Cirrhotic Cardiomyopathy

Cirrhotic cardiomyopathy (CCMP) is a functional disorder characterized by electrophysiologic disturbances and diastolic and/or systolic dysfunction in patients with chronic liver disease, especially those with ascites and portal hypertension. This disorder is a well-defined entity in adults, but pediatric data are limited. Clinical and laboratory findings are generally latent. The diagnostic criteria are prolonged QT on electrocardiography due to metabolic and extrahepatic causes, in addition to some abnormal echocardiography findings. If echocardiographic findings are normal and only specific prolonged QT is present, this disorder is named as “latent CCMP”; otherwise, it is “manifest CCMP.” This disorder is important because it may lead to problems such as cardiac failure and dysrhythmia before or after liver transplantation. Moreover, it may worsen the prognosis

Bilateral Cytomegalovirus Retinitis in a Child with Rhabdomyosarcoma

Reactivation of cytomegalovirus (CMV) leading to retinitis has been commonly reported in association with human immunodeficiency virus (HIV) infection or iatrogenic suppression of the immune system, including transplant recipients. Rhabdomyosarcoma (RMS) is the most common soft tissue malignancy in the pediatric age group, and alveolar histology is associated with unfavorable outcome. Presently described is case of RMS with alveolar histology in a 12-year-old male who developed CMV bilateral retinitis during prolonged period of neutropenic fever after 40 weeks of chemotherapy. He was diagnosed based on CMV-DNA polymerase chain reaction in blood and urine samples, and responded well to intravenous gancyclovir treatment. A high index of suspicion for reactivation of CMV leading to retinitis should be maintained and, if needed, investigated, not only in patients with HIV infection or transplant recipients, but also all patients who are iatrogenically immunosuppressed, including those who experience prolonged neutropenic fever due to lengthy courses of radiotherapy and chemotherapy

Is there a relationship between Helicobacter pylori infection and erosive reflux disease in children?

Aim

Are Symptoms of Gastroesophageal Reflux in Children Associated with Diagnoses of Endoscopic and/or Histological Esophagitis?

Objective: The purpose of this study was to find out whether symptoms in children suspected to have gastroesophageal reflux disease are correlated with the endoscopic and/or histological diagnoses of esophagitis. Material and Methods: The data of 140 children [mean age 8.9 +/- 4.6 (0.16-18) years] who underwent diagnostic upper endoscopy and biopsy of distal esophagus were collected between January 2002 and December 2004. Endoscopic findings were classified according to the Los Angeles system. Histopathological findings were classified according to Knuff & Leape classification. The relationship between symptoms and the diagnoses of endoscopic or histological esophagitis was examined retrospectively. Results: Twenty nine patients (20.7%) had endoscopic esophagitis and 51(36.4%) had histological reflux esophagitis. Prevalence of erosive reflux disease was 12.1 %, and that of non-erosive reflux disease was 24.3%. The symptoms suggesting gastroesophageal reflux did not have a statistically significant correlation with endoscopic or histological esophagitis. Conclusion: The diagnostic value of symptoms in children suspected to have gastroesophageal reflux disease are low. Regardless of the symptoms of gastroesophageal reflux, collecting biopsy samples from esophagus still seems to be a beneficial approach both in children undergoing diagnostic upper endoscopy when there is no contraindication for obtaining a biopsy