Clinical analysis of 255 children with multiple serous effusions

TL;DR

This study examines the causes and patterns of fluid buildup in multiple body cavities in 255 children to help doctors better diagnose and treat the condition.

Contribution

The study identifies age- and sex-specific patterns in the causes of multiple serous effusions in children.

Findings

Pneumonia was the most common cause in preschool and school-aged children.

Triple serous cavity effusions were linked to more severe disease markers like lower hemoglobin and higher C-reactive protein.

Connective tissue diseases predominantly affected adolescent females and involved all three serous cavities.

Abstract

This study aimed to analyze the etiological spectrum, clinical features, and pathological correlates of multiple serous effusions in pediatric patients to inform clinical decision-making.

A retrospective study was conducted on 255 children diagnosed with multiple serous effusions at the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University between January 1, 2014, and July 1, 2024.

The most common identified causes were pneumonia (n = 80, 31.37%), and trauma (n = 28, 10.98%). Etiologies demonstrated age and sex-specific patterns. Pneumonia predominated in preschool/school-aged children, and trauma was more common among preschool/school-aged boys. Tumors mainly affected school-aged/adolescent males, while connective tissue diseases (primarily systemic lupus erythematosus) predominated in adolescent females. Pleural effusion was the most common manifestation (n = 243, 95.3%), followed by peritoneal (n = 187, 73.3%) and pericardial effusions (n = 136, 53.3%). The nature and distribution of effusions correlated with the underlying disease. Pneumonia/tumor cases exhibited higher susceptibility to pleural and pericardial effusions, predominantly exudative. Connective tissue disease cases frequently demonstrated involvement of all three serous cavities, predominantly exudative. Cardiac insufficiency cases typically presented with transudative effusions. The triple serous cavity effusion group exhibited significantly lower hemoglobin, serum albumin, calcium, and IgM levels (p < 0.05), alongside significantly elevated C-reactive protein, brain natriuretic peptide, prothrombin time, international normalized ratio, and D-dimer levels (p < 0.05), indicating more severe disease progression.

The etiology of pediatric multiple serous effusions is diverse and closely linked to patient age and effusion location. The number of affected cavities may serve as an indicator of disease severity.

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