Abstract
BackgroundOutbreaks of Hand Foot and Mouth Disease (HFMD) have occurred in many parts of the world especially in China. We aimed to summarize the characteristics of the levels of blood glucose and white blood cell (WBC) counts in cases of HFMD in Mainland China and Taiwan, using meta-analysis based on systematic review of published articles.MethodsWe systematically reviewed published studies, from the MEDLINE and WANFANG Data, about the levels of blood glucose and WBC counts in cases of HFMD until 15th June 2011, and quantitatively summarized the characteristics of them using meta-analysis.ResultsIn total, 37 studies were included in this review. In Mainland China and Taiwan, generally, the average level of blood glucose, the prevalence of hyperglycemia, WBC counts and the prevalence of leukocytosis increased with the severity of the illness. There was no significant difference in the prevalence of leukocytosis between ANS (autonomic nervous system dysregulation)/PE (pulmonary edema) group and CNS (central nervous system) group, and in the average level of blood glucose between healthy controls and mild cases of HFMD. WBC counts in cases infected by EV71 were less than those in cases infected by CA16.Conclusionsour analyses indicated that blood glucose and WBC counts increased with the severity of HFMD disease, which would help doctors to manage patients efficiently.
Highlights
Hand foot and mouth disease (HFMD), which was first reported in New Zealand in 1957, is an unremarkable illness that commonly occurs in young children, most of whom are younger than 5 years old
Inclusion and exclusion criteria Studies addressing blood glucose and/or white blood cell (WBC) counts, healthy controls and mild cases of Hand Foot and Mouth Disease (HFMD), and/or mild cases and severe cases of HFMD, and/or cases with central nervous system (CNS) and cases with autonomic nervous system dysregulation (ANS) and/or pulmonary edema (PE) [4] and/or cases infected by enterovirus 71 (EV71) (EV71) and cases infected by coxsackievirus A16 (CA16) (CA16) were included
Studies in languages other than English or Chinese, studies without mild cases and severe cases of HFMD or healthy control and mild cases of HFMD or CNS and ANS and/or PE or cases infected by EV71 and cases infected by CA16, studies with mild cases of HFMD only or severe cases of HFMD only, the levels of blood glucose and/or WBC counts not being present as mean and standard deviation (x6s), the level of glucose and/or WBC counts in cerebrospinal fluid and case report, were excluded
Summary
Hand foot and mouth disease (HFMD), which was first reported in New Zealand in 1957, is an unremarkable illness that commonly occurs in young children, most of whom are younger than 5 years old. Hyperglycemia and leukocytosis are two important characteristics in severe cases of HFMD, and blood glucose and white blood cell (WBC) counts change with the severity of the disease, which have been addressed by multiple studies such as those reported by Mao et al [5] and Yu et al [6], and the results are not always consistent. Outbreaks of Hand Foot and Mouth Disease (HFMD) have occurred in many parts of the world especially in China. We aimed to summarize the characteristics of the levels of blood glucose and white blood cell (WBC) counts in cases of HFMD in Mainland China and Taiwan, using meta-analysis based on systematic review of published articles
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