Hepatitis E virus-associated haemophagocytic lymphohistiocytosis.

We report the first documented case of hepatitis E virus-associated haemophagocytic lymphohistiocytosis. This case emphasizes the fact that infectious agents other than those classically described should be taken into consideration as a potential trigger of virus-associated haemophagocytic syndrome. Prompt recognition is crucial to start early treatment of the underlying infection and possibly improve the outcome of this frequently fatal syndrome.

The correlation between the apolipoprotein E genetic polymorphisms and sepsis in children / 中华急诊医学杂志

Objective To study the correlation between apolipoprotein E (APOE) genetic polymorphisms and sepsis in Chinese children.Methods The inpatients suffered with sepsis were enrolled as septic group and the healthy children from child health division were enrolled as control group.The study of APOE genotypes were carried out by polymerase chain reactions followed a high-resolution melting curve analysis.SPSS 16.0 statistical software was used for data analysis.Mann-Whitney U test was used to compare the age between the groups.Hardy-Weinberg equilibrium was tested using the Pearson x2-test.The x2-test was used to compare gender and the genotype distribution between the groups.The odd ratio (OR) was calculated together with its 95％ confidence interval (CI).Potential confounding effects of variables were corrected using a multivariate unconditional logistic regression model.All statistical tests were two-sided and P ＜ 0.05 indicates statistically significance.Results Among a total of 285 children collected from March 2011 to June 2012,there were 88 patients with sepsis and 197 healthy children.In the septic group,15 septic patients were complicated with central nervous system infection.Four apolipoprotein E genotypes were identified to be ε3/ε3,ε2/ε3,ε3/ε4,and ε2/ε4.The percentage of each genotype found in patients of the septic group and the control group was 64.4％ vs.73.1％ (ε3/ε3);16.8％ vs.10.7％ (ε2/ε3);18.8％ vs.14.7％ (ε3/ε4);0％ vs.1.5％ (ε2/ε4),respectively.The number of patients with the genotype ε3/ε3 among septic patients was significantly lower than that among the control individuals (P =0.047,1-β =0.334,OR =0.585,adjusted OR =0.559).The number of patients with the genotype ε3/ε3 among the septic patients with central nervous system infection was 33.3％,which was also significantly lower than that among the septic patients without CNS infection (67.1％).(P =0.014,1-β5 =0.685,OR =0.245,adjusted OR =0.275).Conclusions Apolipoprotein E genetic polymorphisms were associated with the occurrence of sepsis and central nervous system complications in children.The susceptibility of children with genotype ε3/ε3 to sepsis and central nerve system infection complications is significantly lower than that of children with other genotypes.

Clinical analysis on 569 cases of hand, foot and mouth diseases complicated with nerve system damages / 中国基层医药

Objective To investigate the epidemiological and clinical characteristics of hand,foot and mouth disease(HFMD) complicated with central nerve system infection,in order to improve the diagnosis and treatment.Methods Total of 569 cases of HFMD complicated with central nerve system infection were enrolled.The results of pathogen detection and CSF examination were looked into,and epidemiological and clinical characteristics were analyzed retrospectively.Results HFMD of the central nervous system infections increased year by year,endanger the children's life,pathogen detection showed positive for enterovirus type 71 (640/1077,59.4％) and coxsackie virus infection in group A (158/1077,14.7％) ; Clinical manifestation:hand,foot and mouth,hips were rash (100.0％),fever(546/569,95.9.％),temperature higher than 38.5 ℃ (74.7％,425/569),there were various signs and symptoms of nervous system damage,sleepiness (187/569,32.9％),limb jitter(347/569,60.1％),easily frightened (405/569,71.2％),irritability (130/569,22.8％),convulsions (2.4％,14/569),vomiting (67/569,11.8％),choking cough (2.8 ％,16/569),irregular breathing (0.5 ％,3/569) ; Laboratory examination:the central nervous system complications in different CFPro (P =0.992),CFWBC (P =0.994) and CRP (P =0.786),no statistical difference in such aspects of brain stem encephalitis group in CFP(P =0.001),PWBC (P =0.000) and BG (P =0.000),and the differences were statistically significant; Short-term,the combination of large dose of gamma globulin and methylprednisolone had definite efficacy.Conclusion HFMD complicated with central nervous system infections have some epidemiological and clinical characteristics,early diagnosis and treatment can reduce the incidence of severe cases and mortality.