Mycoplasma pneumoniae (Mp) is a unique pathogen that causes not only pulmonary but also extrapulmonary manifestations that must be rapidly diagnosed. A 12-year-old boy, with no relevant medical history, presented with fever, severe epigastric pain, and vomiting. Laboratory findings showed fulminant and cholestatic hepatitis, hemolytic anemia, thrombocytopenia, acute kidney injury, disseminated intravascular coagulopathy, acute myocardial infarction, and rhabdomyolysis. His clinical condition rapidly deteriorated during intubation and continuous renal replacement therapy.
Despite intensive treatment, he did not recover. We report a case of fulminant and fatal multiple organ failure in a previously healthy boy with Mp infection, describing the possible pathomechanisms of multiple organ failure involved in the disease.
Purpose: To evaluate the validity and usefulness of the waist circumference-to-height ratio (WHtR) in screening for metabolic syndrome in Korean adolescents aged 17∼19 years. Methods: Data (body mass index, waist circumference, and height) and blood samples were obtained from adolescents in A University Hospital in 2011. This study included 554 adolescents (176 boys and 378 girls) aged 17∼19 years. Dependent variables were systolic and diastolic blood pressure, fasting blood glucose (FBS), total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). Using the Pearson's correlation analysis and logistic regression analysis, we measured the WHtR against Body mass index (BMI). Results: An assessment was carried out of the ability of the 2 indexes to 1) account for the variability in each metabolic risk factor and 2) correctly identify adolescents with metabolic risk factors. The results revealed that the predictive abilities of the waist-to-height ratio index were better values. The waistto-height ratio showed superior values in predicting concentrations of DBP, FBS, TC, TG and LDL-C. However, BMI showed better values in identifying adolescents with high systolic blood pressure and HDL-C. 3) Normal weight adolescents (BMI: 5 th
≤BMI<85th percentiles) were divided by WHtR (obesity cutoff value: ≥0.51 in male, ≥0.49 in female). WHtR was better than the BMI index for signaling metabolic risk in the normal-weight adolescents.
Conclusion:The WHtR is a better predictor for finding metabolic risk factors in adolescents aged 17∼19 years with normal BMI. The WHtR is proposed as an alternative, convenient measure of screening metabolic syndrome for adolescents aged 17∼19 years independent of age and sex. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 385∼392)
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