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[Measles in the young adult. Clinical features of 201 cases]
L J Casanova-Cardiel1, C Hermida-Escobedo
1Hospital de Infectología, Centro Médico La Raza, Instituto Mexicano del Seguro Social, México, D.F.
Abstract:
The clinical and laboratory characteristics of 201 cases of measles and its associations with complications were analyzed during an outbreak of this disease in Mexico City. The complications were hepatitis (45%), bacterial pneumonia (17%), oral candidiasis (13%), upper gastrointestinal tract hemorrhage (13%), epistaxis (8%), encephalitis (4%), subcutaneous emphysema (2%), and hypocalcemic tetany (1%). In a subgroup of 20 consecutive patients hypocalcemia was found in 14 cases (70%), associated with high levels of calcitonin in three cases. An increased lactate dehydrogenase (LDH) was observed in 83% of the patients, showing a significant association with the occurrence of complications (p = 0.04) especially in the patients with values of LDH above 750 IU/mL (odds ratio of 6.4). Two patients died (1% mortality). The young patients with measles can develop serious complications, and an increased level of LDH may be a prognostic indicative of these complications.
Insights
Measles outbreaks can cause serious complications, particularly in young patients. Elevated lactate dehydrogenase (LDH) levels may indicate a higher risk of these severe measles complications.
Area of Science:
- Infectious Diseases
- Pediatrics
- Clinical Medicine
Context:
- Analysis of 201 measles cases during an outbreak in Mexico City.
- Investigated clinical and laboratory features and associated complications.
Purpose:
- To identify common measles complications and their clinical associations.
- To evaluate the prognostic value of lactate dehydrogenase (LDH) levels in measles patients.
Summary:
- Hepatitis (45%) and bacterial pneumonia (17%) were the most frequent complications.
- Elevated LDH levels (≥750 IU/mL) were significantly associated with increased complication risk (OR 6.4, p=0.04).
- Hypocalcemia occurred in 70% of a subgroup, sometimes linked to high calcitonin.
Impact:
- Highlights the potential severity of measles, even in young individuals.
- Suggests LDH as a potential biomarker for predicting measles complications.
- Informs clinical management and public health strategies during measles outbreaks.