C-reactive protein in children with active ulcerative colitis

WOS: 000300613700044PubMed ID: 2219746

Role of Hematological Parameters in the Diagnosis of Juvenile Idiopathic Arthritis in Children with Arthritis

Early diagnosis and treatment of arthritis are essential for the prognosis of the disease. Especially during the active phase of juvenile idiopathic arthritis (JIA), a prompt diagnosis is necessary to manage the disease properly. New inflammation markers such as neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), mean platelet volume (MPV), and platelet distribution width (PDW) have been investigated in various inflammatory disorders. This study aimed at the diagnostic value of NLR, MLR, MPV, and PDW in differentiating JIA in children with arthritis. Patients and Method: Case-control study with 324 children with arthritis (case group) and 324 healthy children (control group). Additionally, children with arthritis were grouped into JIA and non-JIA. Medical records of children aged 0-18 were retrospectively reviewed. Hematological parameters at the time of diagnosis were recorded. NLR, MLR, MPV, and PDW were analyzed in the study groups. Results: In the case group, 52.8% were boys, and 47.2% were girls; the mean age was 7.7 +/- 4.0 years. The NLR in the case group was significantly higher than the control one (p = 0.001). The mean MPV was lower in the case group than the control group (p = 0.001). There were no differences in NLR and MPV between JIA and non-JIA groups (p = 0.062, p = 0.689). The JIA group's mean PDW was lower than the non-JIA group (p = 0.001). Conclusion: The increase in NLR may indicate inflammation but has no superiority in distinguishing JIA from other arthritis causes. Platelet distribution width was lower in JIA patients, but its clinical utility is limited

INVISIBLE INGESTED FOREIGN BODY: ALUMINUM CAN TOP

WOS: 000338476500008PubMed ID: 2456588

Familial Mediterranean Fever Mimicking Wilson's Disease: A Case Report

WOS: 000443041100010Wilson's disease (hepatolenticular degeneration) is an autosomal recessive defect in cellular copper transport. Impaired biliary copper excretion leads to an accumulation of copper mostly in the liver, brain and cornea. Familial Mediterranean Fever (FMF) is an autosomal recessive autoimmune disease as a result of a mutation in the MEFV gene encoding pyrin protein characterized by recurring fever and polyserositis attacks. In this report, we describe a Turkish female child with cholestatic hepatitis of unknown etiology who was later diagnosed with typical FMF

Peptic ulcer disease in children: An uncommon disorder with subtle symptomatology

WOS: 000317376400007PubMed ID: 23794302Background/aims: Data concerning peptic and infectious ulcers in children are limited. The aim of the study was to investigate the prevalence, presenting symptoms and significance of symptomatology in ulcer diagnosis in the pediatric age group. Materials and Methods: Between January 2000 and 2009, upper gastrointestinal endoscopy charts were examined retrospectively. All children in whom a diagnosis of ulcer was established were included in the study. Demographic, clinical, endoscopic, and histopathologic data were obtained from the patients' records. Peptic ulcer disease prevalence, presenting symptoms and symptomatology were evaluated. Results: Ulcer disease was observed in 31 (3.4%) of 902 patients. The mean age was 10.85 +/- 4.25 (range: 2-17 years), and the male to female ratio was 2:1. The most common symptom was chronic abdominal pain (68%), hematemesis and melena (55%) and vomiting (39%). Helicobacter pylori was identified in 19 patients (61%) with ulcer. In the Helicobacter pylori-positive group, upper intestinal bleeding and pain were the major symptoms. Symptom frequency was not different between Helicobacter pylori-positive and -negative patients (p>0.05). Conclusions: Ulcer disease is an uncommon disorder in children with nonspecific clinical symptoms. Unlike the adult population, symptoms fail to diagnose peptic ulcer disease before gastrointestinal bleeding occurs

Prevelance of hepatitis D co-enfection in children with hepatitis B infection: Cross-sectional analyses from Western Turkey

WOS: 000326481900008PubMed ID: 24254267Background/aims: Effective hepatitis B virus control has warranted a decline in hepatitis B virus prevalence over the world with a relevant reduction in hepatitis B virus-associated delta hepatitis. However, despite the dramatic decline in hepatitis D virus infection rate, no further decrease was recorded after 2000. This cross-sectional study aims to investigate: I- The prevalence of hepatitis D virus co-infection in children with hepatitis B virus infection in Western Turkey; II- The influence of neonatal hepatitis B virus vaccination on hepatitis D virus co-infection rate; and III- The impact of co-infection on prognosis of liver disease. Materials and Methods: Serological markers of hepatitis B virus and hepatitis D virus infections were determined by ELISA in patients with chronic hepatitis during immune tolerance, immunoactive, HBeAg-negative chronic, and inactive carrier state. Delta co-infection rate was evaluated in two groups, children born before and after the national neonatal mass vaccination has started (before and after 2000). Viral load, serum alanine aminotransferase, and histological grade were evaluated in co-infected cases. Results: Overall hepatitis delta virus infection rate was 1,76% (3/170); two patients with eAg-negative chronic hepatitis B and one patient in the immunoactive phase were infected with hepatitis D virus. Mean fibrosis score of hepatitis D virus -infected cases and hepatitis B virus -infected counterparts were 4 +/- 1,7 and 1,3 +/- 1, respectively (p: 0,006). Hepatitis D virus infection was detected in 2 out of 158 children born before and in 1 of 12 born after the neonatal vaccination program. Hepatitis B e-antibody was detected in two patients with delta co-infection (11 and 6 years old), and all mothers of delta hepatitis cases were chronically hepatitis B virus-infected. Conclusions: Delta hepatitis is rare among hepatitis B virus-infected children in the Western region of Turkey. Despite the success of the national vaccination program, delta hepatitis is not a vanishing disease and it has a grave prognosis due to development of early cirrhosis

The Effects of Low FODMAP Diet on the Quality of Life and Gastrointestinal Symptoms in Children with Irritable Bowel Syndrome. A Pilot Study

Objective: Irritable bowel syndrome is a disease that negatively affects life. Recently, diet therapies have been emphasized. Our study, the aim was to investigate the effect of low FODMAP (fermented oligo-, di-, monosaccharide and polyols) diet on the frequency of gastrointestinal symptoms and the effects on quality of life in patients with IBS. Method: 18 children aged between 7-18 years, who were diagnosed with IBS, followed by University of Health Sciences Izmir Dr. Behcet Uz Children's Diseases and Surgery Training and Research Hospital the Child Gastroenterology, Hepatology and Nutrition Clinic were included in the study. The appropriate KINDL scale was applied at the time of application and 2 weeks after the end of the low FODMAP diet. GIS symptoms of the week 0 and 6 KINDL results were compared. KINDL scale was applied to the families before and after dieting and the results were compared. Results: The study was completed with 10 patients. The most common symptom was abdominal pain and it was present in all patients. All symptoms were found to decrease after diet but it was not significant. There was a significant increases in emotional well-being, family divisions and total KINDL results at the 6th week of diet in the children In parent KINDL scales, the results were not considered significant. Conclusion: Despite there was a decrease in GIS related complaints and increase in quality of life in IBS patients who underwent low FODMAP diet, it has been found appropriate to continue the study with larger patient groups for longer follow-up periods

Steroid response in moderate to severe pediatric ulcerative colitis: a single center's experience

WOS: 000286164800009PubMed ID: 21191776Background: We aimed to analyze clinical and inflammatory markers of steroid non-response in patients with moderate/severe ulcerative colitis (UC) at the time of diagnosis. Methods: This study included patients who were graded as having moderate/severe UC and received corticosteroids as first-line therapy. Demographic, clinical and laboratory findings and pediatric ulcerative colitis activity scores (PUCAS) were recorded. Response to corticosteroids was assessed 30 days after the induction and long-term therapy. Results: Twenty-eight children were diagnosed as having moderate/severe UC. Their mean age +/- SD was 12.2 +/- 4 years, and 17% were under 5 years of age. PUCAS at their initial admission was 56.9 +/- 11.8. UC was observed at the left colon in 9 patients (32.1%), and pancolitis in 19 (67.9%). At the end of the 30th day, UC was completely remitted in 15 patients (53.5%), partially remitted in 2 (7.1%), and no response in 11(39.2%). Short-term follow-up showed partial remission in 2 patients, and overall remission with steroid in 17 (60.7%). Non-responders were given second-line treatment; steroid dependency was documented in 2 patients (7.1%) and another 2 (7.1%) patients underwent colectomy. Predictors for steroid non-response were analyzed and only PUCAS at the initial admission was found to be associated with non-response to steroids (51.4 +/- 11.4 vs. 65.4 +/- 6.8, P<0.05). Conclusions: Approximately half of the pediatric patients had complete response to steroid therapy in a long period. PUCAS could be used as a potential marker of "failed response" to steroid, but should be supported with a number of prospective randomized controlled studies. World J Pediatr 2011;7(1):50-5

Validity and reliability study of the pediatric Rome III questionnaire for Turkish children and adolescents

WOS: 000373402800007PubMed ID: 27015618Background/Aims: Questionnaire on Pediatric Gastrointestinal Symptoms: Rome III version (QPGS-RIII), originally developed in English, was adapted to different languages in order to widen its use. The aim of this study was to evaluate the validity and reliability of a questionnaire on the Pediatric QPGS-RIII parent-report form for children and self-report form for children and adolescents, which has been adapted into Turkish. Materials and Methods: The study group comprised 7-18-year-old children/adolescents (n=690) who presented to Ege University School of Medicine, Department of Child Health and Diseases outpatient clinic. In the study, the validity and reliability of the QPGS-RIII Turkish version of the questionnaire was established. Results: Confirmatory factor analysis (CFA) resulted in a 10-factor model satisfactory construct for the validity and in acceptable indices of goodness of fit. Standardized coefficients determined with CFA in the Turkish version of the instrument ranged between 0.15 and 0.87 in the 7-9-year-old children and between 0.13 and 0.98 in the 10-18-year-oldchildren/adolescents. t-values of all the factor loadings were significant. In addition, the test-retest analyses were above 0.70, except for the abdominal migraine factor. Conclusion: Findings relating to the validity and reliability of the study indicated that the Turkish version of the instrument could be adequately used to assess functional gastrointestinal disorders (FGIDs) in Turkish children and adolescents. The Turkish version of the instrument is therefore recommended to be used in epidemiologic studies and in clinical trials to be conducted in a Turkish-speaking population