PT  - JOURNAL ARTICLE
AU  - Andrea Lo Vecchio
AU  - Andrzej Krzysztofiak
AU  - Carlotta Montagnani
AU  - Piero Valentini
AU  - Nadia Rossi
AU  - Silvia Garazzino
AU  - Irene Raffaldi
AU  - Maria Di Gangi
AU  - Susanna Esposito
AU  - Barbara Vecchi
AU  - Maria Luisa Melzi
AU  - Marcello Lanari
AU  - Giorgio Zavarise
AU  - Samantha Bosis
AU  - Mariella Valenzise
AU  - Salvatore Cazzato
AU  - Michele Sacco
AU  - Maria Rita Govoni
AU  - Elena Mozzo
AU  - Maria Donata Cambriglia
AU  - Eugenia Bruzzese
AU  - Chiara Di Camillo
AU  - Davide Pata
AU  - Alessandro Graziosi
AU  - Debora Sala
AU  - Fabio Magurano
AU  - Alberto Villani
AU  - Alfredo Guarino
AU  - Luisa Galli
ED  - ,
TI  - Complications and risk factors for severe outcome in children with measles
AID  - 10.1136/archdischild-2018-315290
DP  - 2019 Jan 13
TA  - Archives of Disease in Childhood
PG  - archdischild-2018-315290
4099  - http://adc.bmj.com/content/early/2019/01/13/archdischild-2018-315290.short
4100  - http://adc.bmj.com/content/early/2019/01/13/archdischild-2018-315290.full
AB  - Objective and design Risk factors for severe measles are poorly investigated in high-income countries. The Italian Society for Paediatric Infectious Diseases conducted a retrospective study in children hospitalised for measles from January 2016 to August 2017 to investigate the risk factors for severe outcome defined by the presence of long-lasting sequelae, need of intensive care or death.Results Nineteen hospitals enrolled 249 children (median age 14.5 months): 207 (83%) children developed a complication and 3 (1%) died. Neutropaenia was more commonly reported in children with B3-genotype compared with other genotypes (29.5% vs 7.7%, p=0.01). Pancreatitis (adjusted OR [aOR] 9.19, p=0.01) and encephalitis (aOR 7.02, p=0.04) were related to severe outcome in multivariable analysis, as well as C reactive protein (CRP) (aOR 1.1, p=0.028), the increase of which predicted severe outcome (area under the receiver operating characteristic curve 0.67, 95% CI 0.52 to 0.82). CRP values >2 mg/dL were related to higher risk of complications (OR 2.0, 95% CI 1.15 to 3.7, p=0.01) or severe outcome (OR 4.13, 95% CI 1.43 to 11.8, p<0.01).Conclusion The risk of severe outcome in measles is independent of age and underlying conditions, but is related to the development of organ complications and may be predicted by CRP value.