solunum yolu enfeksiyonu öyküsü mevcuttu. Başvuruda bakılan ortalama kreatin fosfokinaz düzeyleri 2596 IU/L idi. Enfeksiyöz etken toplam 9 hastada (%26.9) tespit edilebildi. Bu etkenler; İnfluenza B (n=3), A grubu beta hemolitik streptokok (n=2), İnfluenza A/H1N1 (n=1) ve Mycoplasma pneumoniae (n=1) idi. 1 hasta Escherichia coli’ ye bağlı ürosepsis, 1 hasta Metisilin dirençli Stafilococcus aureus’ a bağlı sepsis tanısı aldı. Bulgular hastaların çoğunda en geç 48 saat içerisinde düzelmeye başlamakla birlikte ortalama iyileşme süresi 8.31± 5.8 gündü. : Çocukluk çağı akut enfeksiyon ilişkili inflamatuvar miyozitinin rabdomiyoliz riski nedeniyle hızlı tanınıp yakın izlem gerektirmesi, akut güçsüzlükle başvuran hastaların ayırıcı tanısında mutlaka ilk akla gelen tanılardan olması nedeniyle çocuk hekimleri tarafından çok iyi bilinmelidir.
Inflammatory myopathies can be defined in two groups as infectious and idiopathic myopathies. Infectious myositis, in which active agent can be detected, is a benign condition that usually occurs spontaneously in childhood, characterized by generalized muscle pain and difficulty in walking. The aim of this study is to provide the clinical features of our pediatric patients with acute myositis. : A total of 26 patients with acute infectious and idiopathic myositis who were admitted to Health Sciences University Ankara Dr Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, pediatric neurology outpatient clinic for the last 5 years were retrospectively reviewed. RESULTS: The patients with the mean age of 79.6 months, who had a sudden onset of muscle pain and difficulty in walking with a recent history of upper respiratory tract infection in 73.1% (n: 19) were evaluated. The mean creatine phosphokinase levels were 2596 IU / L. Infectious agents were detected in 7 patients (26.9%). These factors were influenza B (n = 3), group A beta hemolytic streptococci (n = 2), influenza A / H1N1 (n = 1) and Mycoplasma pneumoniae (n = 1). One patient was diagnosed as Escherichia coli induced urinary sepsis and 1 patient was diagnosed as sepsis due to Methicillinresistant Staphylococcus aureus Most of the patients started to recover within 48 hours, but the mean duration of healing was 8.31 ± 5.8 days Acute inflammatory myositis in childhood, which should be recognized rapidly due to the diseases requiring urgent treatment in the differential diagnosis, close follow-up in terms of the risk of rhabdomyolysisis, is usually resulted with a good prognosis important.
Inflammatory myopathies can be defined in two groups as infectious and idiopathic myopathies. Infectious myositis, in which active agent can be detected, is a benign condition that usually occurs spontaneously in childhood, characterized by generalized muscle pain and difficulty in walking. The aim of this study is to provide the clinical features of our pediatric patients with acute myositis. : A total of 26 patients with acute infectious and idiopathic myositis who were admitted to Health Sciences University Ankara Dr Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, pediatric neurology outpatient clinic for the last 5 years were retrospectively reviewed. RESULTS: The patients with the mean age of 79.6 months, who had a sudden onset of muscle pain and difficulty in walking with a recent history of upper respiratory tract infection in 73.1% (n: 19) were evaluated. The mean creatine phosphokinase levels were 2596 IU / L. Infectious agents were detected in 7 patients (26.9%). These factors were influenza B (n = 3), group A beta hemolytic streptococci (n = 2), influenza A / H1N1 (n = 1) and Mycoplasma pneumoniae (n = 1). One patient was diagnosed as Escherichia coli induced urinary sepsis and 1 patient was diagnosed as sepsis due to Methicillinresistant Staphylococcus aureus Most of the patients started to recover within 48 hours, but the mean duration of healing was 8.31 ± 5.8 days Acute inflammatory myositis in childhood, which should be recognized rapidly due to the diseases requiring urgent treatment in the differential diagnosis, close follow-up in terms of the risk of rhabdomyolysisis, is usually resulted with a good prognosis important.
Description
Keywords
Myozit, Myositis, Enfeksiyöz, Viral, Infectious
Citation
Danış, A. (2020). "Pediatrik akut enfeksiyöz miyozitlerin klinik ve laboratuvar özellikleri: 26 hastanın değerlendirilmesi". Güncel Pediatri Dergisi, 18(1),95-103