Gastroesophageal refl ux disease in children: How much we know?

Gastroözefageal refl ü hastalığı (GÖRH) farklı klinik tablolarla karşımıza çıkabilir ve çeşitli hastalıklara eşlik edebilir. Bu çalışma ile GÖRH tanısı alan olguların başvuru yakınmaları, klinik özellikleri ve eşlik eden hastalıkların değerlendirilmesi amaçlandı.Gereç ve Yöntem: Eylül 2003-Aralık 2005 tarihleri arasında Çocuk Gastroenteroloji Bölümünde GÖRH tanısı alan, yaşları 1 ay ve 15 yaş arasında değişen 219 olgu yaş, cinsiyet, başvuru yakınmaları, fizik muayene bulguları, sekonder refl ü nedenleri ve eşlik eden diğer hastalıklar açısından retrospektif olarak değerlendirildi. Bulgular: Yaşları 1 ay-15 yaş arasında değişen 219 olgunun 114 (%52.1)'ü erkekti. Bir yaş ve üstü yaş grubundaki olgu sayısı 168 (%76.7) olup, 1 yaş altı grubun olgu sayısına göre daha fazla idi. En sık başvuru yakınması olarak 1 yaş altı grupta gastrointestinal sistem (GİS) yakınmaları gözlenirken (18 olgu, %35.2), 1 yaş ve üstü grupta GİS yakınmaları ve solunum sistemi (SS) yakınmalarının birlikteliği daha sık gözlendi (74 olgu, %44). Tekrarlayan kusma, aşırı ağlama, huzursuzluk, beslenme zorluğu 1 yaş altı olgularda daha fazla saptandı. Öksürük, karın ağrısı, göğüs ağrısı ve/veya retrosternal ağrı, ses değişikliği, mide bulantısı ise 1 yaş ve üstünde olan olgularda daha fazla idi. Fizik incelemede vücut ağırlığı ve boy Z-skoru değerlendirilen olguların 15 (%6.8)'inde malnütrüsyon, 19 (%8.6)'unda boy kısalığı mevcuttu. Büyüme ve gelişme geriliği 1 yaş altındaki grupta 1 yaş ve üstü olan gruba göre daha fazla olup istatiksel olarak anlamlıydı (p= 0.033). En sık sekonder refl ü nedeni nörolojik hastalıklar olup, 1 yaş altında 6 (%46.1), 1 yaş ve üstünde When comorbid diseases were considered, asthma was observed in 31 cases whereas Helicobacter pylori gastritis in 28 cases, indicating signifi cant diff erence between cases aged = 1 year (p= 0.009).Conclusion: Cases with suspected GERD should be investigated for extra-gastrointestinal findings. To improve quality of life in such patients, these problems, which tend to be chronic, should be recognized and treated earlyGastroesophageal refl ux disease (GERD) can manifest with various clinical presentations and accompany to several diseases. Th is study aimed to assess presenting complaints, clinical characteristics and comorbid disorder in cases with GERD.Materials and Methods: We retrospectively reviewed age, gender, presenting complaints, fi ndings of physical examination secondary causes of refl ux, and comorbid disorders in 219 cases aged 1 month-15 years were diagnosed as GERD in Department of Pediatric Gastroenterology, between September, 2003 and December, 2005.Results: Of 291 cases, 114 (52.1%) were boys. Number of cases aged >= 1 years 168 (76.7%) was higher than those aged aged < 1 year. As presenting complaint, gastrointestinal (GIS) complaints (18 cases; 35.2%) were more common among cases aged < 1 year, whereas association of GIS and respiratory complaints (74 cases; 44%) were more frequently observed among cases aged >= 1 year. Recurrent vomiting, excessive crying, irritability, and feeding diffi culty were more commonly observed among cases aged < 1 year. Cough, abdominal pain, chest pain and/or heartburn, changes in voice and nausea were found more common among cases aged >= 1 year. Th ere was malnutrition in 15 cases (6.8%), short stature in 19 cases (8.6%) according to body weight and height Z scores assessed during physical examination. Growth retardation was more common among cases aged < 1 year when compared to those aged >= 1 year, indicating signifi cant diff erence (p< 0.01). Th e most common secondary cause was neurological diseases observed in 6 cases aged < 1 year (46.1%) and 12 cases aged >= 1 year (41.3%). When comorbid diseases were considered, asthma was observed in 31 cases whereas Helicobacter pylori gastritis in 28 cases, indicating signifi cant diff erence between cases aged < 1 and >= 1 year (p= 0.009).Conclusion: Cases with suspected GERD should be investigated for extra-gastrointestinal findings. To improve quality of life in such patients, these problems, which tend to be chronic, should be recognized and treated earl

Hashimoto thyroiditis associated with ataxia telangiectasia

Ataxia telangiectasia is a rare genetic disease characterized by neurological manifestations, infections, and cancers. In addition to these cardinal features, different autoimmune diseases can be seen in patients with ataxia telangiectasia. Although there were reports of positive autoimmune thyroid antibodies associated with ataxia telangiectasia, to our knowledge, we report the first cases of nodular Hashimoto thyroiditis in two patients with ataxia telangiectasia in the English medical literature. These cases illustrate that despite the rarity of nodular Hashimoto thyroiditis associated with ataxia telangiectasia, physicians should be aware of this possibility. Furthermore, thyroid examination of patient with ataxia telangiectasia is recommended for early diagnosis