ABSTRACT
BACKGROUND: Our goal was to study the demographic, clinical and laboratory profile and outcome of scrub typhus-associated hemophagocytic lymphohistiocytosis (HLH) in the pediatric age group. METHODS: We conducted a prospective observational study in a tertiary care teaching hospital over a period of 1 year. Children in the age group of 1 month to 12 years with IgM ELISA positive for scrub typhus were included in the study. HLH was diagnosed using HLH-2004 criteria. Demographic, clinical and laboratory profile, treatment and outcome of HLH patients were noted and also compared with non-HLH scrub typhus patients. RESULTS: Among 58 children with scrub typhus infection, 18 had HLH. The mean age of patients with HLH was 35.3 ± 44.8 months and 61% were male. Anemia, thrombocytopenia and hyperferritinemia were seen in all the patients. Hypertriglyceridemia, hypofibrinogenemia and coagulopathy were noted in 78%, 56% and 44%, respectively. All the patients were treated with intravenous doxycycline for an average duration of 9.5 days. Intravenous immunoglobulin and methylprednisolone were given in 33% and 22% cases, respectively. Complications like acute respiratory distress syndrome (ARDS) (p = 0.001) and MODS (p = 0.004) were significantly high in the HLH group. Younger age (<3 years), fever > 7 days, presence of convulsion, ARDS and MODS were the clinical predictors of scrub typhus-associated HLH. CONCLUSION: HLH in scrub typhus infected children is being increasingly recognized. Younger age, prolonged fever, presence of convulsion, ARDS and MODS should alert clinicians of the risk of HLH. Treating the primary cause usually cures the disease and immunomodulator therapy need not be routinely administered.
Subject(s)
Lymphohistiocytosis, Hemophagocytic , Scrub Typhus , Child , Child, Preschool , Doxycycline , Female , Fever , Humans , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/drug therapy , Lymphohistiocytosis, Hemophagocytic/epidemiology , Male , Prospective Studies , Scrub Typhus/complications , Scrub Typhus/diagnosis , Scrub Typhus/drug therapyABSTRACT
BACKGROUND: Abdominal epilepsy (AE) is an infrequent cause of recurrent abdominal pain in children. It is characterized by paroxysmal episodes of abdominal pain, a variety of other abdominal complaints, electroencephalogram abnormalities, and response to anti-epileptic agents. We described the clinical profile of six patients with AE. METHODS: We conducted a retrospective survey of AE in children from the records of the hospital. The diagnosis of AE was dependent on recurrent abdominal symptoms, subtle central nervous system abnormalities, electroencephalogram abnormalities and response to anticonvulsant agents. RESULTS: The six patients were diagnosed with AE. The incidence of the disease was 0.07% in all admissions to the pediatric ward. Recurrent pain was common in all patients except two who had additional recurrent vomiting. In this series, the boy to girl ratio (1:2) was unequal. CONCLUSION: High suspicion is required for the diagnosis of AE after exclusion of other possible causes.
Subject(s)
Epilepsies, Partial/diagnosis , Abdominal Pain/etiology , Child , Child, Preschool , Electroencephalography , Epilepsies, Partial/complications , Epilepsies, Partial/epidemiology , Female , Humans , Incidence , India/epidemiology , Infant , Male , Recurrence , Retrospective StudiesABSTRACT
Overweight is a burning problem of school going children especially in affluent society. So urban children are affected more. Hypertension is a major co-morbidity of overweight. The number of overweight and hypertensive children is increasing and more among urban children. In this study sample was taken from rural and urban school going children of various age groups. The prevalence of overweight and hypertension among rural and urban school going children was obtained and relation between overweight and hypertension was established.
