Management and outcome of benign acute childhood myositis in pediatric emergency department
| Autor: | Claudio Bruno, Marta Romanengo, Chiara Panicucci, Emanuela Piccotti, Alberto Gaiero, Giacomo Brisca, Marcello Mariani, Angela Pistorio, Daniela Pirlo |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Rest Physical examination Neurological examination Rhabdomyolysis 03 medical and health sciences 0302 clinical medicine Clinical pathway Recurrence medicine Humans Creatine kinase Child Children Myositis Retrospective Studies Neurologic Examination Analgesics medicine.diagnostic_test business.industry Research Medical record Myoglobinuria lcsh:RJ1-570 lcsh:Pediatrics 030208 emergency & critical care medicine Retrospective cohort study Emergency department medicine.disease Hospitalization Virus Diseases Gait abnormalities Child Preschool Acute Disease Fluid Therapy Female Emergency Service Hospital business 030217 neurology & neurosurgery |
| Zdroj: | Italian Journal of Pediatrics, Vol 47, Iss 1, Pp 1-8 (2021) Italian Journal of Pediatrics |
| ISSN: | 1824-7288 |
| Popis: | Background Benign acute childhood myositis (BACM) is a self-limited syndrome associated with viral infections characterized by symmetric lower extremity pain typically affecting school-aged children. Evolution in rhabdomyolysis and kidney damage is rarely reported. Despite this, the acute presentation commonly concerns both parents and health care providers, often leading to unnecessary workup. The aim of the study was to determine the features and outcome of a large series of children with BACM identifying a management pathway for pediatricians in Emergency Department (ED). Methods We conducted a retrospective study of patients with BACM managed in 2 Italian pediatric ED during a period of 8 and a half years. Demographic data, clinical, and laboratory results were extracted from electronic medical records. Recurrence, complications, treatments, and outcomes were also recorded. Descriptive statistics were produced for first-episode patients and for those with recurrence of myositis. A comparison between groups was performed. Results One hundred and thirteen patients with BACM were identified. Ninety-two children (65 males) had a single episode, while ten (nine males) had recurrence. The mean age at presentation was 6.0 years (range 2–13,2). All patients had normal neurological examination and no one developed myoglobinuria, or renal failure. At first evaluation median CK level was 1413 UI/l (normal values Median CK of “recurrent” patients was higher than “non-recurrent” (2330 vs 1150 U/L, p = 0.009). Viral studies were positive in 51/74 cases, with high prevalence of Influenza viruses. Ninety-six patients (85%) were hospitalized with a median of 4 days. No patients had any residual muscular impairment. Conclusions BACM has an excellent prognosis. Severe pathological conditions can be excluded with a complete history and clinical examination and simple blood and urine tests, avoiding unnecessary diagnostic investigations. Most patients may be discharged home from ED recommending hydration, rest, analgesics and careful follow-up. |
| Databáze: | OpenAIRE |
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