Benign acute childhood myositis: A benign disease that mimics more severe neuromuscular disorder

Pradhan, Sunil; Das, Animesh; Anand, Sucharita

doi:10.4103/jpn.jpn_116_18

Cited by 7 publications

(10 citation statements)

References 15 publications

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“…Most of the patients in our series were preschool-aged male children, a distribution that is congruous with reports in the literature. The reason for the male predominance is unknown, but it could be due to a genetic predisposition [11][12][13][14]. The median age (7.6 years) of our patients resulted slightly higher than the median age reported by some previous studies [3,11,15,16].…”

Section: Discussioncontrasting

confidence: 66%

“…The clinical presentation of our children was typical: acute onset of symmetrical calf muscle pain that results in the inability or refusal to walk after a u-like illness. The most common prodromal symptoms were fever, cough, and rhinorrhea, while gastrointestinal symptoms were rare, according to previous case series [3,4,5,7,11,14]. Lower-limb myalgia and refusal to weight bear were more frequent in our cohort than in the larger previous studies [15,17]; this nding may be due to our inclusion of only the inpatients who may represent the most serious cases, while Brisca et al and Turan et al enrolled all patients diagnosed with BACM at emergency department [15,17].…”

Section: Discussionmentioning

confidence: 70%

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Benign Acute Children Myositis: Five Years’ Experience in a Tertiary Care Pediatric Hospital

Attaianese

Benucci

Lasagni

et al. 2023

Preprint

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Purpose: Benign acute childhood myositis (BACM) is a self-limited childhood illness, and it is mainly caused by viral infections. Clinical and laboratory alterations usually normalize rapidly; generally, the only medical intervention required is supportive (hydration, analgesic medication). The low awareness about BACM often led to delayed diagnosis and unneeded ancillary investigations. This study aims to better characterize the clinical and laboratory features of BACM to improve the diagnostic process and inpatient and outpatient management. Materials and methods: We conducted a retrospective study selecting all children admitted to Meyer's Children's Hospital-IRCCS (Florence, Italy) with a diagnosis of BACM over the last 5 years. Clinical, laboratory, and instrumental data were collected from electronic clinical records and analyzed. Results: Sixteen patients were enrolled. The median age was 7.68 years (IQR 5.7-12.9). Male gender (62.5%) and Caucasian ethnicity (68.75%) were prevalent. Most of the patients were admitted during winter, and a second peak has been found in summer. All patients had bilateral calf pain at admission (87.5%), associated with asthenia, and refuse to walk (93.7%). Prodromal symptoms were fever (81.25%), cough (37.5%), coryza (43.5%), sore throat (50%), and vomiting (31.25%). The median value of CPK was 2,183.5 U/L (IQR 1,395.5-7,156.25) at peak. CPK median time to normalization was 7 days (IQR 7-8.5) from the nadir. Influenza B was the virus most frequently BACM associated, followed by influenza A; a novel association with Sars-CoV-2 has been detected. Two patients had pathogenic variants at the Next Generation Sequencing myopathies panel. Conclusions: School-aged children admitted to the hospital with walking difficulty and myalgia generally after an upper respiratory tract infection with a moderate CPK elevation should remind at first of BACM. Rapid complaint resolution and biochemical markers normalization will prevent unnecessary tests and inappropriate therapies.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 70%

Benign Acute Children Myositis: Five Years’ Experience in a Tertiary Care Pediatric Hospital

Attaianese

Benucci

Lasagni

et al. 2023

Preprint

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“…In the study conducted in India, the most common cause was influenza viruses, especially H1N1 and a small amount of Dengue viruses. Other etiologies investigated such as mycoplasma, cytomegalovirus, Epstein-Barr virus, leptospira, and scrub typhus were negative [ 3 ]. Tütüncü et al [ 4 ] submitted 65 cases from Turkey, etiological evaluation of 15 cases were Influenza A, Influenza B, Lyme, Mycoplasma, RSV and adenovirus as descending order.…”

Section: Discussionmentioning

confidence: 99%

“…In a study conducted in Brazil, a higher frequency in the months of May, June, July, and September was found, when compared to the others, corresponding to the colder months of the year [ 6 ]. Most of the cases occurred in the month of July and August followed by January and February in India [ 3 ]; between August and November in Chili [ 7 ]. The highest rate of admission was in January with 13 patients in our study and most frequent cases were seen between January and April.…”

Section: Discussionmentioning

confidence: 99%

From influenza to SARS-CoV-2: etiological evaluation of acute benign childhood myositis

Tekin

Akoğlu

2021

Acta Neurol Belg

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Aim To present the etiological evaluation results of our acute benign childhood myositis cases. Materials and methods Children, who were referred to pediatric neurology outpatient clinic in Maternity and Children’s Hospital, with difficulty in walking and high creatinine kinase levels were evaluated. Viral and bacterial serological evaluation of children were performed by real-time polymerase chain reaction method. Results Twenty-five children (21 M,4 F) included in the study. The most common complaints were walking difficulty and tenderness, pain on the gastrocnemius muscles. Their creatine kinase levels were between 216 and 8770 IU. Twenty-two children were hospitalized. Analgesic, intravenous fluid, antibiotic and/or antiviral drugs were given. The most common etiologies were influenza A and B. One children was diagnosed as suspected COVID-19 by the symptoms and the findings in thorax computerized tomography but the SARS-CoV-2 PCR and antibody tests were negative. Conclusion School-aged children admitted to hospital with walking difficulty generally after an upper respiratory tract infection with a moderate creatine kinase elevation should remind at first acute benign myositis. Resolution of the complaints in a short time and normalisation of the biochemical markers will prevent unnecessary tests. Endemic and pandemic infections may cause this entity as well.

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“…5,11 Due to the relatively low incidence of BACM, it may be overlooked in the differential diagnosis of acute weakness presenting in a child. 12 Clinicians may focus on more menacing causes of muscle weakness or pain such as Guillain-Barre syndrome, hypokalemia, or rhabdomyolysis. A comparison of the clinical manifestations and laboratory findings of these diagnoses are listed in Table 1.…”

Section: Discussionmentioning

confidence: 99%

A crawling case of benign acute childhood myositis

Hyczko

Rohrbaugh

Suliman

et al. 2021

SAGE Open Medical Case Reports

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Benign acute childhood myositis is a relatively uncommon complication of viral illness, particularly influenza A and B infections. In this abstract, we present a case report of benign acute childhood myositis secondary to influenza. On presentation, he was ill-appearing, febrile and had significant calf pain that limited mobility. Examination revealed mildly erythematous throat and bilateral calf tenderness with pain on dorsiflexion bilaterally. A respiratory virus panel was positive for influenza A subtype H3 and he was found to have an elevated creatine phosphokinase. He was diagnosed with benign acute childhood myositis secondary to influenza type A infection and symptoms gradually resolved following supportive management. Management involves oral hydration, pain management, and follow-up to ensure resolution. Extensive laboratory evaluation and hospitalization are often unnecessary. Benign acute childhood myositis is self-limiting with an excellent prognosis and should be included in the differential for a child who develops difficulty walking, particularly when presentation follows a respiratory infection.

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Benign acute childhood myositis: A benign disease that mimics more severe neuromuscular disorder

Cited by 7 publications

References 15 publications

Benign Acute Children Myositis: Five Years’ Experience in a Tertiary Care Pediatric Hospital

Benign Acute Children Myositis: Five Years’ Experience in a Tertiary Care Pediatric Hospital

From influenza to SARS-CoV-2: etiological evaluation of acute benign childhood myositis

A crawling case of benign acute childhood myositis

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