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Objective:To investigate the incidence and clinical characteristics of Kawasaki disease complicated with arthritis, and explore the relationship with coronary artery disease.Methods:Patients diagnosed with Kawasaki disease at Xiamen Children′s Hospital from January 2015 to June 2020 were included in this study.They were divided into the arthritis group( n=53) and the non-arthritis group( n=401), depending on whether complicated with arthritis.Demographic, clinical symptoms, and laboratory results were retrospectively analyzed. Results:A total of 454 children were included in this study with 53 cases acomplicated with arthritis.There were 32 male cases and 21 female cases.The average age of arthritis group was(5.89±1.35) y, which was older than non-arthritis group[(4.28±1.25) y, P=0.026]. Among the 53 cases of arthritis group, 36 cases (67.92%)of small jiont arthritis, 14 cases(26.41%)of coxitis, ten cases(18.87%)of carpitis, eight cases(15.09%)of gonitis, four cases(7.55%)of anconitis, and three cases(5.66%) of ankle arthritis were involved.There was a statistic difference in the prevalence of intravenous immunogloblin(IVIG)resistant between arthritis group and non-arthritis group(14 cases, 26.14% vs.43 cases, 10.72%, P=0.002). The inflammatory markers(CRP, TNF-α, IL-6) of the arthritis group were significantly higher than those in the non-arthritis group, and the differences were statistically significant( P<0.05, respectively). The incidence of coronary artery disease in the arthritis group(60.38%, 32/53) was higher than that in the non-arthritis group(52.37%, 210/401), but the difference was not statistically significant( P>0.05). Conclusion:Kawasaki disease with arthritis in children is self-limited, with no sequelae.Patients in the arthritis group have a higher rate of IVIG resistance and higher levels of inflammatory markers, but no significant difference in the incidence of coronary artery disease compared with those without arthritis.
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Objective:To analyze the clinical characteristics of plastic bronchitis(PB) caused by adenoviral pneumonia.Methods:The clinical data of 9 children diagnosed with PB caused by adenoviral pneumonia in the Xiamen Children′s Hospital from March to June 2019 were retrospectively analyzed.Results:Among the 9 children(3 boys and 6 girls), 6 patients were under 2 years old.All patients had fever, cough and dyspnea, with the duration of 6-15 days.Laboratory tests showed that procalcitonin(PCT) and increased in 7 children, D-dimer, fibrinogen degraded product (FDP) were increased in 6 children, and lactate dehydrogenase(LDH) was increased in 8 children.Chest imaging examination showed atelectasis with pulmonary consolidation in 9 children, including 4 cases of left lower lobe consolidation, 2 cases of right lower lobe consolidation, 1 case of right upper lung consolidation, and 2 cases of consolidation of multiple lungs in the lower lobe.Seven cases had pleural effusion.By fiberoptic bronchoscopy, the bronchial plastics was removed from the left lower lobe in 5 patients, from the right lower lobe in 3 patients, and from the right upper lobe in 1 patient on the 6th to 20 th day of the disease.Eight patients were discharged after clinical cure.One patient deve-loped multiple organ failure, and discharged from the hospital after the family members gave up rescue.The death was reported by the telephone follow-up death. Conclusions:PB is considered when patients with adenovirus pneumonia have persistent high fever, shortness of breath, dyspnea, pulmonary consolidation/lung atelectasis, increased PCT and LDH, hypercoagulability of the blood, and pleural effusion.Fiberoptic bronchoscopy plays an important role in confirming the diagnosis and improving the prognosis.
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Objective To investigate the correlation and clinical significance between the serum 25-hydrovitamin D3[25-(OH)D3] level and bronchiolitis in children. Methods Sixty-one children with bronchiolitis diagnosed by Xiamen Children′s Hospital between September 2016 and June 2017 were enrolled in the study. Forty-one healthy children were used as the healthy control group. All the children were tested by enzyme-linked immunosorbent assay for serum 25-(OH)D3levels and serum IgE,IgG,IgA and IgM content. The clinical data of children with bronchiolitis group were recorded in the meanwhile. Results (1) Com-paredwiththehealthycontrolgroup,theserumlevelsof25-(OH)D3[(59.47±23.66)nmol/Lvs.(69.94± 25.19)nmol/L],IgM[(1.27±0.49)g/Lvs.(1.56±0.43)g/L]andIgA[(1.38±0.83)g/Lvs.(1.71± 0. 61)g/L] were significantly lower in children with bronchiolitis;while the serum IgE[(106. 59 ± 67. 74) IU/L vs. (75. 95 ± 35. 27)IU/L] was significantly higher(P<0. 05). (2)The serum levels of IgE,IgG and IgA in children diagnosed bronchiolitis with vitamin D deficiency [( 177. 37 ± 82. 72 ) IU/L, ( 5. 46 ± 1. 95)g/L and(0. 68 ± 0. 24) g/L] were obviously different from those of children diagnosed bronchiolitis with vitamin D inadequate[(94.21 ±44.21)IU/L,(7.14 ±2.82)g/L and(1.35 ±0.72)g/L] and vitamin D normal group[(79. 60 ± 44. 30)IU/L,(8. 03 ± 2. 49)g/L and(1. 57 ± 0. 78)g/L](P<0. 05). There was no significant difference about serum levels of IgE,IgG,IgA and IgM between vitamin D inadequate and vita- min D normal group(P>0. 05). (3)The wheeze time was higher in bronchiolitis children with vitamin D deficiency[(3. 97 ± 1. 01) d] than those of patients with vitamin D inadequate[(2. 41 ± 0. 79) d] and vitamin D normal group[(2. 27 ± 0. 88)d](P<0. 05). The level of venous glucocorticoid utilization was higher in bronchiolitis children with vitamin D deficiency than that of patients with vitamin D normal group (58. 82% vs. 29. 03%)(P<0. 05). There was no significant difference about clinical data between vitamin D inadequate and vitamin D normal group(P>0. 05). Conclusion The serum 25-(OH)D3levels are lower in children with bronchiolitis than those in healthy children. The lower the level of vitamin D,the more severe the children with bronchiolitis. Vitamin D deficiency is an important cause of bronchiolitis in children,which may be related to immune dysfunction effected by vitamin D deficiency.
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Objective To study the effects of hydrochloric acid ambroxol injection (mucosolvan) on the premature pneumonia.Methods Hydrochloric acid ambroxol was applied to treat 49 premature with pneumonia.Results The total effective rate of the treatment group was 89.8% and 66.1% of the control group.There was significant difference in the therapeutic effect between the two groups (P