Respiratory viruses and febrile response in children with febrile seizures: A cohort study and embedded case-control study

被引:20
|
作者
Hautala, Maria [1 ,2 ]
Arvila, Jukka [1 ,2 ]
Pokka, Tytti [1 ,2 ]
Mikkonen, Kirsi [1 ,2 ,3 ,4 ,5 ]
Koskela, Ulla [1 ,2 ]
Helander, Heli [1 ,2 ]
Glumoff, Virpi [6 ]
Rantala, Heikki [1 ,2 ]
Tapiainen, Terhi [1 ,2 ,7 ]
机构
[1] Univ Oulu, PEDEGO Res Unit, Res Unit Pediat Dermatol Clin Genet Obstet & Gyne, Med Res Ctr Oulu MRC Oulu, Oulu, Finland
[2] Oulu Univ Hosp, Dept Pediat & Adolescent Med, POB 23, Oulu 90029, Finland
[3] Childrens Hosp, Div Child Neurol, Epilepsia Helsinki, Helsinki, Finland
[4] Helsinki Univ Hosp, Pediat Res Ctr, Helsinki, Finland
[5] Univ Helsinki, Helsinki, Finland
[6] Univ Oulu, Res Unit Biomed, Oulu, Finland
[7] Univ Oulu, Bioctr Oulu, Oulu, Finland
来源
基金
芬兰科学院;
关键词
febrile seizure; Pathogenesis; Respiratory virus; Inflammatory response; multiplex PCR; ANTIINFLAMMATORY CYTOKINES; CEREBROSPINAL-FLUID; RECURRENCES; SERUM;
D O I
10.1016/j.seizure.2020.11.007
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: There are limited data on the pathogen-related and host-related factors in the pathogenesis of febrile seizures (FS). We designed a controlled study to compare the role of different respiratory viruses and febrile response in FS. Methods: In a prospective cohort study of 1899 pediatric emergency room patients aged 6 months-6 years with a positive respiratory virus multiplex PCR, we identified 225 patients with FSs. We first compared the distribution of respiratory viruses in age-stratified patients with FSs with that in other patients. In an embedded case-control study, we compared the febrile response in patients with FSs with that in the controls matched for age, season and the same respiratory virus. Results: The relative risk for FS was the highest for coronavirus OC43, 229E, and NL63 infections [RR: 3.2, 95 % confidence interval (CI): 1.4-7.2) and influenza A and B [RR: 2.5, 95 % CI: 1.4-4.7] as compared to those with other respiratory viral infections. The patients with FSs had a stronger febrile response of 39.2 degrees C (difference: 0.8 degrees C, 95 % CI: 0.5-1.2) later during hospitalization after acute care than the controls matched for the same respiratory virus. Conclusions: Influenza and coronaviruses caused relatively more FS-related emergency room visits than other respiratory viruses. Furthermore, the febrile response was stronger in the patients with FSs than in the controls matched for the same respiratory virus. The results suggest that the pathomechanism of FSs includes modifiable pathogen-related and host-related factors with possible potential in the prevention of FSs.
引用
收藏
页码:69 / 77
页数:9
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