The Comparison of Children Who Were Diagnosed with COVID-19 in the First and the Second Waves of the SARS-CoV-2 Pandemic

Objective: To compare the clinical and laboratory findings and short-term outcomes of those children diagnosed with COVID-19 in the first and second waves of the SARS-CoV-2 pandemic

Acute Aspergillus Laryngotracheobronchitis in a Child with Acute Lymphoblastic Leukemia

Acute Aspergillus Laryngotracheobronchitis in aChild with Acute Lymphoblastic LeukemiaABSTRACTInvasive fungal infection of the laryngotracheobronchial structures is rarely reported. Themortality rate in this condition is extremely high, especially for neutropenic patients. Timelyinitiation of the adequate antifungal drugs and supportive care is very important to improve theprognosis. We present a six-year-old girl with acute lymphoblastic leukemia, who was shown tohave invasive pulmonary aspergillosis with laryngotracheobronchitis, which led to respiratoryfailure. At the time of intubation, pseudomembranes were seen on the laryngeal structuresand fungal laryngotracheobronchitis was considered. Epiglottis swab culture was positive forAspergillus fumigatus and Aspergillus terreus, and the patient was successfully treated with thecombination therapy of voriconazole and caspofungin.Keywords: Laryngotracheobronchitis; Aspergillus; Leukemia</p

Evaluation of the Pediatric Neurology Consultations Requested from the Pediatric Emergency Service: A Single-Center Experience

Objective: Pediatric neurology opinion is one of the most frequently requested consultations in emergency service practice. Symptoms and/or signs such as headache, altered consciousness, seizures, and focal neurological deficits are the most common consultation reasons. We aimed to retrospectively evaluate patients who were consulted with the pediatric neurology department in the pediatric emergency service. Method: This is a descriptive cross-sectional study in which the consultation notes of patients who presented to the pediatric emergency service and required a consultation with the pediatric neurology department between June 2016 and November 2019 were analyzed retrospectively. Results: The number of the consulted patients was 1,265. Sixteen patients left the hospital after their parents signed treatment and examination rejection form, 1,249 consultations were included. The most common reasons for consultation were seizure, routine follow-up of patients that receive home mechanical ventilator support, and headache. The rate of emergency neurological pathologies detected in brain computed tomography and magnetic resonance imaging was 1.7%. The most common electroencephalographic abnormality was focal epileptic discharges. Consultation rate requiring emergent intervention was 14.8% and status epilepticus, central nervous system infections, intracranial masses were the most common causes. Conclusion: The most common reason for consultation was seizure. The rate of consultations requiring acute intervention was low. We think that the emergency service admissions of patients that need examination and treatment in the outpatient clinic may harm the routine functioning of the emergency service. Community education for the use of the emergency room only when necessary is essential

Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes

Background: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Turkiye. Clinical and paraclinical features were compared between patients with dis-ease onset before 12 years (earlier onset) and >= 12 years (later onset) as well as between our current (2015-2021) and previous (< 2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset < 12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought

Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes.

Background: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Turkiye. Clinical and paraclinical features were compared between patients with dis-ease onset before 12 years (earlier onset) and >= 12 years (later onset) as well as between our current (2015-2021) and previous (< 2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset < 12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought