Descrição clínico - epidemiológica de uma série de casos de miosite aguda viral
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Data
2010-05-18
Autores
Cardin, Silvana Paula [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A miosite aguda viral é uma afecção músculo-esquelética precedida por sintomas respiratórios da Influenza. A apresentação é típica, caracterizada por mialgia, fraqueza muscular em membros inferiores, limitação de mobilidade, níveis elevados de enzimas musculares, leucopenia, evolução auto limitada e predomínio no sexo masculino. Examinar a epidemiologia, as características demográficas, clínicas e o desfecho da Miosite aguda viral em uma série de casos, no HC-FMB-UNESP. Avaliação retrospectiva de uma série de casos, identificados no período de 2000 a 2009 no HC-FMB-UNESP, descrevendo-se a fase aguda, a convalescença e recorrência, em pronto-atendimento e acompanhamento ambulatorial. Os dados clínicos e laboratoriais foram identificados nos prontuários, sendo registrados em protocolo padronizado, os sintomas respiratórios e músculo-esqueléticos, exames laboratoriais na apresentação e resolução, incluindo-se as enzimas musculares, creatinofosfoquinase (CPK), creatinofosfoquinase- fração MB (CKMB), desidrogenase lática (DHL) e transaminases (TGO e TGP), hemograma e reação de fase aguda, por meio da velocidade de hemossedimentação (VHS) e proteina C reativa (PCR), que foram registrados por ocasião do diagnóstico e quando possível durante o seguimento. Foram identificados 42 casos e incluídos 35, sendo 27 meninos e 8 meninas (3 : 1) ), com maior freqüência entre 2004-2006, no inverno e com um pico no mês de setembro. O diagnóstico inicial foi Miosite aguda viral em 89% dos casos, sendo o primeiro atendimento realizado no Pronto Socorro (88% ). Os principais sintomas ocorridos nos pródromos foram febre (63%), tosse (31%) e coriza (23%), com duração média de 4,3 dias. Os principais sintomas músculoesqueléticos foram dor em panturrilhas (80%), limitação à deambulação...
Acute viral myositis is a musculoskeletal disorder that follows Influenza respiratory symptoms. Its clinical presentation is typical, being characterized by myalgia, lower limbs muscle weakness, limited mobility, high serum levels of muscle enzymes, leukopenia, self-limited course and higher incidence in males. To examine epidemiology, demographics, clinical presentation and outcome of acute viral myositis in a hospital case-series (HC-FMB-UNESP). A retrospective study conducted in a single center identified a case-series seen from 2000 to 2009. Descriptive features of acute phase, recovery and relapse, from the first symptoms seen in emergency service as well as outpatients follow up, are presented. Clinical data and laboratory investigations were retrieved from medical records, where respiratory and musculoskeletal symptom, investigation results, at onset and follow up, were compiled to fullfil a standard protocol. Serum muscle enzymes, creatinophosphokinase (CK), MB fraction of creatinophosphokinase (CKMB), lactic dehydrogenase (LDH) and transaminases (SGOT and SGPT); hematologic assessment with white blood cell count (WBC) and acute phase reaction measured by erythrocyte sedimentation rate (ESR) and Creactive protein (CRP), at onset and during follow up, when available, were analysed. Forty two cases were identified and 35 were included, being 27 boys and 8 girls (3:1), with a higher frequency from 2004 to 2006, during winter time and a peak in september. Initial diagnosis of acute viral myositis was found in 89% of the cases, being the first visit in the hospital emergency service (88%). Main symptoms preceding onset were: fever (63%), cough (31%) and coriza (23%), with mean duration of 4,3 days. Main musculo-skeletal symptoms were calf-pain (80%), limited walking (57%), abnormal gait (40%), lower limbs... (Complete abstract click electronic access below)
Acute viral myositis is a musculoskeletal disorder that follows Influenza respiratory symptoms. Its clinical presentation is typical, being characterized by myalgia, lower limbs muscle weakness, limited mobility, high serum levels of muscle enzymes, leukopenia, self-limited course and higher incidence in males. To examine epidemiology, demographics, clinical presentation and outcome of acute viral myositis in a hospital case-series (HC-FMB-UNESP). A retrospective study conducted in a single center identified a case-series seen from 2000 to 2009. Descriptive features of acute phase, recovery and relapse, from the first symptoms seen in emergency service as well as outpatients follow up, are presented. Clinical data and laboratory investigations were retrieved from medical records, where respiratory and musculoskeletal symptom, investigation results, at onset and follow up, were compiled to fullfil a standard protocol. Serum muscle enzymes, creatinophosphokinase (CK), MB fraction of creatinophosphokinase (CKMB), lactic dehydrogenase (LDH) and transaminases (SGOT and SGPT); hematologic assessment with white blood cell count (WBC) and acute phase reaction measured by erythrocyte sedimentation rate (ESR) and Creactive protein (CRP), at onset and during follow up, when available, were analysed. Forty two cases were identified and 35 were included, being 27 boys and 8 girls (3:1), with a higher frequency from 2004 to 2006, during winter time and a peak in september. Initial diagnosis of acute viral myositis was found in 89% of the cases, being the first visit in the hospital emergency service (88%). Main symptoms preceding onset were: fever (63%), cough (31%) and coriza (23%), with mean duration of 4,3 days. Main musculo-skeletal symptoms were calf-pain (80%), limited walking (57%), abnormal gait (40%), lower limbs... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Reumatismo nas crianças, Saúde pública, Miosite - Epidemiologia, Influenza, Acute viral myosits
Como citar
CARDIN, Silvana Paula. Descrição clínico - epidemiológica de uma série de casos de miosite aguda viral. 2010. 80 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2010.