Comparison of Clinical and Laboratory Findings According to The Agents in Children with Acute Gastroenteritis

Year 2020, Volume: 29 Issue: 3, 161 - 167, 10.06.2020

Şebnem Özmen , Can Acıpayam , Hatice Güneş , Behiye Nurten Seringeç Akkeçeci , Filiz Orak

https://doi.org/10.17942/sted.665414

Cited By: 1

Abstract

Objective: Acute gastroenteritis (AGE) is the frequently seen infections of childhood. The aim of our study is observing the clinical and laboratory parameters of patients hospitalized with acute gastroenteritis.
Material and methods: Totally, 130 pediatric patients hospitalized at our clinic between January 2016 and January 2019 with a diagnosis of AGE whose ages were between 0-17, diarrheas continued shorter than 14 days with were included in our study. The patients were separated into two groups according to the agents such as viral and bacterial AGE. Patients’ demographics, laboratory and clinical data were recorded from patients’ files and statistical analyses were done.
Results: Of the 130 patients included in the study, 47 were parasitic and 83 were in the viral AGE group. While there was no gender difference between the groups, the mean age was lower in the viral AGE group (p <0.001). The duration of diarrhea was longer and vomiting was higher in the viral AGE group (p = 0.031, p = 0.02, respectively). Parasitic AGE was mostly seen in summer and viral AGE was mostly seen in winter (p = 0.01). The duration of diarrhea was positively correlated with length of stay (p <0.001, r = 0.656), but negatively correlated with mean platelet volume, neutrophil count and C-reactive protein (p = 0.01, r = -0.21, p = 0.02).
Conclusions: We found that length of stay, duration of diarrhea and vomiting were higher in viral gastroenteritis. In addition, we concluded that there were more viral cases in winter and more parasitic cases in summer and acute phase markers were higher in cases with a parasitic origin.

Keywords

Acute gastroenteritis, child, parasitic acute gastroenteritis, viral acute gastroenteritis

Akut Gastroenteritli Çocuklarda Etkenlere Göre Klinik ve Laboratuvar Bulgularının Karşılaştırılması

Abstract

Amaç: Akut Gastroenteritler (AGE) çocukluk çağının sık görülen enfeksiyonlarındandır. Çalışmamızın amacı AGE tanısıyla kliniğe yatırılan vakaların klinik bulgularını ve laboratuvar değerlerini incelemektir.
Gereç ve Yöntem: Çalışmamıza kliniğimizde Ocak 2016 ve Ocak 2019 tarihleri arasında AGE tanısıyla yatan 0-17 yaş aralığında, ishali 14 gün veya daha kısa süreli olan 130 hasta alındı. Hastalar, etkenlere göre paraziter ve viral AGE’li olmak üzere iki gruba ayrıldı. Hastaların demografik, laboratuvar ve klinik verileri hasta dosyalarından elde edildi ve istatistiksel incelemeleri yapıldı.
Bulgular: Çalışmaya alınan 130 hastanın 47’si paraziter 83’ü viral AGE grubunda idi. Gruplar arasında cinsiyet farkı yokken viral AGE grubunda yaş ortalaması düşük bulundu (p<0.001). Viral AGE grubunda ishal süresi daha uzun ve kusma daha fazla idi (p=0,031, p=0,02, sırasıyla). Paraziter AGE en çok yaz, viral AGE en çok kış mevsiminde görüldü (p=0,01). İshal süresi yatış gün sayısı ile pozitif yönde korele iken (p<0,001, r=0,656) ortalama platelet hacmi, nötrofil sayısı ve C-reaktif protein ile negatif yönde korele idi (p=0,01, r=-0,21, p=0,02, r=-0,193, p=0,01, r=-0,209, sırasıyla).
Sonuç: Viral gastroenteritlerde hastanede yatış süresinin, ishal süresinin ve kusmanın daha fazla olduğunu bulduk. Ayrıca kış aylarında daha çok viral, yaz aylarındaysa paraziter vakaların daha sık olduğunu ve paraziter kökenli vakalarda akut faz belirteçlerinin daha yüksek olduğunu bulduk.

Keywords

Akut gastroenterit, çocuk, paraziter akut gastroenterit, viral akut gastroenterit

References

• 1. Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; European Society for Pediatric Infectious Diseases. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014 ;59(1):132-52.
• 2. Bayrakçı B, Özütemiz Ö. Postinfeksiyöz irritabl barsak sendromu. Güncel Gastroenteroloji Dergisi. 2009; 13(3):153-7.
• 3. Kurugöl Z, Devrim İ. Gastrointestinal enfeksiyonlar. J Pediatr Inf 2014; 8:71-81.
• 4. Freedman SB, Thull-Freedman JD, Rumantir M, Atenafu EG, Stephens D. Emergency department revisits in children with gastroenteritis. J Pediatr Gastroenterol Nutr. 2013; 57(5):612-8.
• 5. Fox J, Richards S, Jenkins HR, Powell C. Management of gastroenteritis over 10 years: changing culture and maintaining the change. Arch Dis Child. 2012; 97(5):415-7.
• 6. Churgay CA, Aftab Z. Gastroenteritis in children: Part II. Prevention and management. American Family Physician. 2012; 85(11):1066-70.
• 7. Korczowski B, Szybist W. Serum procalcitonin and C-reactive protein in children with diarrhoea of various aetiologies. Acta Paediatr. 2004; 93(2):169-73.
• 8. Kabayiza JC, Andersson ME, Nilsson S, Baribwira C, Muhirwa G, Bergström T, Lindh M. Diarrhoeagenic microbes by real-time PCR in Rwandan children under 5 years of age with acute gastroenteritis. Clin Microbiol Infect.2014; 20(12):O1128-35.
• 9. Guarino A, Albano F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R. ESPGHAN/ESPID Evidence-Based Guidelines for the Management of Acute Gastroenteritis in Children in Europe Expert Working Group. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: executive summary. J Pediatr Gastroenterol Nutr. 2008; 46(5):619-21.
• 10. Martín A, Pérez-Ayala A, Chaves F, Lora D, Orellana MÁ. Evaluation of the multiplex PCR Allplex-GI assay in the detection of bacterial pathogens indiarrheic stool samples. J Microbiol Methods. 2018; 144:33-36.
• 11. Çubuk E, Aktar F, Yılmaz K, Sabaz MN, Solmaz M, Asena M ve Devecioğlu MC. 2011-2015 Yılları Arasında Üniversitemiz Çocuk Polikliniklerine İshal Şikâyeti ile Başvuran ve Adenovirüs ve/veya Rotavirüs Pozitifliği Saptanan Hastaların Retrospektif Değerlendirilmesi. Van Tıp Derg. 2008; 25(3):374-380.
• 12. Çoban B, Topal B. Evaluation of rotavirus gastroenteritis in children: five years' surveillance in Alanya, Antalya. Turk J Pediatr. 2014; 56(3):280-4.
• 13. Gürbüz F, Tezer H, Şaylı TR. Akut gastroenterit nedeniyle hastaneye yatan hastalarda etkenler ve klinik bulgular: Epidemiyolojik çalışma. Türkiye Çocuk Hast. Derg./Turkish J. Pediatr. Dis. 2010; 4(4):211-218.
• 14. André HP, Sperandio N, Siqueira RL, Franceschini SDCC, Priore SE. Food and nutrition insecurity indicators associated with iron deficiency anemia in Brazilian children: a systematic review. Cien Saude Colet. 2018; 23(4):1159- 1167.
• 15. Çelik T, Güler E, Berksoy EA, Sorguç Y, Arslan N. Entamoeba histolytica’ya Bağlı Akut Gastroenteriti Olan Çocuklarda Ortalama Trombosit Hacminin Değerlendirilmesi. Turkiye Parazitol Derg. 2015; 39:205-8.
• 16. Erdogan S, Yazar AS, Guven S, Durak U, Akova S. Serum transaminase elevation in Patients with rotavirus gastroenteritis. J Clin Anal Med. 2017; 8(6):488-91.
• 17. Kucuk O, Ugras M, Bicer S, Giray T, Col D, Erdag GC, Yalvac Z, Kaspar C, Vitrinel A. Mean Platelet Volume Value Changes In Acute Noninfectious and Infectious Diarrhea. Yeditepe Medical Journal. 2015; 9(33):875-883.
• 18. Mete E, Akelma AZ, Cizmeci MN, Bozkaya D, Kanburoglu MK. Decreased mean platelet volume in children with acute rotavirus gastroenteritis. Platelets. 2014; 25(1):51-4.
• 19. Klinger M.H.F., Jelkmann W. Role of Blood Platelets in Infection and Inflammation. Journal of Interferon and Cytokine Research 2002; 22(9):913-22.
• 20. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link between thrombosis and inflammation? Curr Pharm Des 2011; 17: 47-58.
• 21. Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD. Mean platelet volume in patients with rheumatoid arthritis: The effect of anti-TNF-alpha therapy. Rheumatol Int 2010; 30: 1125–29.
• 22. Akcaboy M, Melek Oguz M, Altınel Acoglu E, Acar M, Zorlu P, Ozbay Hosnut F, Senel S. Systemic Manifestation of Rotavirus Infection in Children: A Report of Three Cases. Iran Red Crescent Med J. 2016; 18(8):e35086.
• 23. Akelma AZ, Kütükoğlu I, Köksal T, Cizmeci MN, Kanburoğlu MK, Catal F, et al. Serum transaminase elevation in children with rotavirus gastroenteritis: seven years’ experience. Scand J Infect Dis. 2013;45:362-7.
• 24. Berend K, de Vries AP, Gans RO. Physiological approach to assessment of acid-base disturbances. N Engl J Med. 2015; 372(2):195.
• 25. Tüzüner U, Gülcen BS, Özdemir M, Feyzioğlu B. Gastroenteritli Cocukların Dışkılarında Adenovirus ve Rotavirus Sıklığı ve Mevsimsel Dağılımı. Klimik Dergisi. 2016; 29(3):121-4.
• 26. Kızılırmak A, Çalışkan E, Temizkan RC. Akut Gastroenteritli Çocuklarda Rotavirus ve Adenovirus Sıklığı. Konuralp Tıp Dergisi. 2017; 9(2):35-39.
• 27. Sugeçti S, Çelen U, Azaklı PT, Yenice S, Koçer F. Akut Gastroenteritli Çocuklarda İmmünokromatografik Olarak Enterik Adenovirus ve Rotavirus Antijen Varlığının Mevsimsel Prevelansı. J Pediatr Inf. 2015; 9:161-5.
• 28. Akıncı N, Erener Ercan T, Yalman N. Akut gastroenteritli çocuklarda Adenovirus ve Rotavirus. J Pediatr Inf 2007; 1: 98-101.