Diagnostic challenges of abdominal tuberculosis in children: cases report

Background: Tuberculosis (TB) still remains a public health issue. Growing migration rates increase the risk of spreading TB from endemic countries. Early detection is important for successful treatment especially in children who are particularly susceptible to developing severe forms of TB disease. Abdominal tuberculosis is uncommon form of TB and it is rarely found in children. It accounts for less than 1% of all tuberculosis cases in children. Case report: The aim of our study was to present diagnostic challenges dealing with abdominal TB in children. Clinical data of 3 children with abdominal tuberculosis during the past 10 years in Lithuanian University of Health Sciences, Kaunas Clinics Pediatric Surgery department were collected and analysed. Patients manifested unspecific symptoms such as abdominal pain, persistent fever, nausea and fatigue. After standard investigations such as blood test, CRP, urine analysis, abdominal ultrasound and X-ray the diagnosis remained unclear. After some additional examination, patients underwent diagnostic laparoscopy. Diagnosis of abdominal tuberculosis was confirmed by peritoneum biopsy and histopathological examination. They recovered fully after anti-tuberculosis therapy. Conclusions: Early diagnosis is challenging and appropriate treatment often is delayed because of the non-specific and deceptive clinical presentation of abdominal TB

Autoantikūnų prieš mielino oligodendrocitų glikoproteiną sukeltų ligų ypatumai vaikams: ryšys su optiniu neuritu ir lyčių skirtumai

Summary. Background and aim. Despite the increasing clinical data on anti-myelin oligodendrocyte glycoprotein (anti-MOG)-associated inflammatory demyelinating dis- eases, there are many un answered questions. This article aims to elu cidate the peculiarities of clinical presentation, association with optic neuritis (ON), relapsing course, investigations, treatment, and gender differences in pediatric anti-MOG-related disorders. Methods. The study involved 51 patients: 46 patients described in publications and 5 pa- tients treated in Vilnius University Hospital Santaros klinikos Pediatrics Centre between 2017 and 2020. Result. Acute disseminated encephalomyelitis (ADEM) was the most common (61%) clinical syndrome as the first presentation in anti-MOG-associated inflammatory demyelinating diseases in children. ON was present in 23.5% of patients at the beginning of the disease. 49% of chil dren had relapses. ON was present in 49% of patients during the course of the relapsing anti-MOG spectrum disease. There was a statistically significant dif- ference in relapse rate between the patients with and without ON during the course of illness – relapses occurred in 72% of patients with ON and 27% of patients without ON. We found a statistically significant gender difference – girls were more likely to relapse than boys, regard- less of the presence of ON. 76% of patients reached full recovery during the follow-up period. Conclusions. For the first time, the disease usually presents as acute disseminating encephalomyelitis. About half of children with myelin-oligodendrocyte glycoprotein spec- trum disease experience recurrence of the disease and ON. Girls are significantly more likely to relapse than boys. Children with ON have a higher risk of the disease recurrence