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Published on: October 2, 2015
Measles in children who have malignant disease
Abstract:
A review study examined the clinical course of measles diagnosed in children being treated for malignant disease in Newcastle upon Tyne during 1973-86. Of the 17 cases diagnosed, five were fatal. Factors associated with a favourable outcome were a typical rash and Koplik's spots, which were accompanied by a detectable serum antibody response and the disappearance of measles giant cells from nasopharyngeal secretions. Pneumonitis severe enough to require assisted ventilation was invariably fatal. Pneumonitis and encephalitis were the main complications. Treatment included immunoglobulin, interferon, and ribavirin, but none could clearly be shown to be effective. The comparatively low mortality in this series may have been due to the extensive use of the fluorescent antibody technique in Newcastle during the study period and therefore detection of less severe cases as compared with other reports.
Insights
Measles in children with cancer can be fatal, especially with severe pneumonitis. Early signs like rash and Koplik
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Virology
Background:
- Measles poses a significant risk to immunocompromised children, particularly those undergoing treatment for malignant diseases.
- Understanding the clinical course and outcomes of measles in this vulnerable population is crucial for improving patient management.
Purpose of the Study:
- To review the clinical presentation, complications, and outcomes of measles in children with malignant diseases.
- To identify factors associated with favorable and unfavorable outcomes in this patient group.
Main Methods:
- Retrospective review of 17 cases of measles diagnosed in children with malignant disease between 1973 and 1986.
- Analysis of clinical data, including symptoms, complications, treatment modalities, and mortality.
- Correlation of clinical findings with laboratory markers, such as serum antibody response and viral detection in nasopharyngeal secretions.
Main Results:
- Five out of 17 cases were fatal, with severe pneumonitis requiring assisted ventilation being invariably fatal.
- Typical measles rash and Koplik's spots, along with a detectable serum antibody response and clearance of measles giant cells, were associated with a favorable outcome.
- Pneumonitis and encephalitis were the primary complications.
- Treatments including immunoglobulin, interferon, and ribavirin showed no clear efficacy.
Conclusions:
- Measles in children with cancer has a high mortality rate, particularly when complicated by severe pneumonitis.
- Early detection of measles, potentially facilitated by sensitive diagnostic techniques like the fluorescent antibody technique, may contribute to identifying less severe cases and improving survival rates.
- Further research is needed to establish effective treatments for measles in immunocompromised pediatric patients.
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