Kronik ishal ile başvuran olgularda otoantikor pozitifliği

Amaç: Kronik ishal yakınması ile başvuran olgularda serolojik belirteçler olan otoantikorların (ANA, p-ANCA, ASCA, PAb, GAb) sıklığını belirlemek ve inflamatuar barsak hastalığı (İBH) tanısında bu otoantikorların ayırıcı tanıdaki rolünü saptamak. Gereç ve Yöntem: Çalışmamızda 51 kronik ishal olgusunun serumları ve 35 sağlıklı kontrol grubu serumları çalışıldı. Serum örneklerinin alındığı dönemdeki klinik ve laboratuar verileri, tetkikler neticesinde aldıkları tanılar kaydedildi. Çalışmamızda tüm hastalarda ANA, p- ANCA, ASCA, GAb, PAb immünfloresan titerplane teknik kullanılarak çalışıldı. Sonuçlar: Kronik ishali olan olguların yaş ortalaması 60,90±59,76 (9-206) ay, kontrol grubunun yaş ortalaması 65,2±52,8 (8-180) ay olarak hesaplandı. Kronik ishalle başvuran 51 hastadan 11'inde ( % 21,6) ANA, 3'ünde (% 5,9) pANCA, 1'inde (% 2) PAb, 1'inde (% 2) GAb, 1'inde (% 2) ASCA pozitifliği saptandı. Kontrol grubunda 35 kontrolden 8'inde (% 22,9) ANA, 7'sinde (% 20) ASCA pozitifliği saptandı. pANCA, GAb, PAb pozitifliği saptanmadı. Kontrol grubu ile karşılaştırıldığında kronik ishal olgularında ANA (p=0,545), pANCA (p=0,203), GAb (p=0,593), PAb (p=0,93) pozitifliği ile istatistiksel olarak anlamlı fark saptanmadı. Kontrol grubunda ASCA (p=0,007) yüksek bulundu. Kronik ishal olgularının içinde İBH tanısı alan 6 olgudan 1'inde (% 16,7) ANA, 1'inde (% 16,7) pANCA, 1'inde (% 2) GAb, 1'inde (% 2) ASCA pozitifliği saptandı. PAb pozitifiliği saptanmadı. İBH ile İBH dışı kronik ishal olguları karşılaştırıldığında İBH'nda ANA (p=0,756) pANCA pozitifliği (p=0,232), PAb pozitifliği (p=0,712) istatistiksel olarak anlamlı oranda artmış saptanmadı. ASCA (p=0,006) ve GAb (p=0,006) pozitifliği istatistiksel olarak anlamlı oranda yüksek saptandı. Tartışma: Kronik ishalli olgularda otoantikor düzeyleri yüksek saptanmazken, İBH tanısı olan olgularda ASCA ve GAb anlamlı olarak yüksek bulunmuştur. pANCA, ASCA, PAb, GAb bakılmasına dayanan serolojik testler İBH tanısı koymada ve ayırıcı tanısında tek başına tanı koymadan çok yardımcı testler olabilir

Is There a Relation Between Vitamin B-12 Levels and Headaches in Children and Adolescents?

Objective: Primary headaches are common and benign discomforts both in children and adolescents. However, they have a negative influence on the quality of life. This retrospective study aimed to determine the relationship between vitamin B-12 results and primary headaches in Turkish children

The Effect of L-Thyroxine Treatment on Hypothyroid Symptom Scores and Lipid Profile in Children with Subclinical Hypothyroidism

Objective: To evaluate i) the frequency of typical hypothyroidism symptoms in children with subclinical hypothyroidism (SH), ii) to evaluate the association of SH with lipoproteins and iii) to investigate possible improving effects of L-thyroxine (LT4) treatment on these findings. Methods: Twenty-seven children with SH who had elevated thyroid-stimulating hormone (TSH: >4.94 µIU/L) but normal free T4 levels and healthy euthyroid children of similar age and sex were enrolled in the study. Anthropometric and laboratory (lipid profile and thyroid function tests) measurements were performed at diagnosis and six months after euthyroidism was achieved. All children were also subjected to a questionnaire on hypothyroid symptoms at diagnosis. The SH patients were subjected to the questionnaire also following treatment. Pre-treatment data were compared with those of controls and post-treatment measurements. Results: Anthropometric and laboratory parameters of the groups were not statistically different except for higher TSH levels in the SH group. Serum lipoprotein levels and dyslipidemia frequency were similar between the groups. Compared to the controls, hypothyroidism symptom score was significantly higher in the SH group. Six months after euthyroidism was achieved, a significant reduction in the hypothyroid symptom score was obtained in the SH group. Except for significantly higher serum TSH values, no significant differences regarding demographic characteristics, symptom scores and lipid parameters were present between patients with Hashimoto’s thyroiditis and the remaining SH patients. Conclusion: The results of this study showed that in children with SH i) the hypothyroidism symptom score was significantly higher than in euthyroid children, ii) LT4 treatment improved the hypothyroidism symptom score and iii) SH does not seem to be associated with dyslipidemia

Celiac Disease in Childrenand Adolescents withHashimoto Thyroiditis

AIM: The aim of this study was to evaluate clinical and laboratory findings and determine the prevalence of celiac disease (CD) in children with Hashimoto thyroiditis (HT). MATERIAL AND METHODS: The data of a total of 80 patients with positive anti-thyroid antibodies who were aged between 6 and 17.9 years were retrospectively studied. Age, gender, complaints at the time of presentation, family history of thyroid disorders, clinical and laboratory findings were recorded. The levels of thyrotropin, free thyroxin, thyroid autoantibodies (thyroid peroxidase and thyroglobulin antibodies), immunoglobulin A (IgA), anti-tissue transglutaminase antibodies (IgA-tTG), and thyroid ultrasonography findings were enrolled. RESULTS: Eighty patients (65 females (81.2%) and 15 males (18,8%)) were included in the study. Family history of thyroid disease was present in 38 (47.5%) patients. The most common complaints at the time of presentation were goiter (%30) and weight gain (%25). Forty three (53.8%), 23 (28.7%), and 14 (17.5%) patients presented with euthyroidism, subclinical hypothyroidism and obvious hypothyroidism. Thirty seven (46.2%) patients had goiter. IgA-tTG was found to be positive after a diagnosis of HT was made in only one patient (1.25%) and the diagnosis of CD was confirmed when intestinal biopsy of this patient revealed villus atrophy, crypt hyperplasia and increase in the intraepithelial lymphocyte count. CONCLUSIONS: In our study, it was found that the most common complaints at presentation in patients with a diagnosis of hashimoto thyroiditis included goiter, weakness and weight gain and the prevalence of celiac diseases was found to be 1.25% (1/80). This study shows that the prevalence of CD in patients with a diagnosis of HT is higher compared to the prevalence in the healthy pediatric population