Assesment of Upper Gastrointestinal Bleeding in the Pediatric Emergency Department

Introduction:Upper gastrointestinal bleeding is an important emergency problem that can occur at any age in childhood and requires urgent treatment for the underlying cause. Etiological causes of gastrointestinal bleeding vary by age and geographic region. In this study; we aimed to investigate the demographic characteristics, etiological causes, endoscopic intervention results, and the relationship between analgesic/antipyretic drug use and bleeding in patients admitted to the pediatric emergency department with upper gastrointestinal bleeding.Methods:The records of patients aged 1 month to 18 years who presented to our pediatric emergency department with upper gastrointestinal bleeding between January 2017 and 2019 were retrospectively reviewed. Demographic features, complaints at admission, etiological reasons, endoscopy findings, diagnoses, and antipyretic/analgesic drug use were recorded.Results:There were 108 patients presenting with upper gastrointestinal bleeding, and 53.7% of the patients were male. The mean age was 76.7±58.3 months. Hematemesis was present in 100 patients. Symptoms of the patients; vomiting was present in 82.4%, upper respiratory tract infection in 36.1%, fever in 29.6%, and abdominal pain in 25.9%. There were 52 patients with a history of antipyretic and/or analgesic drug use. An endoscopic examination was performed in 74 patients. In patients who underwent endoscopic examination; pathological changes were detected in 26 of 32 patients who used drugs and 30 of 42 patients who did not use drugs.Conclusion:In patients presenting to the pediatric emergency department with upper gastrointestinal bleeding, the bleeding is usually acute and self-limiting, but requires prompt diagnosis and treatment. Approximately half of the patients in our study had a history of antipyretic/analgesic drug use in etiology. When the endoscopic findings of drug users and non-users were compared, no statistically significant difference was observed in terms of pathological findings

Behavioral characteristics and cognitive development among school age children born to women with epilepsy

Introduction: Greater risks of congenital malformation as well as cognitive and behavioral development in later childhood occur as a result of in utero exposure to antiepileptic drugs (AEDs). We examined the effects of AEDs on behavioral characteristics and cognitive development among school age children born to women with epilepsy

Panayiotopoulos syndrome and Gastaut syndrome are distinct entities in terms of neuropsychological findings

Background: Although the courses of self-limited focal epilepsies of childhood are considered as benign, a handful of studies suggested that these children may suffer from cognitive problems. Implementing tailor-made educational strategies would aid these children to reach their full potentials. Therefore, it is crucial to understand and differentiate the complete neuropsychological and behavioral profiles of these rather common syndromes. We aimed to examine the distinct cognitive and behavioral profiles of the Panayiotopoulos syndrome (PS) and the Gastaut syndrome (GS), comparatively

Hematological involvement in pediatric systemic lupus erythematosus: A multi-center study

Introductio

The characteristics of patients with COVID-19-associated pediatric vasculitis: an international, multicenter study

Objective: COVID-19 associated pediatric vasculitis other than Kawasaki disease (KD)-like vasculitis in multisystem inflammatory syndrome in children (MIS-C) is very rare. We aimed to analyze the characteristics, treatment and outcome in COVID-19-associated pediatric vasculitis (excluding KD-like vasculitis in MIS-C). Methods: The inclusion criteria were as follows: 1) <18 years at vasculitis onset; 2) evidence of vasculitis; 3) evidence of SARS-CoV-2 exposure; 4) ≤3 months between SARS-CoV-2 exposure and vasculitis onset. Patients with MIS-C were excluded. Results: Forty-one patients (median age 8.3 years; M/F=1.3) were included from 14 centers and six countries. The most frequent vasculitis subtype was IgA vasculitis/Henoch Schönlein purpura (IgAV/HSP) (n=30). The median duration between SARS-CoV-2 exposure and vasculitis onset was 13 days. Skin (92.7%) and gastrointestinal (61%) involvements were the most common manifestations of vasculitis. Most patients (68.3%) received corticosteroids; while 14.6% used additional immunosuppressive drugs. Remission was achieved in all. All IgAV/HSP patients had skin manifestations while 18 (60%) and 13 (43.3%) had gastrointestinal system and renal involvement, respectively. When we compared the features of these patients with those of a pre-pandemic pediatric IgAV/HSP cohort (n=159), fever (30% vs. 5%; p<0.001) and renal involvement (43.3% vs. 17.6%; p=0.002) were more common, while recovery without treatment (10% vs. 39%; p=0.002) and complete recovery (86.7% vs. 99.4%; p=0.002) were less frequent among COVID-19-associated IgAV/HSP patients. Conclusion: This is the largest cohort of children with COVID-19 associated vasculitis (excluding MIS-C). Our findings suggest a more severe disease course in COVID-19-associated pediatric IgAV/HSP patients compared to pre-pandemic patients. This article is protected by copyright. All rights reserved