PMID- 32432061
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2296-2360 (Print)
IS  - 2296-2360 (Electronic)
IS  - 2296-2360 (Linking)
VI  - 8
DP  - 2020
TI  - Hypoperfusion With Vomiting, Abdominal Pain, or Dizziness and Convulsions: An 
      Alert to Fulminant Myocarditis in Children.
PG  - 186
LID - 10.3389/fped.2020.00186 [doi]
LID - 186
AB  - Objective: To investigate the clinical features, treatment methods, and outcomes 
      of fulminant myocarditis (FM) in children. Methods: The clinical data of 23 
      children with FM hospitalized in the First Affiliated Hospital of USTC, Division 
      of Life Sciences and Medicine, University of Science and Technology of China 
      (Anhui Provincial Hospital) and Anhui Provincial Children's Hospital from January 
      2011 to September 2019 were retrospectively analyzed. Results: Among the 23 
      patients analyzed, 10 were male and 13 were female. The patients aged from 6 
      months to 14 years old (6.5 +/- 3.4 years), and 18 patients were over 3 years old. 
      There were 14 cases with respiratory symptoms, 16 cases with gastrointestinal 
      symptoms, 15 cases with neurological symptoms, and 19 cases with hypoperfusion 
      manifestations. Creatine kinase MB (CK-MB) and cardiac troponin I (CTnI) levels 
      were increased in 19 and 21 cases, respectively. Electrocardiography (ECG) showed 
      ST-T changes in 18 cases and atrioventricular blocks (AVB) in 15 cases. 
      Echocardiography (ECHO) showed cardiac chamber enlargement (CCE) in eight cases, 
      left ventricular systolic dysfunction in five cases, decrease in left ventricular 
      ejection fraction (LVEF) in four cases, reduction in wall motion in two cases, 
      and pericardial effusion in seven cases. Intravenous immunoglobulin (IVIG) and 
      glucocorticoids were administered to 19 and 20 patients, respectively. Fourteen 
      patients were treated with temporary pacemakers, one patient received 
      extracorporeal membrane oxygenation (ECMO), one patient received continuous renal 
      replacement therapy (CRRT), and one patient received ECMO combined with CRRT. 
      Twenty patients improved at discharge, and three patients died. Conclusion: 
      Preschool and school-age children showing hypoperfusion symptoms, such as 
      paleness, cold, clammy limbs, and capillary refill time (CRT) extension, 
      accompanied by vomiting, abdominal pain, dizziness, convulsions, and other 
      symptoms, should be carefully examined for FM. CK-MB, CTnI, ECG, and 
      echocardiogram need to be performed at the earliest opportunity. In the early 
      stages of FM, vital signs should be actively monitored, high-dose IVIG and 
      glucocorticoids should be administered, and life support technologies such as 
      temporary pacemakers, ECMO, and CRRT should be used to increase the survival rate 
      of children with FM as needed.
CI  - Copyright (c) 2020 Zhu, Zhang, Hang, Zhang, Xiong, Fang and Chen.
FAU - Zhu, Angang
AU  - Zhu A
AD  - Department of Pediatrics, Anhui Provincial Hospital, Wannan Medical College, 
      Hefei, China.
FAU - Zhang, Tian
AU  - Zhang T
AD  - Department of Pediatrics, Anhui Provincial Hospital Affiliated to Anhui Medical 
      University, Hefei, China.
FAU - Hang, Xiaobi
AU  - Hang X
AD  - Department of Pediatrics, Anhui Provincial Children's Hospital, Hefei, China.
FAU - Zhang, Xiaoguang
AU  - Zhang X
AD  - Department of Pediatrics, Anhui Provincial Hospital Affiliated to Anhui Medical 
      University, Hefei, China.
FAU - Xiong, Yingying
AU  - Xiong Y
AD  - Department of Pediatrics, Anhui Provincial Hospital, Wannan Medical College, 
      Hefei, China.
FAU - Fang, Tao
AU  - Fang T
AD  - Division of Life Sciences and Medicine, Department of Pediatrics, The First 
      Affiliated Hospital of USTC, Anhui Provincial Hospital, University of Science and 
      Technology of China, Hefei, China.
FAU - Chen, Mingwu
AU  - Chen M
AD  - Department of Pediatrics, Anhui Provincial Hospital, Wannan Medical College, 
      Hefei, China.
AD  - Division of Life Sciences and Medicine, Department of Pediatrics, The First 
      Affiliated Hospital of USTC, Anhui Provincial Hospital, University of Science and 
      Technology of China, Hefei, China.
LA  - eng
PT  - Journal Article
DEP - 20200505
PL  - Switzerland
TA  - Front Pediatr
JT  - Frontiers in pediatrics
JID - 101615492
PMC - PMC7214534
OTO - NOTNLM
OT  - children
OT  - fulminant
OT  - hypoperfusion
OT  - myocarditis
OT  - retrospective analysis
EDAT- 2020/05/21 06:00
MHDA- 2020/05/21 06:01
PMCR- 2020/05/05
CRDT- 2020/05/21 06:00
PHST- 2020/01/31 00:00 [received]
PHST- 2020/03/30 00:00 [accepted]
PHST- 2020/05/21 06:00 [entrez]
PHST- 2020/05/21 06:00 [pubmed]
PHST- 2020/05/21 06:01 [medline]
PHST- 2020/05/05 00:00 [pmc-release]
AID - 10.3389/fped.2020.00186 [doi]
PST - epublish
SO  - Front Pediatr. 2020 May 5;8:186. doi: 10.3389/fped.2020.00186. eCollection 2020.