Clinical Observations of Kikuchi-Fujimoto Disease in Children and Adolescents: A Single Center Experience / 이화의대지

OBJECTIVES: Kikuchi-Fujimoto disease (KFD) is characterized by lymphadenopathy and fever, and is usually self-limited. This study analyzed the clinical characteristics of pediatric patients with KFD. METHODS: This retrospective, observational, single-center study was conducted in South Korea from March 2008 to October 2015. KFD was diagnosed based on clinical, radiological or histological findings and excluded when there were any other causes of lymphadenopathy. Medical records were reviewed for clinical and laboratory manifestations. RESULTS: A total of 35 cases were included. The mean patient age was 12.1±2.9 years (range, 5 to 17 years); the male-to-female ratio was 1:0.8. The main clinical manifestations were cervical lymphadenopathy and fever in 34 cases (97%). The mean duration of fever was 12.2±8.3 days (range, 2 to 37 days). We noted enlargement of lymph nodes in the cervical, mesenteric (n=5, 14%), axillary (n=2, 6%), and inguinal (n=1, 3%) regions. Hepatosplenomegaly, loss of appetite, and rash were observed. On laboratory examinations, elevation of ferritin, leukopenia, and positivity for anti-nuclear antibodies were frequently observed. Twelve patients underwent biopsy and 23 cases were diagnosed by radiological findings. The mean duration of hospitalization for all cases was 7.9±2.9 days (range, 3 to 13 days) and steroids were administered in 10 cases. KFD recurrence was observed in 2 cases (5.7%) with the time to relapse of 7 months and 4 years. There were no cases with systemic lupus erythematous or other autoimmune disease. CONCLUSION: KFD should be considered in pediatric patients with lymphadenopathy and prolonged fever. Patients with KFD should be monitored for recurrence and the development of autoimmune disease.

C-reactive protein and N-terminal pro-brain natriuretic peptide discrepancy: a differentiation of adenoviral pharyngoconjunctival fever from Kawasaki disease / 소아과

PURPOSE: To differentiate adenoviral pharyngoconjunctival fever (PCF) from acute Kawasaki disease (KD) using laboratory tests before results of virus-real time polymerase chain reaction and ophthalmologic examination are obtained. METHODS: Baseline patient characteristics and laboratory measurements were compared between 40 patients with adenovirus infection and 123 patients with KD. RESULTS: The patients with adenovirus infection were generally older than those with KD (median: 3.9 years vs. 2 years, P=0.000). White blood cell and, platelet count, and aspartate aminotransferase, alanine aminotransferase, and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels showed significant differences between the 2 groups, but the C-reactive protein (CRP) levels did not (6.8±3.0 mg/dL vs. 8.3±5.8 mg/dL, P=0.126). In the adenovirus infection group, the CRP levels were < 1, < 3, < 10, and ≥10 mg/dL in 2 (5%), 3 (7.5%), 30 (75%), and 5 patients (12.5%), respectively. The cutoff NT-proBNP level was 265 pg/mL. Discrepancy was defined as CRP and NT-proBNP levels of ≥3 or < 3 mg/dL, and < 265 or ≥265 pg/mL, respectively. Among the 35 patients with adenovirus infection whose CRP levels were ≥3 mg/dL, 29 (82.9%) showed a discrepancy. Conversely, of the 103 patients with KD whose CRP levels were ≥3 mg/dL, 83 (80.6%) showed no discrepancy. Between the groups, a significant difference in discrepancy rate was observed (P=0.000). None of the patients with adenovirus infection had CRP and NT-proBNP levels of < 3 mg/dL and ≥265 pg/mL, respectively. CONCLUSION: With a sensitivity of 82.9% and a specificity of 80.6%, CRP and NT-proBNP levels may differentiate between adenoviral PCF and acute KD.

Clinical Characteristics and Epidemiology of Enteroviral Meningitis Compared to Non-Enteroviral Meningitis in Infants under 3 Months of Age / 이화의대지

OBJECTIVES: To compare the epidemiology, clinical presentation, laboratory findings, seasonality and hospital course of enteroviral meningitis (EM) and non-enteroviral meningitis (NEM) cases in infants under 3 months of age. METHODS: A retrospective chart review was performed of infants under 3 months of age or less with viral meningitis admitted to Ewha Womans University Mokdong Hospital between January 2010 and December 2016. RESULTS: EM patients were more likely to have siblings compared with NEM. Most of EM was diagnosed during the summer season. Almost 80% of EM was diagnosed between July and September. Fever lasted longer in EM patients compared to NEM. White blood cell count (WBC) from the cerebrospinal fluid was higher in EM patients compared with NEM patients. WBC in blood were lower in EM patients compared with NEM patients. C-reactive protein was lower in EM patients compared with NEM patients. Most of the patients were initially started on antibiotics therapy to rule out bacterial meningitis. EM patients received shorter duration of antibiotic treatment compared with NEM patients. CONCLUSION: This study was conducted to augment the understanding of the incidence, epidemiology, transmission in infants, clinical presentation, laboratory findings, seasonality and hospital courses of enteroviral meningitis compared to NEM. Early recognition, rapid diagnosis and proper clinical management can reduce duration of antibiotic treatment.

Obesity and Weight Control Prevalence of Middle School Students in Seoul, Gyong-gi Area

The purpose of this study was to evaluate the obesity and weight control prevalence according to the gender and weight control attempt among middle school students in Seoul and Kyunggi-do, Korea. The mean age of subjects were 14.4 years old. The mean height, weight and BMI value of boy students were 164.0 cm, 53.0 kg, and 19.7 kg/m2, respectively, and the mean height, weight and BMI value of girl students were 159.4 cm, 49.8kg, and 19.6kg/m2, respectively. Both weight and BMI value of the weight loss attempt groups were significantly heavier and higher than those of the other groups (p < 0.01). In the perception on the body image, the girls perceived themselves to be more fat compared to boys, and the weight loss attempt group perceived their body image to be more fat compared to the other groups (p < 0.001). As for the interest degree of weight control, the interest degree of girls was higher than that of boys (p < 0.01). According to weight control attempt, in the order of the weight loss attempt group, the weight gain attempt group and the no weight control attempt group, the interest degree was significantly higher (p < 0.001). In the frequency and hours of exercise, there was significant difference by gender (p < 0.001). According to weight control attempt, the weight gain attempt group exercised more frequently than the other attempt groups (p < 0.01).

A Study on Weight Control and Dietary Life among Middle School Students: Nutrition Knowledge, Dietary Behavior and Food Frequency

The purpose of this study is to compare the nutrition knowledge, dietary behavior and food frequency according to the gender and weight control attempt among middle school students in Seoul and Gyunggi-do, Korea. The subjects were divided into three groups, one with experience in attempting to lose their weight, one with experience in attempting to gain their weight and one with no experience in attempting to control their weight. Nutrition knowledge level of girls was higher than that of boys (p < 0.01), but there were no significant difference according to weight control attempt. As for the scores of dietary behavior, there were no significant differences by gender but according to weight control attempt, the scores of dietary behavior of the weight loss attempt group were higher than those of the other attempt groups (p < 0.01). In the food intake frequency, there were significant differences according to weight control attempt (p < 0.05, p < 0.01).