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Neuropediatrics 2022; 53(06): 418-422
DOI: 10.1055/a-1792-7606
Original Article

Benign Acute Childhood Myositis: Our Experience on Clinical Evaluation

Silvia D'Amico‡   *
1   Department of Clinical and Experimental Medicine, Postgraduate Training Program in Pediatrics, University of Catania, Catania, Italy
,
Gloria Gangi‡   *
1   Department of Clinical and Experimental Medicine, Postgraduate Training Program in Pediatrics, University of Catania, Catania, Italy
,
Massimo Barbagallo
2   Pediatric Unit, Azienda di rilievo nazionale ARNAS “Garibaldi,” Catania, Italy
,
Toni Palermo
2   Pediatric Unit, Azienda di rilievo nazionale ARNAS “Garibaldi,” Catania, Italy
,
Maria Carla Finocchiaro
3   Pediatric General and Emergency Operative Unit, Cannizzaro Hospital, Catania, Italy
,
Antonella Distefano
3   Pediatric General and Emergency Operative Unit, Cannizzaro Hospital, Catania, Italy
,
Raffaele Falsaperla
4   Department of Clinical and Experimental Medicine, University Hospital “Policlinico-San Marco,” Catania, Italy
,
Silvia Marino
4   Department of Clinical and Experimental Medicine, University Hospital “Policlinico-San Marco,” Catania, Italy
,
Filippo Greco
5   Unit of Pediatrics and Pediatric Emergency, AOU “Policlinico,” PO “San Marco,” University of Catania, Catania, Italy
,
Pierluigi Smilari
5   Unit of Pediatrics and Pediatric Emergency, AOU “Policlinico,” PO “San Marco,” University of Catania, Catania, Italy
,
Piero Pavone 
5   Unit of Pediatrics and Pediatric Emergency, AOU “Policlinico,” PO “San Marco,” University of Catania, Catania, Italy
› Author Affiliations
Funding None.
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Abstract

Background Benign acute childhood myositis (BACM) is a transient condition mainly affecting children of school age characterized by muscle pain, typically localized to the calf muscle with symmetrical lower extremity pain and difficulty in walking. Usually, the symptomatology is preceded by a viral infection including influenza, parainfluenza, rotavirus, and mycoplasma.

Methods The case series was conducted in four pediatric hospitals in Catania, Italy, over a 12-year observational period. Clinical examination, laboratory data, course, treatment, and complications of the affected children were extracted from electronic medical records of each hospital.

Results For the case series, 50 children diagnosed with BACM were enrolled: the mean age of affected children was 5.35 years, 86% of were males, and in 56% the affections occurred during the winter. In the affected children, the clinical picture was characterized by previous fever and/or symptoms of inflammation of the upper airways, and followed by pain in the lower extremities up to uncoordinated gait. In 17 cases the etiological agent was isolated, including the influenza virus type B as the most frequent and influenza virus type A, Mycoplasma pneumoniae, beta-hemolytic streptococcus, and herpes simplex virus. Children were treated with supportive therapy. In all the children the muscular symptomatology had a good evolution with progressive marked reduction of pain and of the high level of CKemia. Neither clinical recurrences nor sequelae were reported.

Conclusion BACM shows to have in most of the cases a favorable evolution, a spontaneous remission of symptoms, and a good prognosis. However, the disorder generates parental distress for the acute presentation and the striking muscle dysfunction. It is worthy a rapid and early diagnosis to avoid unnecessary diagnostic investigations and a careful follow-up necessary to exclude persistence of symptoms or creatine kinase elevation.

Keywords

myositis - rhabdomyolysis - renal damage - hyperCKemia - muscle disorder

Author Contributions

S.D., G.G., and P.P. designed the research study, consulted the literature, and wrote the manuscript. S.D., F.G., P.S., R.F., S.D., M.F., S.M., .T.P., and M.B. collected clinical data of the patients and made the tables. All authors contributed to editorial changes in the manuscript. All authors read and approved the final manuscript.


Ethical Approval

The study was conducted ethically in accordance with the World Medical Association's Declaration of Helsinki and was approved by the ethics committee of the University of Catania, Italy (Ethical Committee Catania Clinical Registration no. 97/2020/PO). Informed consent was obtained from the parents/or caregivers of the probands.


* These authors contributed equally.




Publication History

Received: 02 November 2021

Accepted: 05 March 2022

Accepted Manuscript online:
09 March 2022

Article published online:
28 August 2022

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