Idiopathic Hypercalciuria in Iranian Children

Objective: The aim of this study was to determine the prevalence of idiopathic hypercalciuria (IH) in school children in Ahvaz, a city with different ethnic groups located in the Southwest of Iran. Material & Methods: In a descriptive cross sectional study from October to December 2006, we determined urinary calcium (UCa) and urinary creatinine (UCr) in the morning urine samples of 500 primary school children. The levels of 24-hour UCa and UCr were measured in these children. Level of 24-hour UCa exceeding 4 mg/kg/day was considered as hypercalciuria, and UCa/UCr ratio exceeding 0.21 (mg/kg) was considered abnormal. Children who had hypercalciuria with a normal concentration of serum Ca were categorized as idiopathic hypercalciuric. Findings: Of 500 children aged 6-12 years, 231 were males and 269 females. In the first screening, 64 (12.8%) children (45 males, 19 females) had an abnormal UCa/UCr ratio. But in the end only 15 had the criteria of IH, i.e. the prevalence of IH was 3% (1.8-4.8%, confidence interval of 95%). The prevalence in females and males was 0.74% and 5.6%, respectively (P= 0.003). Of these children 10 had hematuria (including 2 cases of gross hematuria), 8 children gave a history of recurrent abdominal pain, 5 children suffered from dysuria and 3 persons had a history of personal or familial urolithiasis. Conclusion: The study showed that 3% of primary school children in Ahvaz had IH predisposing to short-term and long-term complications of the disease. IH was significantly more common in boys than in girls

A comparision of intestinal biopsies and serologic anti-tissue transglutaminase in children with seliac disease in Ahvaz city in 2015

Background: CD or gluten-sensitive enteropathy is caused by dietary gluten ingestion in geneticallysusceptible individuals.The aim of the study was to compare the current diagnostic methods of CD and relationship between these methods. Material and Method: In this study 50 patients suspicious to have celiac disease were studied. After IgA anti-TTG test using Eliza method, the patients went under upper endoscopy, then  histopathologic findings were grouped by Marsh classification. Results:  Fifty patients, 23 males and 27 females with mean age of 8.36 were included in the study. TTG-IgA test was positive in 45 patients. Most pattients were categorized as Marsh stage III ( 28 cases) by histopathologic examination, which can be seen in other studies. We found significant correlation between histopathologic and serologic findings (p-valu=0.014). no significant correlation was found between histopathological test and patients age. Conclusion: Based on the results obtained in this study between histopathologic findings and serologic findings were significant relationship, The diagnostic approach presented in this study may also be useful in the assessment of CD. In the end, for a definitive diagnosis of celiac disease, molecular tests and also determination of haplotype HLADQ are recommende

ANTI-TTG AMONG CHILDREN WITH CHRONIC FUNCTIONAL CONSTIPATION UNRESPONSIVE TO 6 WEEKS OF TREATMENT OF CONSTIPATION

ABSTRACT BACKGROUND Celiac disease is a glutten induced enteropathy. Some authors recommended screening celiac in children with constipation. There are studies to evaluate celiac disease in children with constipation. But most of them included children regardless to treatment failure. OBJECTIVE The aim of this study was to evaluate frequency of elevated anti TTG in children with constipation after failure to improve during 6 week of appropriate treatment of constipation. METHODS In this cross sectional study, 550 children with prolonged constipation were included. Place of study was Pediatric Gastroenterology clinic of Abuzar children’s hospital. Prolonged constipation was defined as a constipation which failed to resolved after 6 weeks of appropriate treatment. Constipation was defined according to ROME III criteria. After parental agreement, 5 mL of blood was obtained. Serum anti TTG level was measure using ELISA method by Orientec kit. Anti TTG>10 was considered positive if IgA was normal. SPSS version 16.0 (Chicago, IL, USA) was used for data analysis. Chi square, t-test, and Mann Whitney test used for data analysis. RESULTS In this study 550 children (m=277, f=273) were included. Mean age of the cases was 6.8±2.9 year. Anti TTG antibody level was 5.8±2.8 unit/mL. Of these case, 42 (7.6%) had positive anti-TTG antibody. Celiac disease was confirmed in 40 cases after histopathology examination. CONCLUSION Anti-TTG was positive in 7.6% children with chronic constipation who failed to respond after 6 week of treatment. Another multicenter study with longer follow up period is recommended

Autoimmune Hepatitis in Children: Experiences in a Tertiary Center

Objective: Autoimmune hepatitis (AIH) is a necroinflammatory liver disease of unknown etiology that occurs in the children of all ages. The present study aimed to evaluate the clinical and paraclinical presentations, including pattern of autoantibodies, response to treatment, mortality, and liver transplantation outcome in the Iranian children with AIH. Methods: The medical records of 87 children (56 girls and 31 boy) diagnosed with AIH between 2001 and 2010 were retrospectively analyzed for clinical and paraclinical profiles and also treatment outcome. Findings: The mean age of the patients was 10.1±4.5 years (64.4% females). The most common clinical findings were jaundice (70.1%), splenomegaly (67.8%), and hepatomegaly (51.7%). Antinuclear, anti-smooth muscle, and anti LKM antibodies were positive in 14/62, 22/53 and 6/40 patients, respectively (36 patients had type 1 AIH, 6 patients had type 2 AIH, 26 patients were seronegative, and autoantibodies were not available in 19 cases). The most common histological finding in the liver biopsies was chronic hepatitis with interface activity that was seen in 65 (74.7%) patients. The complete response was seen in 52 (59.8%) patients and 24 (27.6%) patients underwent liver transplantation. One-year and five-year survival rates were 87.5% and 80% in the transplanted patients. Conclusion: AIH should be kept in mind in the differential diagnosis of both acute and chronic liver diseases in the children and treatment with combination of corticosteroids and azathioprine is a good treatment option. In the patients with end stage liver cirrhosis that did not respond to medical therapy, liver transplantation is the treatment of choice