[II-JCKAP2-1] Clinical Characteristics in Children with Acute Myocarditis: Utility of a Serum Lactate Dehydrogenase in Early Diagnosis
キーワード：acute gastroenteritis, acute heart failure, ventricular tachycardia
Background: Early diagnosis of acute myocarditis (AMC) is crucial because of its rapid progression and high mortality rate. Initial symptoms such as fever, abdominal pain, and vomiting are non-specific and pose challenges for clinicians in distinguishing AMC from acute gastroenteritis.
Methods: We retrospectively reviewed the clinical characteristics of seven patients with AMC who were hospitalized at our institution between April 2011 and March 2022. We compared these findings with those of 19 patients with acute gastroenteritis.
Results: The common initial symptoms of patients with AMC included fever (71%), vomiting (71%), abdominal pain (57%), and diarrhea (29%), which did not differ significantly from those in patients with acute gastroenteritis. Cardiomegaly detected on plain radiography was significantly more prevalent in the AMC group (42%) than in the acute gastroenteritis group (0%). Patients with AMC had significantly higher serum lactate dehydrogenase (LDH) levels than those with viral (p=0.037) or bacterial (p=0.012) acute gastroenteritis. LDH demonstrated a sensitivity of 71% and specificity of 100% (area under the curve, 0.857) for predicting AMC when using a cut-off value of 400 U/L.
Conclusions: Serum LDH level is a valuable and easily implemented diagnostic tool for the early identification of AMC. Additionally, radiographic findings, such as cardiomegaly, may aid in the diagnosis. Early recognition of AMC is critical for timely intervention and improved patient outcomes.
Methods: We retrospectively reviewed the clinical characteristics of seven patients with AMC who were hospitalized at our institution between April 2011 and March 2022. We compared these findings with those of 19 patients with acute gastroenteritis.
Results: The common initial symptoms of patients with AMC included fever (71%), vomiting (71%), abdominal pain (57%), and diarrhea (29%), which did not differ significantly from those in patients with acute gastroenteritis. Cardiomegaly detected on plain radiography was significantly more prevalent in the AMC group (42%) than in the acute gastroenteritis group (0%). Patients with AMC had significantly higher serum lactate dehydrogenase (LDH) levels than those with viral (p=0.037) or bacterial (p=0.012) acute gastroenteritis. LDH demonstrated a sensitivity of 71% and specificity of 100% (area under the curve, 0.857) for predicting AMC when using a cut-off value of 400 U/L.
Conclusions: Serum LDH level is a valuable and easily implemented diagnostic tool for the early identification of AMC. Additionally, radiographic findings, such as cardiomegaly, may aid in the diagnosis. Early recognition of AMC is critical for timely intervention and improved patient outcomes.