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Outcome of Benign Acute Childhood Myositis

The Experience of 2 Large Tertiary Care Pediatric Hospitals

Rosenberg, Tom MD*; Heitner, Shmuel MD; Scolnik, Dennis MB, ChB; Levin Ben-Adiva, Einav MD*; Rimon, Ayelet MD*; Glatstein, Miguel MD*

doi: 10.1097/PEC.0000000000000830
Original Articles
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Objective The aims of the study were to determine the evolution of benign acute childhood myositis in children and to assess the relationship between creatine phosphokinase (CPK) values and myoglobinuria.

Study design A retrospective study of patients with benign acute childhood myositis seen in 2 tertiary care university-affiliated pediatric hospitals during overlapping 4-year periods.

Methods Demographic data, historical details, clinical, and laboratory results were extracted from the charts of children younger than 16 years with a CPK greater than 3 times normal. Complications, treatments, and outcomes were recorded.

Results Fifty-four children were included, 43 (80%) were male, and mean age was 7.3 years (median [range], 6 [3–16] years), none showed abnormal neurological findings, manifested hematuria, or developed renal failure. Mean CPK level at presentation was 1872 IU/L (range, 511–8086 IU/L). None developed renal failure, and there were no adverse outcomes on follow-up.

Conclusions Acute childhood myositis is a predominantly benign disease. Neurological examination is usually normal and rhabdomyolysis is rare. Although severe pathological comorbid conditions must be excluded, a complete history and examination, coupled with simple blood and urine tests, can help minimize unnecessary diagnostic investigations.

From the *Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana-Dwek Children Hospital, Sourasky Medical Center, University of Tel Aviv, Tel Aviv;

Division of Pediatric Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel; and

Division of Pediatric Emergency Medicine, Clinical Pharmacology Toxicology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Disclosure: The authors declare no conflict of interest.

Reprints: Miguel M. Glatstein, MD, Division of Pediatric Emergency Medicine, Dana-Dwek Children's Hospital, 6 Weizman St, Tel- Aviv 64239, Israel (e-mail: Nopasara73@hotmail.com).

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