Spontaneous Intracranial Hypotension: A Case Report

Spontaneous intracranial hypotension is a rare syndrome of low ccrebrospinal fluid pressure due to spontaneous cerebrospinal fluid leaks. The main feature is orthostatic headache. We describe a case of spontaneous intracranial hypotension in a 5-year-old girl with a 1-month history of headache, sudden onset hearing loss, and ataxia. Magnetic resonance imaging (MRI) showed an enlargement of cervical venous plexus and lumbar puncture revealed a low opening pressure. Magnetic resonance myelography showed leakage of the contrast material at the level of the third and fourth lumbar vertebra. Bed rest and caffeine treatment yielded no resolution of symptoms. Following a lumbar epidural blood patch, her headache and ataxia resolved completely without any improvement in hearing. A second blood patch also yielded no effect on hearing. Spontaneous intracranial hypotension should be considered in the differential diagnosis of headache, also in the pediatric age group

The Effect of Vitamin D Prophylaxis on 25-OH Vitamin D Levels in Children

Background: Vitamin D deficiency is a major public health problem. The aim of our study was to determine serum 25-hydroxyvitamin D levels among healthy children aged 3-36 months in a setting where vitamin D prophylaxis is a national policy for infants during the first year of life and among pregnant women

Adenovirus and Rotavirus in Children with Acute Gastroenteritis

Aim: Infectious diarrhea is one of the most important causes of mortality during childhood period in our country. Little is known about the epidemiology of rotavirus and adenovirus infections in Turkey. With this study, we aimed to determine the incidence of rotavirus and enteric adenovirus gastroenteritis in patients admitted to our pediatrics outpatient clinic

Comparison of Different Iron Preparations in the Prophylaxis of Iron-deficiency Anemia

We compared the efficacy of ferrous sulfate (divalent) and ferric polymaltose (trivalent) compounds for the prophylaxis of iron-deficiency anemia (IDA). Study infants included exclusively breast milk-fed term infants. Subjects were divided randomly into 2 groups at 4 months of age and group 1 (n=56) received divalent and group 2 (n=56) received trivalent iron (Fe) preparation at a dose of 2 mg/kg/d for 5 months. At 9 months of age, after a 5-month prophylaxis, a significant increase was observed in hemoglobin (Hb), hematocrit, serum Fe levels, and transferrin saturation in both groups. However, group 1 had significantly higher Hb, hematocrit, mean corpuscular volume, Fe, and transferrin saturation than group 2 (11.7 +/- 0.6 g/dL, 34.6% +/- 1.7%, 76.2 +/- 2.9 fL, 55.5 +/- 1.8 mcg, 20.8 +/- 3.9 g/L, respectively in group 1 vs. 11.3 +/- 0.5 g/dL, 33.5% +/- 1.5%, 74.7 +/- 3.2 fL, 42.5 +/- 1.8 mcg, 14.1 +/- 7.5 g/L, respectively in group 2). No significant difference was found in ferritin values between the groups. Fe deficiency was found in 17 (30.3%) of the subjects in group 1, and 23 (41%) of subjects in group 2 whereas 5 (8.9%) subjects had IDA in group 1 and 12 (12%) in group 2 which were insignificant between groups. No significant difference was found with regard to side effects between 2 Fe preparations. Although divalent Fe therapy led to a higher Hb and serum Fe level, both ferrous and ferric Fe preparations were effective for prophylactic use in the prevention of Fe deficiency and IDA with comparable side effects

Spondyloepimetaphyseal dysplasia with joint laxity, leptodactylic type: longitudinal observation of radiographic findings in a child heterozygous for a KIF22 mutation

Spondyloepimetaphyseal dysplasia with joint laxity, leptodactylic type (SEMDJL2), is a rare disorder due to a KIF22 gene mutation and characterized by postnatal short stature, midface hypoplasia and generalized ligamentous laxity. Radiologic hallmark includes severe involvement of the epiphyses and the slender appearance of the metacarpals and phalanges. The aim of the study was to evaluate radiologic findings of SEMDJL2 in a child followed from age 2 years 9 months to 11 years. Using whole-exome sequencing, we identified a single nucleotide de novo p.Pro148Leu mutation in the KIF22 gene. The child had midface hypoplasia, short stature, hip dislocation and generalized laxity of the joints in the first examination. Knee subluxation and bilateral severe genu valgum became prominent after 3.5 years of age. Short stature became evident gradually with increasing age, and height was 3.6 standard deviations below the mean for age. Small epiphyses with delayed maturation and metaphyseal vertical striations at the distal metaphysis of the femur were observed on initial radiographs. However, the slender metacarpals and proximal phalanges and progressive epiphyseal dysplasia with small and flattened epiphyses on both wrists and knees became more prominent after 7 years of age. In conclusion, we observed that typical radiologic findings became apparent after early childhood

Seroprevalance of pertussis antibodies in maternal and cord blood of preterm and term infants

Background: The resurgence of pertussis has resulted in an increased morbidity and mortality, especially among young infants. The aim of our study was to determine the antibody concentrations against pertussis antigens in cord and maternal blood in both preterm and term infant-mother pairs and to evaluate the efficacy of transplacental antibody transfer

Tetanus and diphtheria immunity among term and preterm infant-mother pairs in Turkey, a country where maternal and neonatal tetanus have recently been eliminated

The aim of our study was to investigate the anti-tetanus and anti-diphtheria antibody titres and the placental transfer of these antibodies in a group of vaccinated and unvaccinated mothers and their term or preterm offsprings. Anti-tetanus and anti-diphtheria toxoid IgG antibodies were measured quantitatively by ELISA in 91 infant-mother pairs. Protective concentrations of anti-tetanus and anti-diphtheria were found in 58.3 and 50 % of mothers in the unvaccinated group and 94.5 and 85.5 % of the mothers in the vaccinated group. Protective concentrations were found in 63.9 and 50 % of cord samples, respectively, in the unvaccinated group and in 96.4 and 85.5 % of cord samples, respectively, in the vaccinated group (p = 0.0001). There were no differences in the maternal and cord geometric mean concentrations (GMCs) of anti-toxoid antibodies between those who received two doses or one dose of Td. The GMCs of maternal and cord anti-tetanus and anti-diphtheria were statistically similar between preterm and term groups. Placental transfer ratios (TR) for anti-tetanus and anti-diphtheria were 175 and 150 %, respectively, in the preterm group and 213 and 178 %, respectively, in the term group. There was a strong correlation between maternal and cord anti-toxoid antibody levels. Maternal vaccination was the only predictor of having protective concentrations of anti-toxoid antibodies in cord blood

Primary hypertrophic osteoarthropathy caused by homozygous deletion in HPGD gene in a family: changing clinical and radiological findings with long-term follow-up

Autosomal recessive primary hypertrophic osteoarthropathy1 (PHOAR1) is characterized by delayed closure of the fontanels, digital clubbing, arthropathy and periostosis. Homozygous mutations in hydroxyprostaglandin dehydrogenase (HPGD) gene are the underlying pathology of PHOAR1. The aim of this study was to analyze the HPGD gene and the changing clinical and radiological findings with advancing age of two siblings with the diagnosis of PHOAR1. A novel 2-bp homozygous deletion was found in exon 3 (c.310-311delCT) of HPGD gene in the patients. Clinical and radiological findings of the siblings were evaluated between 4 months and 8 years and 6 months of age. The painful swelling and sweating of the hands and feet, cranial ossification defect and expanded diaphyses were evident at infantile period and gradually showed improvement until 4 years of age. After the age of 4 years, digital clubbing and swelling of knees persisted, palmoplantar hyperkeratosis developed and acro-osteolysis became evident on hand radiographs. In conclusion, we suggest that the clinical findings of the patients with PHOAR1 should be classified in two periods as early and late childhood. We also observed that there was intrafamilial variability of clinical findings