Pediatrics
doi: 10.25005/2074-0581-2020-22-3-403-408
CLINICAL AND LABORATORY FEATURES OF ENDOGENOUS INTOXICATION SYNDROME IN CHILDREN UNDER 3 YEARS WITH PNEUMONIA

R.M. Abdurakhimov1,2, A. Vokhidov3

1Department of Morphology, Faculty of Medicine, Tajik National University, Dushanbe, Republic of Tajikistan
2Tajik Scientific Research Institute of Preventive Medicine, Dushanbe, Republic of Tajikistan
3«Istiklol» Health Complex, Dushanbe, Republic of Tajikistan

Objective: To study the clinical features of the course and the dynamics of some haematological indices in endogenous intoxication syndrome in children under 3 years of age suffering from pneumonia.

Methods: There were 80 children under surveillance, of which 60 were pneumonia patients (main group), and 20 healthy children (control group). Laboratory survey included determining levels of leukocyte index of intoxication (LII), lactic and uric acids. The respiratory failure (RF) I is noted in 51.6%, RF II in 34.2% and RF III in 14.2% of cases.

Results: Clinically and radiologically, 60.5% of children were diagnosed with bilateral processes in lungs, and in 39.5% the unilateral process. Signs of endogenous intoxication were: hyperhidrosis (59.4%), acrocyanosis (46.6%), perioral cyanosis (55.5%), mottled skin integument (49.2%), pronounced subcutaneous venous network (48.2%). The LII rate in the acute period had a strong tendency towards an increase of up to 5 days, with a gradual reduction to normal reference values by the end of the first week. It was found that high levels of lactic and uric acids were closely correlated with hypoxia. For example, in RF I, II and III levels of lactic acid were 1.3±0.1, 1.9±0.2 and 2.61±0.25 respectively. Children with RF III have degrees of lactic acid concentration that was statistically significant (p<0.001) higher than in the control group.

Conclusion: Lactic and uric acid levels depend on the degree of RF and can indicate the severity of endogenous intoxication syndrome. The reduction of LII indices below 3.0 by the end of the first week of the disease, maybe a sign of a favorable outcome.

Keywords: Pneumonia, respiratory failure, endogenous intoxication, leukocyte index of intoxication, lactic acid, uric acid.

Download file:

References
  1. Alieva ZhK, Bokonbaeva SD. Osobennosti etiologicheskoy struktury i kliniki vnebol’nichnoy pnevmonii u detey rannego vozrasta iz mnogodetnykh semey [Features of the etiological structure and clinic of community-acquired pneumonia in young children from large families]. Sovremennyye problemy nauki i obrazovaniya. 2018;4:196.
  2. Tsarkova SA. Vnebol’nichnaya pnevmoniya u detey [Community-acquired pneumonia in children]. Ekaterinburg, RF: UGMU; 2015. 79 p.
  3. Bobrovnichiy VI. Pnevmonii u detey: epidemiologicheskie aspekty [Pneumonia in children: epidemiological aspects]. Meditsinskiy zhurnal. 2018;2:29-30.
  4. Abromovich ML, Ploskireva AA. Osobennosti gematologicheskikh pokazateley pri ostrykh respiratornykh infektsiyakh u detey raznogo vozrasta [Features of hematological parameters in acute respiratory infections in children of different ages. Lechashchiy vrach. 2015;11:59-64.
  5. Alekseeva LA, Ibragimova OM, Babachenko IV, Bessonova TV, Golovachyova NN. Znachenie gematologicheskikh pokazateley pri ostrykh respiratornykh virusnykh infektsiyakh u detey [The value of hematological parameters in acute respiratory viral infections in children]. Zhurnal infektologii. 2013;5(3):43-9.
  6. Zubarenko AV, Kopeyka AK, Papinko RM. Integral’naya otsenka gematologicheskikh pokazateley pri vnebol’nichnoy pnevmonii u detey raznogo vozrasta [Integrated assessment of hematological parameters in community-acquired pneumonia in children of different ages]. Zaporozhskiy meditsinskiy zhurnal. 2019;21(1):78-83.
  7. Ostrovskiy VK, Semyonova OP, Mashchenko AV, Alimov RR, Kurapova MI. Nekotorye dannye o pokazatelyakh normy leykotsitarnogo indeksa intoksikatsii [Some data on indicators of normal leukocyte intoxication index]. Klinicheskaya laboratornaya diagnostika. 2003;1:45-6.
  8. Sakovich AR. Gematologicheskie leykotsitarnye indeksy pri ostrom gnoynom sinusite [Hematologic leukocyte indices in acute purulent sinusitis]. Meditsinskiy zhurnal. 2012;4:88-91.
  9. Kovalenko LA, Sukhodolova GN. Integral’nye gematologicheskie indeksy i immunologicheskie pokazateli pri ostrykh otravleniyakh u detey [Integrated hematological indices and immunological parameters in acute poisoning in children]. Obshchaya reanimatologiya. 2013;9(5):24-8.
  10. Malakhova MYa. Metody biokhimicheskoy registratsii endogennoy intoksikatsii (soobshchenie vtoroe) [Methods of biochemical registration of endogenous intoxication (second message)]. Efferentnaya terapiya. 2011;1(2):61-4.
  11. Anaev EKh. Laktat i lyogkie: ot teorii k praktike [Lactate and lungs: from theory to practice]. Pul’monologiya. 2014;6:108-14.
  12. Sadovnikova IV. Klinicheskie proyavleniya endogennoy intoksikatsii i mekhanizmy metabolicheskoy zashchity organizma pri khronicheskikh gepatitakh u detey [Clinical manifestations of endogenous intoxication and metabolic defense mechanisms in children with chronic hepatitis]. Sovremennye tekhnologii v meditsine. 2011;3:168-70.
  13. Shmoylov DK, Karimov IZ, Odinets TN. Patogeneticheskaya rol’ endogennoy intoksikatsii [The pathogenetic role of endogenous intoxication]. Laboratornaya diagnostika. 2012;2:65-9.
  14. Fyodorova OV, Fedulova EN, Tutina OA, Kopeykin VN. Patogeneticheskaya sorbtsionnaya terapiya endogennoy intoksikatsii vospalitel’nykh zabolevaniy kishechnika u detey [Pathogenetic sorption therapy of endogenous intoxication of inflammatory bowel diseases in children]. Pediatricheskaya farmakologiya. 2009;6(5):34-7.
  15. Kurochkin MYu, Davydova AG, Gorodkova YuV, Kapusta VN. Osobennosti intensivnoy terapii tyazhelykh vnegospital’nykh infektsiy u detey [Features of intensive care of out-of-hospital infections in children]. Meditsina neotlozhnykh sostoyaniy. 2015;7:56-60.
  16. Rakhmatova RA. Korrektsiya dykhatel’noy nedostatochnosti u novorozhdyonnykh s vrozhdyonnymi porokami razvitiya [Correction of respiratory failure in newborns with congenital malformations]. Pediatriya i detskaya khirurgiya Tadzhikistana. 2012;2:34-5.
  17. Shumatova TA, Prikhodchenko NG. Optimizatsiya otsenki tyazhesti pnevmonii u detey v otdelenii intensivnoy terapii [Optimization of assessing the severity of pneumonia in children in the intensive care unit]. Tikhookeanskiy meditsinskiy zhurnal. 2008;1:71-4.
  18. Ismoilov KI, Davlatova SТ, Ismoilova МА. Osobennosti razlichnykh zven’ev gemostaza pri pnevmonii u detey grudnogo vozrasta [Features of the various components of hemostasis of pneumonia in infants]. Zdravookhranenie Tadzhikistana. 2015;4:16-20.
  19. Ochilova SS, Aliev ShR, Yodgorova NT. Etiologicheskaya rol’ i analiz mikoplazm u detey s ostroy i khronicheskoy pnevmoniey [The etiological role and analysis of mycoplasma in children with acute and chronic pneumonia]. Biologiya i integrativnaya meditsina. 2016;5:74-84.
  20. Ochilova SS, Aliev ShR, Yodgorova NT. Mikrobniy peyzazh slizistoy obolochki dikhatel’noy sistemy u detey s mikoplazmennoy pnevmoniey [The view of microbes of mucous membrane of respiratory tract in children suffered from acute pneumonia with etiology of mycoplasma]. Biologiya i integrativnaya meditsina. 2017;3:53-64.
  21. Antonovich ZhV. Nozokomial’naya pnevmoniya: sovremennye podkhody k diagnostike i lecheniyu [Nosocomial pneumonia: modern approaches to diagnosis and treatment]. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski. 2019;3(2):626-35.

Authors' information:

Abdurakhimov Rustam Miralievich
Assistant, Department of the Morphology, Faculty of Medicine, State National University; Applicant, Tajik Scientific Research Institute of Preventive Medicine
Researcher ID: AAT-5823-2020
ORCID ID: 0000-0003-4639-2727
SPIN: 1335-8025
Author ID: 930642
E-mail: abdurakhimov67@list.ru

Vokhidov Abdusalom
Doctor of Medical Sciences, Full Professor, Leading Researcher, Istiklol Health Complex
Researcher ID: AAT-5810-2020
ORCID ID: 0000-0003-1464-8097
E-mail: avokhidov@hotmail.com

Information about support in the form of grants, equipment, medications

The work was carried out according to the plan of scientific research works of Tajik Scientific Research Institute of Preventive Medicine (state registration number – 0102ТД968). The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Vokhidov Abdusalom
Doctor of Medical Sciences, Full Professor, Leading Researcher, Istiklol Health Complex

734064, Republic of Tajikistan, Dushanbe, N. Karabaev str., 60

Tel.: +992 (907) 707996

E-mail: avokhidov@hotmail.com

Materials on the topic:
  1. IMPACT OF THE COVID-19 PANDEMIC ON VITAMIN D LEVELS IN CHILDREN OF RYAZAN
  2. EPIDEMIOLOGICAL ASPECTS OF CONTEMPORARY PHYSICAL DEVELOPMENT IN CHILDREN
  3. OXIDANT AND ANTIOXIDANT STATUS IN NEONATES WITH SPECIFIC INTRAUTERINE INFECTIONS
  4. CLINICAL AND ANAMNESTIC PATTERN AND SENSITIZATION TO AEROALLERGENS IN CHILDREN WITH ATOPIC BRONCHIAL ASTHMA
  5. Exercise-related changes of the physiological indicators in children with different forms of spastic cerebral palsy
  6. ACID-BASIC BALANCE, BLOOD GASES AND ECHOCARDIOGRAPHIC CHANGES IN BRONCHIAL ASTHMA IN CHILDREN
  7. ADHERENCE TO THERAPY AND ITS IMPACT ON THE CONTROL OF ASTHMA SYMPTOMS IN CHILDREN
  8. FEATURES OF CLINICAL MANIFESTATIONS, CELLULAR AND HUMORAL IMMUNITY OF NEWBORNS WITH INTRAUTERINE MIXED INFECTIONS
  9. HUMAN HERPES VIRUS TYPE 6 INFECTION IN CHILDREN AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION IN THE REPUBLIC OF BELARUS
  10. INDICATORS OF SORPTION ABILITY AND PERMEABILITY OF ERYTHROCYTE MEMBRANES IN CHILDREN AND NEWBORNS, LIVING IN THE AREA OF INCREASED RADIATION BACKGROUND

◄ Back to the list