Comparisons of Clinical Features among Influenza A (H1N1) and Seasonal Influenza A and B during 2009 to 2010 at a Single Institution / 소아알레르기및호흡기학회지

PURPOSE: This study was performed to compare the clinical features of pediatric patients who were diagnosed with influenza A (H1N1) or seasonal influenza A and B during 2009 and 2010 at a single institution. METHODS: Among children who visited the Dong-A University Hospital with fever (>37.8degrees C) and acute respiratory symptoms from September 2009 to February 2010, 1,004 children who were diagnosed with influenza A (H1N1) or seasonal influenza A and B by reverse transcription-polymerase chain reaction (RT-PCR) were enrolled. Monthly incidence, fever duration before diagnosis, symptoms (fever, cough, rhinorrhea, sore throat, headache, vomiting, abdominal pain, diarrhea, seizure, and dyspnea) and signs (rales, wheezing) were reviewed retrospectively in each group based on medical records. RESULTS: Influenza A (H1N1) was detected in 944 patients (94.0%), followed by seasonal influenza A in 42 (4.2%) and seasonal influenza B in 8 (1.8%). The positive rate of influenza infection was highest in November 2009 (n=557, 55.5%). Mean duration of fever before RT-PCR was 1.6 days (range, 1.5 to 1.8 days). Except fever, cough was the most common symptom (n=792, 78.9%), followed by rhinorrhea in 407 patients (40.5%). Rales and wheezing were detected in 16 patients (1.6%) and 19 (1.9%), respectively. Significant differences were observed for the number of patients who had cough, headache, vomiting, and wheezing among the three groups (P<0.05). CONCLUSION: Although the incidence of cough, headache, vomiting, and wheezing differed significantly among the three groups, the number of patients in each group was too different to compare the results.

Hypertension Caused by Renal Arteriovenous Fistula

We describe a case of secondary hypertension caused by renal arteriovenous fistula. An 8-year old girl was hospitalized with a severe headache, vomiting, and seizure. Renal angiography demonstrated multiple renal arteriovenous fistula and increased blood renin concentration in the left renal vein. Thus, left renal arteriovenous fistula and renin induced secondary hypertension were diagnosed. Her blood pressure was well controlled by medication with angiotensin converting enzyme inhibitor.

The Efficacy of a Leukotriene Receptor Antagonist and a Second-generation Anti-histamine in the Treatment for Children with Moderate to Severe Persistent Allergic Rhinitis / 소아알레르기및호흡기학회지

PURPOSE: We evaluated the efficacy of leukotriene receptor antagonist and second generation anti-histamine in children with moderate to severe persistent allergic rhinitis. METHODS: Twenty eight patients who were treated with second generation anti-histamine for 4 weeks (Zyrtec syrup(R), Group A) and 58 patients who were treated with leukotriene receptor antagonist for 4 weeks (Singulair(R), Group B) were enrolled in this study. Control group (n=22) was received only first generation anti-histamine (Hydroxyzine) intermittently. Efficacy were evaluated by nasal scores in nasal congestion, rhinorrhea, nasal itching, sneezing and total nasal symptom score (a sum of patient ratings of nasal congestion, rhinorrhea, nasal itching, sneezing) before treatment and at 2 and 4 weeks after treatment. RESULTS: There were no difference in the total IgE and total eosinophil count of 3 groups. There were also no significant difference in the initial symptom scores. For nasal congestion, group A and B showed significant improvement at 2 and 4 weeks after treatment compared with controls (each P=0.006, P=0.000, P=0.023, P=0.001). For sneezing, group A and B showed significant improvement at 2 weeks after treatment compared with controls (each P=0.048, P=0.011) and group B also showed significant improvement at 4 weeks after treatment compared with controls (P=0.041). In total nasal symptom score (TNSS), group A and B showed significant improvement at 2 and 4 weeks after treatment compared with controls (each P=0.014, P=0.005, P=0.008, P=0.005). CONCLUSION: In the moderate to severe persistent allergic rhinitis, leukotriene receptor antagonist or second generation anti-histamine is effective in nasal congestion and sneezing.