Does interferon and ribavirin combination therapy increase the rate of treatment response in children with hepatitis C?

Background: Interferon-alpha was the first accepted treatment of chronic hepatitis C. In recent years, adding ribavirin has produced better response rates in adult patients than monotherapy with interferon-alpha. Whether adding ribavirin also improves treatment results in pediatric patients remains unclear

Zinc nutrition in children with chronic liver disease

Body zinc status of 13 pediatric patients with chronic liver disease was compared with controls, and the relation of the zinc status with the severity of the liver disease was investigated. Mean serum zinc level of the patients with chronic liver disease was significantly lower than mean serum zinc level of the controls (11.2 mu mol/L vs. 12.7 mu mol/L, P < 0.05). Seven patients had serum zinc levels below 10.7 mu mol/L, whereas all of the controls had higher values. When serum zinc levels were compared between patients with chronic active hepatitis (CAH) and chronic persistent hepatitis (CPH), CAH group had a significantly lower mean serum zinc level than the CPH group (9.6 mu mol/L vs. 12.3 mu mol/L, P < 0.05). Mean hair zinc level of the patients was higher than the mean hair zinc level of the controls; this difference was highly significant (218 mu g/g for patients vs. 91 mu g/g for controls, P < 0.001). Mean hair zinc level of the CPH group was 198.64 mu g/g, whereas CAH group had a mean hair zinc of 267.88 mu g/g, which is significantly higher (P < 0.05). The difference between mean urinary zinc excretion of the CAH and CPH groups was also statistically significant with 6.27 mu mol/day in the patients with CAH and 2.41 mu mol/day in the patients with CPH (P < 0.05). We conclude that serum zinc levels and body zinc turnover of the pediatric patients are decreased in chronic liver disease in association with the severity of hepatocellular injury, whereas urinary zinc excretion is increased in the more severe form of liver disease, and in this context, zinc supplementation is indispensable in chronic liver disease. J. Trace Elem. Exp. Med. 13:271-276, 2000. (C) 2000 Wiley-Liss, Inc

Celiac disease and glycogenic acanthosis: a new association?

A 6-y-old boy and an 8-y-old girl were admitted to our clinic with anaemia and failure to thrive. Laboratory tests revealed iron deficiency anaemia and positive antigliadin antibodies in both of the patients. Slightly raised grey-white plaques were observed on oesophageal mucosa during endoscopical investigation of the patients. While intestinal mucosal samples confirmed diagnosis of celiac disease histologically, histopathological assessment of oesophageal lesions demonstrated glycogenic acanthosis. Since glycogenic acanthosis associated with celiac disease hasn't been reported in the literature previously to our knowledge, case reports of our patients were presented

Helicobacter pylori infection in Turkish children with gastrointestinal symptoms and evaluation of serology

Helicobacter pylori infection is a common etiopathogenetic factor in children with gastrointestinal symptoms in the developing world. Although serology offers an easy noninvasive method of diagnosis, its sensitivity and specificity are reported to be low among children. in this prospective study, we investigated the frequency and endoscopical and morphological findings of H. pylori infection in 180 Turkish children who underwent upper gastrointestinal endoscopy either for peptic symptoms or on a routine basis and in asymptomatic pediatric patients who underwent endoscopy for other reasons, and then evaluated the diagnostic accuracy of serology in our population. Overall H. pylori infection was diagnosed in 77 of the 180 patients (42.7%) by histology and urease test. The sensitivity of H. pylori specific IgG antibody assay by ELISA was determined to be 100%, while the specificity was 98%, the positive predictive value 97.4%, the negative predictive value 100%. Frequency of H. pylori infection is high in Turkish pediatric patients without gastrointestinal symptoms as well as in children with gastrointestinal complaints. H. pylori specific antibody assay is a noninvasive and sensitive method for the diagnosis of H. pylori infection in the Turkish pediatric population

An insight into the relationships between hepcidin, anemia, infections and inflammatory cytokines in pediatric refugees: a cross-sectional study

Contains fulltext : 69769.pdf (publisher's version ) (Open Access)BACKGROUND: Hepcidin, a key regulator of iron homeostasis, is increased in response to inflammation and some infections, but the in vivo role of hepcidin, particularly in children with iron deficiency anemia (IDA) is unclear. We investigated the relationships between hepcidin, cytokines and iron status in a pediatric population with a high prevalence of both anemia and co-morbid infections. METHODOLOGY/PRINCIPAL FINDINGS: African refugee children <16 years were consecutively recruited at the initial post-resettlement health check with 181 children meeting inclusion criteria. Data on hematological parameters, cytokine levels and co-morbid infections (Helicobacter pylori, helminth and malaria) were obtained and urinary hepcidin assays performed. The primary outcome measure was urinary hepcidin levels in children with and without iron deficiency (ID) and/or ID anaemia (IDA). The secondary outcome measures included were the relationship between co-morbid infections and (i) ID and IDA, (ii) urinary hepcidin levels and (iii) cytokine levels. IDA was present in 25/181 (13.8%). Children with IDA had significantly lower hepcidin levels (IDA median hepcidin 0.14 nmol/mmol Cr (interquartile range 0.05-0.061) versus non-IDA 2.96 nmol/mmol Cr, (IQR 0.95-6.72), p<0.001). Hemoglobin, log-ferritin, iron, mean cell volume (MCV) and transferrin saturation were positively associated with log-hepcidin levels (log-ferritin beta coefficient (beta): 1.30, 95% CI 1.02 to 1.57) and transferrin was inversely associated (beta: -0.12, 95% CI -0.15 to -0.08). Cytokine levels (including IL-6) and co-morbid infections were not associated with IDA or hepcidin levels. CONCLUSIONS/SIGNIFICANCE: This is the largest pediatric study of the in vivo associations between hepcidin, iron status and cytokines. Gastro-intestinal infections (H. pylori and helminths) did not elevate urinary hepcidin or IL-6 levels in refugee children, nor were they associated with IDA. Longitudinal and mechanistic studies of IDA will further elucidate the role of hepcidin in paediatric iron regulation