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Hospitalized Versus Outpatient Benign Acute Childhood Myositis: A 10-Year Single-Center Experience
Yasemin Özkale1, Murat Özkale2, Şeyda Beşen3
1Department of Pediatrics, Faculty of Medicine, Dr Turgut Noyan Teaching and Medical Research Center, Baskent University, 01140 Adana, Turkey.
Insights
Benign acute childhood myositis (BACM) in children is usually self-limiting. However, elevated creatine kinase (CK) levels and inability to walk may indicate hospitalization is needed, with etiological factors influencing severity.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Benign acute childhood myositis (BACM) is a common, self-limiting condition in children, often following viral infections.
- Understanding factors differentiating hospitalized from outpatient pediatric BACM cases is crucial for clinical management.
- Identifying specific etiological agents and their impact on BACM severity can refine diagnostic and treatment approaches.
Purpose of the Study:
- To compare clinical, laboratory, and etiological characteristics of hospitalized versus outpatient pediatric patients with BACM.
- To identify factors associated with the need for hospitalization in children diagnosed with BACM.
- To analyze outcomes, including rhabdomyolysis and recurrence, in pediatric BACM cases.
Main Methods:
- Retrospective single-center study analyzing data from 93 children diagnosed with BACM over a 10-year period.
- Comparison of demographic, clinical, laboratory, and etiological data between hospitalized and outpatient groups.
- Analysis of factors linked to hospital admission, disease severity, and recurrence.
Main Results:
- Hospitalized pediatric BACM patients exhibited significantly higher creatine kinase (CK) levels and more frequent inability to walk compared to outpatients.
- Influenza A-associated BACM showed lower CK levels and shorter fever duration; viral panel negative cases had longer symptoms and higher hospitalization rates.
- Sandfly fever virus was identified in two hospitalized patients; rhabdomyolysis occurred in three hospitalized cases, all with full recovery.
Conclusions:
- Elevated CK levels and inability to walk are key indicators for hospitalization in pediatric BACM.
- Etiological differences significantly impact BACM severity, underscoring the importance of identifying causative agents.
- The identification of sandfly fever virus in BACM cases highlights the need to consider regional viral pathogens in differential diagnoses.
Abstract:
Background and Objectives: The objectives of this study were to compare the clinical, laboratory, and etiological characteristics, as well as outcomes, of hospitalized and outpatient children with benign acute childhood myositis (BACM) and to identify factors associated with hospitalization. Materials and Methods: This retrospective single-center study included children diagnosed with BACM over a 10-year period. Demographic data, clinical features, laboratory parameters, etiological agents, treatments, hospitalization status, and recurrence were analyzed. Hospitalized and outpatient patients were compared to determine factors associated with hospital admission. Results: A total of 93 patients were included. Hospitalized patients had significantly higher creatine kinase (CK) levels and a higher frequency of inability to walk compared with outpatients. No significant differences were observed between the groups regarding age, sex, gastrointestinal symptoms, serum creatinine levels, or inflammatory markers. Influenza A (INFA)-associated BACM was characterized by lower CK levels and shorter fever duration, whereas viral panel negative (VPN) cases had longer symptom duration and were more frequently hospitalized. Notably, sandfly fever virus was identified in two hospitalized patients, representing an uncommon but clinically relevant etiological agent in our cohort. Rhabdomyolysis occurred in three patients, all of whom were hospitalized and recovered without sequelae. The recurrence rate was 11.8%, with no significant association between recurrence and demographic or clinical variables. Conclusions: Although BACM is typically self-limiting, elevated CK levels and inability to walk may help identify patients who require hospitalization. Etiological differences influenced disease severity, and the detection of sandfly fever-associated BACM highlights the importance of considering regional viral agents in the differential diagnosis.
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