Laboratory Findings of Benign Convulsions With Mild Gastroenteritis: A Meta-Analysis

Abstract

Investigating factors associated with benign convulsions with mild gastroenteritis (CwG) is important for early detection and treatment. In previous studies, uric acid (UA) has been reported to be associated with CwG. However, the association between CwG and abnormal laboratory values remains inconclusive. We performed a meta-analysis of recent reports to determine the association between CwG and laboratory findings, including UA, in patients with acute gastroenteritis without convulsions. We conducted electronic searches of three databases (PubMed, EMBASE, and Cochrane Library) and one scholarly search engine (Google Scholar (Google, Inc., Mountain View, CA, USA)) up to February 2023 for studies on CwG. Eligible studies were observational studies that assessed patients with CwG, reported laboratory data, and stated the presence or absence of convulsions during illness episodes. Patients were children with mild gastroenteritis, with the exposure group developing convulsions and the control group not. The outcome was a comparison of laboratory data between the two groups. The effect size was calculated using the standardized mean difference (SMD), and random-effects models were used for the analysis because of high heterogeneity. In total, 148 articles were included in this study. After the screening, nine studies, including 8,367 patients, were selected for the meta-analysis. The most prevalent laboratory finding was an increased serum UA level, with an SMD of 1.42 (N = 6,411; 95% confidence interval (CI): (1.12, 1.72); Z = 9.242, p< 0.001; I ² = 81.68%, p= 0.002). The optimal serum UA cutoff value was 7.21 mg/dL, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.827 (95% CI: (0.807, 0.846)). This meta-analysis suggests that CwG is strongly associated with increased serum UA levels. These results demonstrate that more attention should be paid when interpreting laboratory findings in pediatric patients with acute gastroenteritis.

Keywords: benign convulsions with mild gastroenteritis; chatgpt; child; convulsion; gastroenteritis; hyperuricemia; laboratory finding; meta-analysis; seizure; uric acid.

Figure 1. Flow diagram of the study process

Figure 2. Forest plot of studies on CwG and serum UA levels

Tsujita Y [8], Chae SH [9], Yoo IH [10], Yoo SY [11], Fang C [12], and Jiang D [13] Abbreviations: CwG, benign convulsions with mild gastroenteritis; UA, uric acid; SMD, standardized mean difference; CI, confidence interval, RE, random-effects

Figure 3. Sensitivity analysis of studies on CwG and serum UA levels without an outlier

Chae SH [9], Yoo IH [10], Yoo SY [11], Fang C [12], and Jiang D [13] Abbreviations: CwG, benign convulsions with mild gastroenteritis; UA, uric acid, SMD, standardized mean difference

Figure 4. Result of subgroup analysis by country (Korea and China)

Yoo SY [11], Yoo IH [10], Chae SH [9], Jiang D [13], and Fang C [12] Abbreviations: SMD, standardized mean difference; CI, confidence; RE, random-effects; FE: fixed-effects

Figure 5. ROC for the prediction of CwG based on serum UA levels

Abbreviations: ROC, receiver operating characteristic curve; CwG, benign convulsions with mild gastroenteritis; UA, uric acid; AUC, area under the receiver operating characteristic curve

Figure 6. ChatGPT

Figure 7. ChatGPT