Journal of Yeungnam Medical Science

Case Report

Colchicine for steroid-resistant recurrent pericarditis in a child: Ju Hee Shin, Dong Hyun Lee, Hee Joung Choi; Yeungnam Univ J Med. 2018;35(2):222-226. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.222

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Recurrent pericarditis is rare in children and is considered idiopathic in most cases. Its course is chronic, and preventing recurrences is important for the patient’s quality of life. Although a treatment strategy in pediatric recurrent pericarditis has not yet been established, non-steroidal anti-inflammatory drugs (NSAIDs) are the most common treatment for management of this condition, followed by corticosteroids, colchicine, immunosuppressive agents, immunoglobulins, and interleukin-1β receptor antagonists (e.g. anakinra). Herein, we report a case of recurrent pericarditis with pericardial effusion in a 5-year-old child who presented with fever and epigastric pain. He responded poorly to NSAIDs and corticosteroid therapy, but was successfully treated with colchicine.

Citations

Citations to this article as recorded by

Anakinra in idiopathic recurrent pericarditis: a comprehensive case series and literature review
Zeynep Toker Dincer, Sejla Karup, Erkin Yilmaz, Osman Corbali, Feyza Nur Azman, Melike Melikoglu, Serdal Ugurlu
Zeitschrift für Rheumatologie.2024;[Epub] CrossRef
Pediatric Pericarditis: Update
Rida Shahid, Justin Jin, Kyle Hope, Hari Tunuguntla, Shahnawaz Amdani
Current Cardiology Reports.2023;[Epub] CrossRef
Effects of Systemic Steroid Administration on Recurrence of Pericardial Effusion in Pediatric Patients After Hematopoietic Stem Cell Transplantation
Kieran Leong, Martha E. Heal, John L. Bass, Varun Aggarwal, Shanti Narasimhan, Ashish Gupta, Gurumurthy Hiremath
Journal of Pediatric Hematology/Oncology.2020; 42(4): 256. CrossRef

Original Articles

Clinical features according to chest radiologic patterns of Mycoplasma pneumonia in children.: Young Hyun Kim, Jin Hyeon Kim, Sae Yoon Kim, Young Hwan Lee; Yeungnam Univ J Med. 2016;33(2):98-104. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.98

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Abstract PDF: BACKGROUND
Clinical differences in Mycoplasma pneumonia (MP) in children and adolescent patients according to abnormal infiltrate patterns on the chest X-ray were compared. METHODS: From 2012 to 2015, patients (n=336) diagnosed with MP at Yeungnam University Medical Center have been classified as eiher lobar pneumonia or bronchopneumonia based on the infilterate patterns observed on chest X-ray. Cases were analyzed retrospectively for gender, age, seasonal incidence rate, main symptoms (fever duration, extrapulmonary symptoms), and laboratory results, including white blood cell count, hemoglobin, platelets, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), as well as concurrent respiratory virus infection. RESULTS: The following results were observed. First, lobar pneumonia affected 22.0% of all MP patients and was the most common in preschool children, with a high incidence rate in November and December. Second, lobar pneumonia had a longer fever duration than bronchopneumonia (p<0.001), and also showed significantly higher platelets (336.8 vs. 299.1 k/µL, p=0.026), ESR(46.3 vs. 26.0mm/hr, p<0.001) and CRP (4.86 vs. 2.18mg/dL, p=0.001). Third, viral co-infection was more common in bronchopneumonia (p=0.017), affecting 66.7% of infants and toddlers (p=0.034). Finaly, lobar consolidation was most common in both lower lobes. CONCLUSION: MP in children has increased in younger age groups, and the rate of lobar pneumonia with severe clinical symptoms is higher in older children.

Urinary tract infections in pediatric oncology patients with febrile neutropenia.: Kyoo Hyun Suh, Sun Young Park, Sae Yoon Kim, Jae Min Lee; Yeungnam Univ J Med. 2016;33(2):105-111. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.105

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Abstract PDF: BACKGROUND
Neutropenic fever is one of the most common and potentially severe complications of chemotherapy in pediatric oncology patients, while urinary tract infection (UTI) is one of the most prevalent bacterial infections in these patients. Therefore, this study was conducted to investigate features of UTI with neutropenic fever in pediatric oncology patients. METHODS: We retrospectively reviewed and analyzed the medical records, laboratory results and image findings of cases of neutropenic fever in the Department of Pediatrics of Yeungnam University Medical Center, South Korea between November 2013 and May 2015. Episodes were divided into two groups, UTI vs. non-UTI group according to the results of urine culture. The results were then compared between groups. The analysis was performed using IBM SPSS 23.0. A p-value <0.05 was considered to indicate a significant difference between groups. RESULTS: Overall, 112 episodes of neutropenic fever were analyzed, among which 22 episodes (19.6%) showed organisms on urine culture and were classified as UTI. The remaining 90 episodes were classified as non-UTI. Only four episodes (18.2%) of the UTI group showed pyuria on urine analysis. In the UTI group, 76.5% were sensitive to the first line antibiotics and showed higher clinical response than the non-UTI group. Among hematologic malignancy patients, the UTI group revealed higher serum β 2-microglobulin levels than the non-UTI group (1.56±0.43 mg/L vs. 1.2±0.43 mg/L, p<0.028). CONCLUSION: UTI in pediatric neutropenic fever responds well to antibiotics. Hematologic malignancy cases with UTI reveal increased serum β2-microglobulin level. These results will be helpful to early phase diagnosis of UTI.

Presumptive Diagnosis of Mycoplasma pneumoniae Pneumonia in Children.: Chang Eon Lee, Su Jin Park, Won Duck Kim; Yeungnam Univ J Med. 2012;29(2):89-95. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.89

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Abstract PDF: BACKGROUND
As Mycoplasma pneumoniae pneumonia has increased in Korea, its relevance to infants, toddlers, and adolescents has magnified as well as. However, it is difficult to perform the serological test and PCR test routinely for diagnosis in actual clinical practice. Thus, the authors conducted this study to help clinicians do presumptive diagnosis of Mycoplasma pneumoniae pneumonia using clinical, radiological, and hematological findings. METHODS: The study population consisted of 224 children between 1 month and 14 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups of 100 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the ELISA method. Groups with negative result in Mycoplasma IgM antibody test were classified into the viral group (98 patients with respiratory virus) and the bacterial group (46 patients with the bacteria detected in the blood sputum culture or antibiotic treatment except macrolide improved the patient's condition). These groups were compared and analyzed using clinical, hematological,and radiographic differences and scoring system. RESULTS: Clinical, hematological, and radiographic characteristics of Mycoplasma pneumoniae pneumonia have shown the intermediate level results between bacterial pneumonia and viral pneumonia. In terms of scoring system, the mean score of Mycoplasma pneumoniae pneumonia was 4.23, which was the intermediate level between bacterial pneumonia (mean score=6.67) and viral pneumonia (mean score=1.48). CONCLUSION: Results suggest that the combination of the scoring system information can increase the accuracy in the diagnosis even if they may have difficulties on diagnosis, because clinical manifestations, hematological, and radiographic findings are nonspecific.

Case Report

One Case of Lupus Nephritis Flare in Child During Tapering the Steroid: Jung Youn Choi, Yong Hoon Park; Yeungnam Univ J Med. 2007;24(2 Suppl):S755-760. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S755

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Abstract PDF: Systemic lupus erythematosus (SLE) is a chronic multisystemic inflammatory autoimmune disease. Hematologic abnormality is more frequent and the frequency of using high dose steroid and immunosuppressant as treatment is higher in children, because the number of involved major organ is numerous and the disease progress is often rapid in the SLE of children. We reported an experience of lupus nephritis flare after tapering the steroid in 9 years old boy who was diagnosed focal proliferative glomerulonephritis.

Original Articles

The Comparison of Intelligence Efficacy According to Methylphenidate Administration in Attention Deficit Hyperactivity Disorder(ADHD) Patients.: Hyung Bae Park, Dae Seok Bai, Jeong Sang Ha, Wan Seok Seo, Chang Jin Song; Yeungnam Univ J Med. 2001;18(2):253-266. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.253

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Abstract PDF: BACKGROUND
The causes of ADHD(attention deficit hyperactivity disorder) are various, it is impossible to understand the whole characteristics of ADHD, only with simple intellignece testing scales. We compared cognitive characteristics of ADHD group with normal controls with Korean Kaufman Assessment Battery for Children(K-ABC), It is well known to evaluate neuropsychological and cognitive aspects of the children. MATERIALS AND METHODS: Age and sex matched 40 ADHD patients and 40 normal controls tested with the K-ABC. Each subscales compared between pre-treatment patients and controls, pre-treatment and post-treatment in patient group, post-treatment patients and controls. RESULTS: Significant differences are ovserved in sequential processing, simultaneous processing, cognitive processing and achievement between pre-treatment patients and controls, and in gestalt closure between pre-treatment and post-treatment patients group. But there are no significant differences between pre-treatment patients and controls in gestalt closure and reading/decoding. CONCLUSIONS: Methylphenidate improved the scores of simultaneous scale, which means improvement of executive functions such as divided attention, analysis and organization. Methylphenidate also reduced distractibility.

Lead level in hair of elementary school children in urban and rural areas.: Yung Woo Byun, Jun Sakong, Chang Yoon Kim, Jong Hak Chung; Yeungnam Univ J Med. 1993;10(1):103-113. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.103

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Abstract PDF: This study was conducted to explore the feasibility of using the lead level in the hair of children as a screening test for lead intoxication of children and as an indicator for environmental pollution. Lead concentration of hair was measured for 268 seven to nine-year-old elementary school children in Taegu city (147 children) and Gampo. town(121 children). The lead level in hair was measured by atomic absorption spectrophotometer equipped with a graphite furnace atomizer. The following information was obtained for all children : sex, age, father's occupation and smoking habits, kinds of hair cleaner, fingernail biting habits, and status of the child's hands and clothing. The mean lead level in hair was 8.7+/-2-9 microg/g in the urban area and 7.7+/-2.2 pg/g in the rural area. There were significant differences between two groups(p(0.01). The difference of lead levels in hair measured by cleanliness of the child's hands (clean : 7.4+/- 2.7 pg/g, dirty : 8.2+/- 2.6 pg/g) and child's clothing(clean : 8.0+/- 2.5 microg/g, dirty : 9.3+/- 2.6 microg/g) were statistically significant, but other factors were not significant. In multiple regression analysis, difference of residency and age were significant variables for lead level in the hair of children. These findings suggest that measurement of lead level in the hair is a useful method for the screening of the lead intoxication of children and monitoring environmental conditions.

A clinical study on children with delayed language development.: Jeong Ho Kim, Han Ku Moon, Jeong Ok Hah; Yeungnam Univ J Med. 1991;8(2):24-34. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.24

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Abstract PDF

Delayed emergence of speech or language are frequent causes for concern about development during early childhood. Delay in evaluation and proper management until school entry in more likely to result in frustration, anxiety and school failure. Many language disturbances and their attendant behavior disorders respond to intensive language therapy. Authors analyzed the medical records of 52 children with delayed language development evaluated during 30 months from January 1986 through June 1988. The results were as follows: 1. The majority of cases were evaluated at the age of 2-2.9 year old (16 cases, 30.8%) and 3-3.9 year old (11 cases, 21.2%) 2. Male to female ratio was 3:1 3. The most common cause was mental retardation (53.8%), followed by developmental language disorder (23.1%) and autism (13.5%) 4. The most common associated condition was dysarticulation (17.3%), followed by strabismus (9.6%) and seizures (7.7%) 5. Special education was recommended in cases of 23 (44.2%), speech therapy in 12 cases (23.1%) and consultation to child psychiatry in 7 cases (13.5%) Making diagnosis of underlying disorders in not simple because assessment of intelligence in young children in difficult and only a few tests are standardized. More detailed study on children with delayed language development and development of psychometric tests for handicapped children are necessary, especially in Korea.

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The usefulness of diagnostic tests in children with language delay
Seung Taek Oh, Eun Sil Lee, Han Ku Moon
Korean Journal of Pediatrics.2009; 52(3): 289. CrossRef

Electrocardiographic Findings in School Children.: Jae Honng Park, Jin Gon Jun, Jeong Lan Kim; Yeungnam Univ J Med. 1987;4(2):23-27. Published online December 31, 1987; DOI: https://doi.org/10.12701/yujm.1987.4.2.23

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Abstract PDF: Mass electrocardiographic (ECG) examination was performed on 13,801 children (male 7,526 and female 6,275) of elementary and middle school in Taegu from May 1. 1986. to April 30. 1987. We read their ECG according to the “pediatric Electrocardiography”1) The results were as following: The incidence of ECG abnormality was 1.05% (male 1.3% and female 0.75%). Fifty eight children (0.42%) had atrial and ventricular hypertrophy; two right atrial hypertrophy, five left atrial hypertrophy, thirty five right ventricular hypertrophy and sixteen left ventricular hypertrophy respectively. Ectopic beats occurred in 25 children (0.18%); They were atrial in 12 children, ventricular in 8 children and junctional in 5 children. There were 62 children (0.45%) of conduction disturbance; They were first degree atrioventricular (A-V) block in 21 children, type I second degree A-V block in 1 child, A-V dissociation in 1 child, right, right bundle branch block in 36 children, left bundle branch block in 1 child and WPW syndrome in 2 children. Nonspecific ST, T changes and sinus tachycardia were found in 3 and one children respectively.

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