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Published on: December 20, 2016
Hypoglycaemia was common in acute gastroenteritis in a prospective hospital-based study, but electrolyte imbalances
Mohammed Qadori1, Elmira Flem2, Terese Bekkevold2
1Department of Paediatrics, Ostfold Hospital Trust, Grålum, Norway.
Insights
Routine blood tests in children with gastroenteritis can reveal common hypoglycemia, but severe electrolyte issues are rare. This study links blood abnormalities to gastroenteritis severity, aiding diagnostic workups.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Chemistry
Background:
- The utility of routine blood sampling in diagnosing acute gastroenteritis in children is debated.
- Understanding the correlation between gastroenteritis severity and blood test abnormalities is crucial for effective patient management.
Purpose of the Study:
- To investigate the relationship between the severity of acute gastroenteritis and specific blood test abnormalities in pediatric patients.
- To determine the frequency of hypoglycemia and major electrolyte disturbances in children with acute gastroenteritis.
Main Methods:
- Prospective enrollment of children under five years with gastroenteritis across four Norwegian hospitals.
- Assessment of gastroenteritis severity using Vesikari scores and analysis of blood samples for various biochemical markers.
- Correlation analysis between clinical parameters, viral etiology (rotavirus), and laboratory findings.
Main Results:
- Hypoglycemia was frequently observed (15% of cases), particularly in severe gastroenteritis and rotavirus infections.
- Elevated urea, low bicarbonate, and negative base excess were associated with disease severity, demonstrating high specificity but low sensitivity.
- Major electrolyte disturbances, such as significant hyponatremia, were infrequent in this cohort.
Conclusions:
- Hypoglycemia is a common finding in pediatric acute gastroenteritis and warrants monitoring.
- While certain blood markers correlate with severity, their low sensitivity suggests limited utility for routine screening.
- Routine blood sampling may not be necessary for all cases, but specific tests can aid in managing severe gastroenteritis.
Aim:
Using routine blood sampling in a gastroenteritis diagnostic workup is debatable. This study examined the relationship between the severity of acute gastroenteritis and blood test abnormalities.
Methods:
We prospectively enrolled children under five years of age referred for outpatient or inpatient management for gastroenteritis from February 2014 to April 2016. The four study hospitals cared for 30% of Norwegian children. The severity of gastroenteritis was assessed using Vesikari scores. Blood samples were analysed at each hospital.
Results:
The 659 children had a median age of 19 months. The rotavirus was found in 314/514 children with stool samples (61%). Severe gastroenteritis, indicated by a Vesikari score of ≥11, was found in 392/549 (71%) with completed scores, but only 40 of 649 (6%) assessed for dehydration were more than 5% dehydrated. None had sodium <130 mmol/L. Glucose of 3.0-3.3 mmol/L was detected in 52/578 (9%) and <3.0 mmol/L in 33/578 (6%). Hypoglycaemia, elevated urea, low bicarbonate and negative base excess were associated with disease severity. The duration of vomiting and the rotavirus infection were associated with hypoglycaemia. Elevated urea, low bicarbonate and negative base excess had high specificities, but low sensitivities.
Conclusion:
Hypoglycaemia was common in acute gastroenteritis, but major electrolyte disturbances were infrequent.
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