Etiology,Clinical Characteristics And Immunological Studies In Severe Patients With Hand,Foot And Mouth Disease

Objective To explore the etiology, clinical manifestations and immunology of severe patients with hand, foot and mouth disease (HFMD) in Jinan area in2009.Method186children enrolled in Jinan infectious disease hospital in2009were included in this study, who met the diagnosis criteria of the Guidelines for diagnosis and treatment of hand, foot and mouth disease for severe cases. The detailed epidemiological data and clinical manifestations were collected; the T-lymphocyte subsets (CD3+、CD4+、CD8+、CD16+、CD56+) were tested by flow cytometry; IgG, IgA and IgM in sera were tested by ELISA; and the pathogens were detected by RT-PCR (three different pairs of primers, include enterovirus general primers, entero virus71special primers and coxsackie virus A16special primers). Cases were divided into four groups according to the pathogens.Result The main pathogens in children with severe HFMD were EV71(132/184,71.2%), COXA16:(35/184,19.0%), EV (15/184,8.2%) and the negative (4/184,2.2%).There were no significant differences in clinical manifestations (age, gender, body temperature, peripheral white blood cell count and glucose) except tremor. The percentage of NK cell in EV71group was lower than that in the other three groups.Conclusion1. EV71was the major pathogen in children with severe HFMD.2. Tremor could improve the possibility of EV71infection in severe cases with HFMD.3. Worse nature immunity was related with EV71infection.Significance1. Tremor could improve the possibility of EV71infection in severe cases with HFMD.2. Worse nature immunity was found in the children infected by EV71, Worse nature immunity may mean poor prognosis.