All issues > Volume 47(6); 2004

Original Article

Korean J Pediatr. 2004;47(6):623-627. Published online June 15, 2004.

Is Acute Nonspecific Mesenteric Lymphadenitis Associated with Acute Abdominal Pain in Epidemic Aseptic Meningitis?

Hae Rim HR Kim¹, Kiyoung KY Ku², Young Hwan YH Lee³, Sin S Kam³, Jin-Bok JB Hwang⁴

¹Department of Pediatrics, Keimyung University School of Medicine, College of Medicine, Daegu, Korea
²Han-Young Pediatric Clinic, Daegu, Korea
³Department of Diagnostic Radiology, Daegu Catholic University School of Medicine, Daegu, Korea
⁴Department of Preventive Medicine, College of Medicine, KyungPook National University, Daegu, Korea

Correspondence Jin-Bok JB Hwang ,Email: pedgi@korea.com

Abstract

Purpose
: Acute abdominal pain in an epidemic aseptic meningitis which is mostly an enterovirus as causative agent, is noted in 23-55% of patients. An enterovirus is also known as one of the causes of acute nonspecific mesenteric lymphadenitis(ANML). The purpose of this study was to see if ANML was associated with acute abdominal pain in epidemic aseptic meningitis.
Methods
: Between June 2001 and July 2001, data from 30 patients, aged 3 years to 14 years, with aseptic meningitis was reviewed. Abdominal ultrasonography was performed on all the patients and ANML was defined as a cluster of five or more lymph nodes measuring 5 mm or greater in their longitudinal diameter in the right lower quadrant with no identifiable specific inflammatory process.
Results
: The clinical symptoms of the 30 patients were : fever(76.7%), vomiting(90.0%), diarrhea(20.0 %) and abdominal pain(40.0%). The average peripheral blood leukocytes count on admission was 7,996?,701(4,500-14,500)/mm3. ANML, according to the ultrasonography, was shown in 93.3% of aseptic meningitis patients; the number of mesenteric nodes was 9.2?.3(5-20), with 7.4% of the 27 control cases being mesenteric nodes positive(P<0.05). The patients with ANML were divided into two groups; those with and without abdominal pain, 42.9% and 57.1% respectively. Two patients without ANML showed no abdominal pain. The count of mesenteric nodes was not significantly correlated with the duration to diagnosis, with or without fever, peripheral blood leukocytes count, and with or without abdominal pain.
Conclusion
: ANML is presumed to be a cause of the acute abdominal pain in epidemic aseptic meningitis. Further clinical observations are recommended on the reason why ANML can be associated with and without abdominal pain.

Keywords :Meningitis, Aseptic, Abdominal pain, Mesenteric lymphadenitis