최근 유행한 소아 인플루엔자에서 소화기계 침범 양상이 나타난 환자들의 임상양상 및 예후인자

Abstract

Purpose: Influenza is increasing nowadays, and its gastrointestinal (GI) involvement manifestations are not rare but there are a few domestic clinical studies for it. This study was done to know its recent clinical features and prognostic factors. Methods: I collected clinical informations of influenza patients who had visited and been diagnosed at the Department of Pediatrics, Yogin Severance Hospital from January 2014 to May 2016. Clinical features of the patients with GI involvement were investigated and then classified by admission duration. Clinical parameters were compared between them. Results: There were 27 cases (24.1%) who had GI manifestations. Its annual incidence in total admitted influenza cases were increase from 13.5% in 2014 to 29.5% in 2016. Their mean month age were 77.2±47.0 months old. There were 16 male and 11 female. Their clinical manifestations were poor feeding (51.9%), vomiting (48.1%), abdominal pain (48.1%), diarrhea (29.6%), nausea (25.9%). More than 75% of them had these symptoms as their main chief complaints. There were two cases without respiratory manifestations. Their mean admission duration were 2.5±1.3 days. When patients were classified for two group by admission duration, group A (>3 days, N=6) showed higher frequency of vomiting ( P =0.006) and elevated serum aspartate aminotransferase level ( P =0.021), higher mean tCO2 level ( P =0.006) than group B (≤3 days, N=21). Other clinical parameters such as age, sex, antigenic type, complete blood counts, serum level of blood urea nitrogen, creatine, glucose, elevated rate of serum alanine aminotransferase, urinary findings were not significantly different between two groups. Conclusion: The GI involvements in influenza cases are not rare nowadays and its incidence is increasing. Although those cases usually showed respiratory manifestations, GI manifestations were main features for many of them. Most of them have fair general prognosis, but it can be worse in the patients with vomiting and increased serum aspartate aminotransferase level, so that should be kept in mind who care febrile childhood patients during influenza season.