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Is Acute Nonspecific Mesenteric Lymphadenitis Associated with Acute Abdominal Pain in Epidemic Aseptic Meningitis?

Korean Journal of Pediatrics 2004;47(6):623-627.
Published online June 15, 2004.
Is Acute Nonspecific Mesenteric Lymphadenitis Associated with Acute Abdominal Pain in Epidemic Aseptic Meningitis?
Hae Rim Kim1, Kiyoung Ku2, Young Hwan Lee3, Sin Kam3, Jin-Bok Hwang4
1Department of Pediatrics, Keimyung University School of Medicine, College of Medicine, Daegu, Korea
2Han-Young Pediatric Clinic, Daegu, Korea
3Department of Diagnostic Radiology, Daegu Catholic University School of Medicine, Daegu, Korea
4Department of Preventive Medicine, College of Medicine, KyungPook National University, Daegu, Korea
여름철 무균성 뇌막염 환자의 복통과 장간막 림프절염의 연관성에 관한 연구
김혜림1, 구기영2, 이영환3, 감신3, 황진복4
1계명대학교 의과대학 소아과학교실
2한영한마음연합소아과의원
3대구가톨릭대학교 의과대학 방사선과학교실
4경북대학교 의과대학 예방의학교실
Correspondence: 
Jin-Bok Hwang, Email: pedgi@korea.com
Abstract
Purpose
: Acute abdominal pain in an epidemic aseptic meningitis which is mostly an enterovirus as causative agent, is noted in 23-55% of patients. An enterovirus is also known as one of the causes of acute nonspecific mesenteric lymphadenitis(ANML). The purpose of this study was to see if ANML was associated with acute abdominal pain in epidemic aseptic meningitis.
Methods
: Between June 2001 and July 2001, data from 30 patients, aged 3 years to 14 years, with aseptic meningitis was reviewed. Abdominal ultrasonography was performed on all the patients and ANML was defined as a cluster of five or more lymph nodes measuring 5 mm or greater in their longitudinal diameter in the right lower quadrant with no identifiable specific inflammatory process.
Results
: The clinical symptoms of the 30 patients were : fever(76.7%), vomiting(90.0%), diarrhea(20.0 %) and abdominal pain(40.0%). The average peripheral blood leukocytes count on admission was 7,996?,701(4,500-14,500)/mm3. ANML, according to the ultrasonography, was shown in 93.3% of aseptic meningitis patients; the number of mesenteric nodes was 9.2?.3(5-20), with 7.4% of the 27 control cases being mesenteric nodes positive(P<0.05). The patients with ANML were divided into two groups; those with and without abdominal pain, 42.9% and 57.1% respectively. Two patients without ANML showed no abdominal pain. The count of mesenteric nodes was not significantly correlated with the duration to diagnosis, with or without fever, peripheral blood leukocytes count, and with or without abdominal pain.
Conclusion
: ANML is presumed to be a cause of the acute abdominal pain in epidemic aseptic meningitis. Further clinical observations are recommended on the reason why ANML can be associated with and without abdominal pain.
Key Words: Meningitis, Aseptic, Abdominal pain, Mesenteric lymphadenitis


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