title: [Clinical features and prognostic factors in children with fulminant myocarditis].
abstract: OBJECTIVE
  To investigate the clinical features and prognostic factors in children with fulminant myocarditis.
  
  
  METHODS
  The clinical data of 24 children with fulminant myocarditis were retrospectively analyzed. According to the prognosis, these children were classified into two groups: survival (n=12) and death (n=12). The risk factors influencing prognosis in children with fulminant myocarditis were identified by logistic regression analysis.
  
  
  RESULTS
  Among the 24 cases of fulminant myocarditis, gastrointestinal symptoms were found as initial symptoms in 14 cases, neurological symptoms in 12 cases, respiratory symptoms in 1 case, and cardiac symptoms in 2 cases. On admission, serum levels of creatine kinase MB, troponin I, and brain natriuretic peptide (BNP) were all increased. Besides, left ventricular ejection fraction (LVEF) decreased in 22 cases (92%), cardiothoracic ratio increased in 10 cases, third-degree atrioventricular block was observed in 8 cases, ST-segment changes were found in 11 cases and ventricular tachycardia was identified in 2 cases. LVEF in the death group was lower than in the survival group (P<0.05), while the peak level of serum BNP during hospitalization in the death group was higher than in the survival group (P<0.05). The multivariate logistic regression analysis revealed that LVEF was the risk factor influencing prognosis (OR=7.418; P<0.05).
  
  
  CONCLUSIONS
  Fulminant myocarditis has no specific clinical features in children. A decreased LVEF is a risk factor for poor prognosis in children with fulminant myocarditis.
authors.affiliation: Department of Pediatric Intensive Care Unit, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, China. liucf@sj-hospital.org.
authors.forename: Liang
authors.initials: L
authors.lastname: Pei
authors.forename: Ni
authors.initials: N
authors.lastname: Yang
authors.forename: Yu-Hang
authors.initials: YH
authors.lastname: Yang
authors.forename: Zhang-Yan
authors.initials: ZY
authors.lastname: Guo
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Chun-Feng
authors.initials: CF
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D002648:Child; D052279:Creatine Kinase, MB Form; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009205:Myocarditis / Q000503:physiopathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D016277:Ventricular Function, Left
chemical_list: D020097:Natriuretic Peptide, Brain; D052279:Creatine Kinase, MB Form