J Clin Neurol.  2019 Oct;15(4):496-501. 10.3988/jcn.2019.15.4.496.

Elevated Serum Uric Acid in Benign Convulsions with Mild Gastroenteritis in Children

• Yoo IH
• Kim W
• Cho J
• Kim H
• Lim BC
• Hwang H
• Chae JH
• Choi J
• Kim KJ

• KMID: 2467759
• DOI: http://doi.org/10.3988/jcn.2019.15.4.496

Abstract

BACKGROUND AND PURPOSE
To identify whether serum uric acid levels are significantly higher in patients with benign convulsion associated with mild gastroenteritis (CwG) than in patients with acute gastroenteritis.
METHODS
This retrospective study compared the serum levels of uric acid between CwG, acute gastroenteritis, and febrile seizure after correcting for the varying degree of mild dehydration using serum HCO3⁻ levels. We also compared the serum uric acid levels between patients with CwG and febrile seizures in order to exclude the effect of seizures on uric acid.
RESULTS
This study included 154 CwG patients (age range 0.73-3.19 years), 2,938 patients with acute gastroenteritis, and 154 patients with febrile seizure. The serum uric acid level was significantly higher in CwG patients than in patients with acute gastroenteritis [9.79±2.16 mg/dL vs. 6.04±2.3 mg/dL (mean±SD), p<0.001]. This difference was also significant after correcting for dehydration. The serum uric acid level was significantly higher in CwG patients than in dehydration-corrected acute gastroenteritis patients (9.79±2.16 mg/dL vs. 6.67±2.48 mg/dL, p<0.001). The serum uric acid level was not elevated in patients with febrile seizure.
CONCLUSIONS
We have confirmed that serum uric acid is elevated in CwG patients even after correcting for their dehydration status, and that this was not a postictal phenomenon. Highly elevated serum uric acid in CwG could be a useful clinical indicator of CwG in patients with acute gastroenteritis.

Keyword

gastroenteritis; seizure; uric acid

MeSH Terms

Child*
Dehydration
Gastroenteritis*
Humans
Retrospective Studies
Seizures*
Seizures, Febrile
Uric Acid*
Uric Acid

Figure

• 

  Fig. 1 Boxplot of serum uric acid level of the three groups (CwG, acute gastroenteritis, and febrile seizure). *p<0.05. CwG: benign convulsions associated with mild gastroenteritis.

• 

  Fig. 2 Serum UA level in patients with CwG and acute gastroenteritis after 1:4 matching by HCO3− levels. A: Histogram of serum UA in CwG and HCO3− matched AGE patients. B: Distribution of serum UA in CwG and HCO−3-matched acute gastroenteritis patients shown in a density plot. Dashed lines indicate mean serum UA levels of each group (*p<0.05). CwG: benign convulsions associated with mild gastroenteritis, UA: uric acid.

• 

  Fig. 3 Receiver operating characteristics curve of serum uric acid level's capacity to predict CwG over HCO3−-matched acute gastroenteritis patients. Optimal cutoff value is depicted in a red dot. AUC: area under the curve, CwG: benign convulsions associated with mild gastroenteritis.

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