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Benign acute childhood myositis: Factors associated with muscle symptoms and resolution
Betül Öztürk1, Aytaç Göktuğ1, İlknur Bodur1
1Department of Pediatric Emergency, University of Health Sciences, Dr Sami Ulus Maternity and Children's Education and Research Hospital, Ankara, Turkey.
Background:
Benign acute childhood myositis (BACM) is associated with several viral infections. The aim of this study was to evaluate the progression of myositis symptoms, laboratory findings and oseltamivir treatment in children with influenza- and non-influenza-associated BACM.
Methods:
Patients aged 0-18 years old, admitted to the pediatric emergency department in the seasonal influenza period between 2018 and 2020 were retrospectively analyzed. Patients with acute onset calf tenderness, pain, difficulty in walking and elevated serum creatine phosphokinase were included and were grouped according to influenza rapid test kit results as influenza (A and B) positive, and influenza negative. The time to symptom resolution, laboratory data and the oseltamivir treatment were compared between the groups.
Results:
There were 94 patients (67 male, 27 female) with a mean age of 77 ± 22 months. Influenza A was detected in 21, influenza B in 27, and neither were detected in 46 patients. Time to symptom resolution of BACM was shorter in the influenza-positive patients than in influenza-negative patients (2.9 ± 1.4 days and 3.5 ± 1.5 days, respectively, P = 0.027). Oseltamivir did not reduce the symptom resolution time in influenza patients. All children had normal hemoglobin and platelet counts, elevated creatine phosphokinase and 76% of them had leukopenia. Neither clinical recurrence nor metabolic disease were reported.
Conclusion:
Symptoms of BACM tended to resolve slightly earlier in influenza-positive patients and the duration of symptoms was not affected by oseltamivir treatment.
Insights
Benign acute childhood myositis (BACM) symptoms resolved faster in children with influenza. Oseltamivir treatment did not impact symptom duration for BACM in children, regardless of influenza status.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Benign acute childhood myositis (BACM) is a common, self-limiting condition often linked to viral infections.
- Understanding the specific viral triggers and treatment efficacy is crucial for pediatric care.
Purpose of the Study:
- To compare symptom progression, laboratory findings, and the effect of oseltamivir in children with influenza-associated versus non-influenza-associated BACM.
- To evaluate the clinical course of BACM in relation to influenza infection status.
Main Methods:
- Retrospective analysis of 94 pediatric patients (0-18 years) presenting with BACM symptoms during influenza seasons (2018-2020).
- Patients were categorized based on rapid influenza diagnostic test results (Influenza A, Influenza B, or negative).
- Comparison of time to symptom resolution, laboratory markers (creatine phosphokinase, hemoglobin, platelets, white blood cell count), and oseltamivir treatment outcomes between groups.
Main Results:
- Influenza-positive patients (n=48) showed a significantly shorter time to symptom resolution (2.9 days) compared to influenza-negative patients (n=46, 3.5 days; P=0.027).
- Oseltamivir treatment did not alter symptom resolution duration in influenza-positive BACM cases.
- Elevated creatine phosphokinase and leukopenia were common findings; no recurrences or metabolic diseases were reported.
Conclusions:
- BACM symptoms tend to resolve more rapidly in children with concurrent influenza infections.
- Oseltamivir treatment does not appear to shorten the duration of symptoms in pediatric BACM, even when associated with influenza.
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