Childhood Langerhans Cell Histiocytosis Increased during El Niño 1997-98: A Report from the Taiwan Pediatric Oncology Group

兒童蘭格罕氏組織球增生症於1997-98聖嬰現象時增加：台灣兒童癌症研究群(TPOG)之報告

陳榮隆(Rong-Long Chen) ； 林國信(Kuo-Sin Lin) ； 張婉惠(Wan-Hui Chang) ； 謝玉林(Yuh-Lin Hsieh) ； 陳博文(Bow-Wen Chen) ； 江東和(Tang-Her Jaing) ； 楊兆平(Chao-Ping Yang) ； 洪悠紀(Iou-Jih Hung) ； 彭慶添(Ching-Tien Peng) ； 徐山靜(San-Ging Shu) ； 盧孟佑(Meng-Y)

《Acta Paediatrica Taiwanica》 44卷1期 (2003/02) Pp. 14-20

https://doi.org/10.7097/APT.200302.0014

摘要

本研究分析臺灣兒童癌症研究群(TPOG)自1995年至1999年登錄55例年齡小於15歲之兒童蘭格罕氏組織球增生症個案之流行病學及臨床資料。其中32例診斷於本世紀發生最大聖嬰現象之1997年及1998年，此二年兒童蘭格罕氏組織球增生症之年發生率明顯較高(32例比22例，p=0.003)，且此時期蘭格罕氏組織球增生症之診斷時間分佈在夏(15例)、秋(8例)，春季(1例)則罕見；臺灣地區城鄉雨量最多的夏季，冬季最稀少。經分析1997年及1998年個案比起其他年份最顯著增加者爲我發生骨骼亞型(p=0.017)，且診斷年齡較低(p=0.039)；其他器官及症狀表現(如皮膚、肝臟、脾臟疾病、發燒等)，則1997年及1998年者爲三項比較容易活性復發或惡化之獨立變因。與聖嬰現象相關之感染或其他環境因子可能與兒童蘭格罕氏組織球增生症有所關聯。

關鍵字

蘭格罕氏組織球增生症 ； 聖嬰現象 ； 兒童期 ； 台灣

並列摘要

From 1995-1999, a nation-wide study ofLangerhans cell histiocytosis (LCH) in children less than 15 years old was conducted by the Taiwan Pediatric Oncology Group. The demographic and clinical data of 55 cases were analyzed. Thirty-two cases presented from the beginning of1997 to the end of 1998, when the most severe El Niño in the century occurred. The incidence was higher than expected during this El Niño period (32 cases versus 22 cases, p=0.003). During 1997-98, most LCH was diagnosed in summer (n=15), autumn (n=8), and winter (n=8) but rarely in spring (n=1); coincidentally, rainfall was least in winter but peaked in summer. During 1997-98, the most significant increase occurred in the polyostotic LCHsubcategory (p=0.017), with younger ages at diagnosis (p=0.039). The incidence of LCH cytopenia, fever, and diseases of the skin, liver, spleen or other organs did not differ significantly. Local treatment modality, disseminated diseases and diagnosis during the El Niño of 1997-98were independent risk factors predicting the recurrence or progression of LCH. Our findings suggest that particular infections or other environmental factors associated with El Niño might be related to the etiology of childhood LCH.

並列關鍵字

Langerhans cell histiocytosis ； El Niño ； children ； Taiwan