Globoid Cell Leukodystrophy (Krabbe Disease)

How to Cite This Article: TAvasoli A. Globoid Cell Leukodystrophy (Krabbe Disease). Iran J Child Neurol. Autumn 2014;8;4(Suppl.1):14-15.pls see pdf

Immune mediated myasthenia gravis in children, current concepts and new treatments: A narrative review article

Myasthenia gravis (MG) is the most frequent transmission disease in the neuromuscular junction. Juvenile myasthenia gravis (JMG) is an autoimmune antibody-mediated disease of postsynaptic endplate defined as MG presentation in patients before the age of 18 years old. While many clinical features of JMG are identical to the adults, there are some significant differences between them regarding presentation, clinical course, antibody level, and thymus histopathology. In JMG, ocular symptoms are more frequent, the clinical course is comparably benign, and the outcome is better than adult MG. Antibodies attack the muscle endplate proteins in the postsynaptic membrane and interfere with transmission. These antibodies in most patients are against the acetylcholine receptors, but they may also be directed toward muscle-specific kinase, lipoprotein-related protein 4, and agrin. Findings show racial influences and genetic effects on the occurrence of JMG. The essential clinical symptom is fatigable weakness of muscles that can be in the form of isolated ocular type or more disseminated weakness. The diagnosis of JMG is essentially clinical, with fluctuating patterns of weakness and easy fatigability, but a series of diagnostic evaluations can confirm the diagnosis. Precise diagnostic evaluation and distinction from congenital myasthenic syndromes is critical. The treatment plan is conducted according to the clinical course (ocular or generalized), antibody type, and disease severity. The mainstay of treatment includes symptomatic therapy, long-lasting immunosuppressive treatment and treatment of myasthenic crisis. Novel medications are introduced and conducted to the specific pathophysiologic mechanisms of the disease, and they are used primarily in the refractory MG

Renal Function in Children with Febrile Convulsions

How to Cite This Article: Afsharkhas L, Tavasoli A. Renal Function in Children with Febrile Convulsions.Iran J Child Neurol. 2014 Autumn;8(4):57-61.AbstractObjectiveFebrile convulsions (FC) are the most frequent seizure disorder in children.Some studies have detected serum electrolyte disturbances in patients with FC.This study determines serum electrolytes, renal function tests, and frequency of urinary tract infection in hospitalized children with FC.Materials & MethodsIn this descriptive, cross sectional study, we evaluated 291 children with FC admitted to the Neurology ward of Ali-Asghar Children’s Hospital from 2008–2013. Data was recorded on age, sex, type (simple, complex), and recurrence of seizures, family history of FC and epilepsy, serum electrolytes, renal function tests, and urinary tract infections.ResultsA total of 291 patients with diagnosis of FC were admitted to our center. Of these 291 patients, 181 (62.2%) were male. The mean age was 24.4 ± 14.6 months.There were simple, complex, and recurrent FCs in 215 (73.9%), 76 (26.1%) and 61 (21%) of patients, respectively. Urinary tract infections (UTI) were found in 13 (4.5%) patients, more present in females (p-value = 0.03) and under 12 months of age (p-value = 0.003). Hyponatremia, hypocalcemia, and hypokalemia was detected in 32 (11%), 16 (5.5%), and 4 (1.4%) of cases, respectively. Twentyfour (8.2%) patients had a glomerular filtration rate less than 60 ml/min/1.73m2.There were no abnormalities in serum magnesium, BUN, and creatinine levels.ConclusionDuring FCs, mild changes may occur in renal function but a serum electrolyte evaluation is not necessary unless patients are dehydrated. In children with FC, urinary tract infections should be ruled out. ReferencesGhofrani M. Febrile Convulsion: Another look at an old subject. Iran J Child Neurology 2006 June:1(1):5-9.Swaiman K, Ashwal S, Ferriero D, Schor N. Swaiman’s Pediatric Neurology: Principles and Practice. 5th edition.2012.Pp.790-798.Mohammadi M. Febrile Seizures: Four Steps Algorithmic Clinical Approach. Iranian Journal of Pediatrics 2010; 20(1):5-15.Commission on Epidemiology and Prognosis, International League against Epilepsy. Guidelines for epidemiologic studies on epilepsy. Epilepsia 1993;34(4):592–6.Saghazadeh A, Mastrangelo M, N. Genetic background of febrile seizures. Rev Neurosci 2014;25(1):129-61.NP. Evaluation of the child who convulses with fever. Pediatr 2003;5(7):457-61.Karimzadeh P, Fahimzad A, Poormehdi MS. Febrile Convulsions: The Role Played By Paraclinical Evaluation. Iran J Child Neurology 2008;2(4):21-24.Kwong KL, Tong KS, So KT. Management of febrile convulsion: scene in a regional hospital. Hong Kong Med J 2003 Oct; 9(5):319-22.Amiri M, Farzin L, Moassesi ME, Sajadi F. Serum trace element levels in febrile convulsion. Biol Trace Elem Res 2010; 135(1-3):38-44.Amouian S, Mohammadian S, Behnampour N Tizrou M. Trace Elements in Febrile Seizure Compared to Febrile Children Admitted to an Academic Hospital in Iran, 2011. Journal of Clinical and Diagnostic Research 2013 Oct;7(10): 2231-2233.Behrman E R. Nelson Textbook of Pediatrics . In: Bleyer A, Ritchey A.K. Nephrology section. 19th edition. 2011. P.1731-1845.Momen A, Monajemzadeh SM. the Frequency of Urinary Tract Infection among Children with Febrile Convulsion. Iranian Journal of Child Neurology 2011: 1(1):29-31.Sahib El-Radhi A, Carroll J, Klein N. Clinical Manual of Fever in Children. Springer. 2011. P.8-9.Heydarian, F, Ashrafzadeh F, Kam S. Simple Febrile Seizure: The Role of Serum Sodium Levels In prediction of Seizure Recurrence during the First 24 Hours. Iranian Journal of Child Neurology 2009;3(2):31-34.Nickavar A, Hassanpour H, Sotoudeh K. Validity of Serum Sodium and Calcium Screening in Children with Febrile Convulsion. Acta Medica Iranica 2009;47(3):229-231.Talebian A, Vakili Z, Talar SA, Kazemi SM, Mousavi GA. Assessment of the relation between serum zinc & magnesium levels in children with febrile convulsion. Iran J Pathol 2009; 4(4):157-160.Teach SJ, Geil PA. Incidence of bacteremia, Urinary Tract Infection & Unsuspected bacterial meningitis in children with febrile seizures. Pediatric Emergency care 1999; 15(1)9-12

The association between failure to thrive or anemia and febrile seizures in children between 6 months to 6 years old age

Objectives: Febrile seizure is the most common seizure disorder in childhood. Anemia or failure to thrive can predispose children to Febrile seizure by affecting the nervous system function. The current study investigates the association between febrile seizures and Anemia or failure to thrive.Materials and Methods: This case-control study was performed on 307children 6 months to 6 years old age hospitalized at the Ali Asghar children`s Hospital from 2011 to 2014 divided into two groups: a case group including 158 children with febrile seizures and a control group including 149 febrile children without seizure. The amount of Hgb, Hct, RBC count, MCV, MCH, and MCHC was recorded and weight-for-age and weight-for-height was calculated based on the WHO Z-Score charts.The date were compared between two groups.Results: There were no differences regarding  age and sex between the groups. Statistically significant differences were found regarding the mean RBC count between the case group (4.38×106 ± 0.72×106) and the control group (4.24×106 ± 0.84×106) (p=0.013), as well as about the mean MCV that was 78.73 ± 0.97 and 76.78 ± 1.00 in the case and control groups respectively(p=0.005). Anemia was seen in 28.5% of the case and 42.3% of control group which was statistically significant (p=0.012). There was not statistically significant difference regarding  failure to thrive between two groups.Conclusion: in children with febrile seizures anemia was lower comparing with febrile children without seizure. Moreover, there was not any association between failure to thrive and febrile seizures.

Sleep Symptoms and Polysomnographic Patterns of Obstructive Sleep Apnea in Obese Children

How to Cite This Article: Tavasoli A, Jalilolghadr Sh, Lotfi Sh. Sleep symptoms and polysomnographic patterns of obstructive sleep apnea in obese children. Iran J Child Neurol. Winter 2016; 10 (1):14-20.AbstractObjectiveThis study was conducted to investigate the sleep symptoms and polysomnographic patterns of obstructive sleep apnea in overweight and obese children.Materials & MethodsOverweight or obese children aging 6-18 yr old referred during 2010 to Endocrinology Clinic of Ghods Hospital in Ghazvin, central Iran were enrolled in the study. Polysomnography was done for the diagnosis of obstructive sleep apnea and the BEARS and Children’s Sleep Habits questionnaires were used to survey sleep behaviors.ResultsWe enrolled 30 children (14 males, 16 females). Twenty-one cases had body mass index (BMI) >95% and 9 had 85% <BMI<95%. Respiratory disturbance in polysomnography was seen in 90% of cases. Symptoms included snoring 18 (60%); frequent awakening 17 (56.6%); nocturnal sweating 15 (50%); daytime sleepiness 12 (40%); sleep talking 10 (33.3%); bedtime resistance 9 (30%); nightmares 8 (26.6%); waking up problems 6 (20%); sleep walking 6 (20%); difficult breathing 4 (13.3%); bedwetting 3 (10%) and sleep onset delay 2 (6.06%). Severe, moderate and mild apnea – hypopnea Index (AHI) were seen in 12, 9 and 6 subjects, respectively. A significant Pearson correlation was found between the BMI values and sleep latency.ConclusionPrevalence of obstructive sleep apnea is high among overweight and obese children. Physicians should be familiar with its manifestations and consider polysomnography as an invaluable diagnostic test. There was no relation between the degree of obesity and severity of obstructive sleep apnea

Frequency of Meningitis in Children Presenting with Febrile Seizures at Ali- Asghar Children’s Hospital

How to Cite This Article: Tavasoli A, Afsharkhas L, Edraki A. Frequency of Meningitis in Children Presenting with Febrile Seizure in Ali-Asghar Children’s Hospital. Iran J Child Neurol. 2014 Autumn; 8(4):51-56.AbstractObjectiveFebrile seizures (FS) are the most common type of childhood seizures, affecting 2–5% of children. As the seizure may be the sole presentation of bacterial meningitis in febrile infants, it is mandatory to exclude underlying meningitis in children presenting with fever and seizure. To determine the frequency of meningitis in children with FS and related risk factors, the present study was conducted at Ali-Asghar Children’s Hospital.Materials & MethodsThe records of children aged from 1-month–6 years of age with fever and seizure admitted to the hospital from October 2000–2010 were studied. The charts of patients who had undergone a lumbar puncture were studied and cases of meningitis were selected. The related data was collected and analyzed with SPSS version 16.ResultsA total of 681 patients with FS were known from which 422 (62%) lumbar punctures (LP) were done. Meningitis (bacterial or aseptic) was identified in 19 cases (4.5%, 95% CI 2.9–6.9 by Wilson- Score internal) and bacterial meningitis in 7 (1.65%, 95% CI 0.8–3.3). None of the patients with bacterial meningitis had meningeal irritation signs. Complex FS, first attack of FS, and impaired consciousness were more common in patients with meningitis when compared to non- meningitis patients.ConclusionMeningitis is more common in patients less than 18 months presenting with FS; however, complex features of seizures, first attack of FS, or impaired consciousness seem significant risk factors for meningitis in these children and an LP should be considered in this situation. ReferencesKimia A, Ben-Joseph EP, Rudleo T, et al. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics.2010; 126: 62-69.Hom J, Medwid K, The low rate of bacterial meningitis in children, ages 6 to 18 months, with simple febrile seizures. AcadEmerg Med 2011; 18(11):1114-1120.Fetveit A. Assessment of febrile seizures in children. Eur J Pediatr 1998; 167(1); 17-27.Subcommittee on Febrile Seizures. Febrile seizures: Guidelines for the neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics 2011; 127(2):389-394.Rosman NP. Evaluation of the child who convulses with fever. Pediatr Drugs 2003; 5(7):457- 461.Dubos F, De la Rocque F, Levy C et al. Sensitivity of the bacterial meningitis score in 889 children with bacterial meningitis. J Pediatr 2008; 152:378-382.Nigrovic LE, Kuppermann N, Macias CG, et al. Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis. JAMA 2007; 297(1):52-60.American Academy of Pediatrics. Provisional Committee on quality improvement, Subcommittee on Febrile Seizures. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. Pediatrics 1997; 769-772.Najaf-Zadeh A, Dubos F, Hue V, et al. Risk of bacterial meningitis in young children with a first seizure in the context of fever: a systematic review and meta- analysis. PLoS One. 2013; 8(1):e55270. Doi: 10. 1371/journal. pone.0055270.Owusu-Ofori A, Agbenyega T, Ansong D, et al. Routine lumbar puncture in children with febrile seizures in Ghana: should it continue? International Journal of Infectious Diseases 2004; 8:353-361.Kimia AA, Capraro AJ, Hummel D, Johnston P, Harper MB. Utility of lumbar puncture for first simple febrile seizure among children 6 to 18 months of age. Pediatrics 2009; 123(1): 6–12.Shaked O, Pena BM, Linares MY, Baker RL. Simple febrile seizures: are the AAP guidelines regarding lumbar puncture being followed? Pediatr Emerg Care 2009; 25(1):8-11.Seltz LB, Cohen E, Weinstein M. Risk of bacterial or herpes simplex virus meningitis/encephalitis in children with complex febrile seizures. Pediatr Emerg Care 2009;25(8): 494–497.Casasoprana A, Hachon Le Camus C, Claudet l, et al. Value of lumbar puncture after a first febrile seizure in children aged less than 18 months. A retrospective study of 157 cases. Arch Pediatr, 2013. Pil: S0929-693X (13)00238-8.Kwang SK. Bacterial meningitis beyond the neonatal period. In: Cherry JD, Harrison GJ, Kaplan Sh L, Steinbach W.J, Hotez PJ, eds. Feigin and Cherry’s textbook of pediatric infectious diseases: Philadelphia, Elsevier, Saunders.2014.P:425-472.Ehsanipour F, Khodapanahandeh F, Aslani Z. The prevalence of meningitis in children with febrile seizure hospitalized at Hazrat Rasoul hospital (1997-2002). Journal of Iran University of Medical Sciences 2004; 44;907-912.Al-Eissa YA. Lumbar puncture in the clinical evaluation of children with seizures associated with fever. PediatrEmerg Care 1995; 11(6):347-350.Ghotbi F, Shiva F. An assessment of the necessity of lumbar puncture in children with seizure and fever. J Pak Med Assoc 2009; 59(5):292-295.Tinsa F, EL GhrbiA, NcibiN, et al. Role of lumbar puncture for febrile seizure among infants under one year old. Tunis Med 2010; 88(3): 178-183.Joshi Bataloo R, Rayamaihi A, Mahaseth C. Children with first episode of fever with seizure: is lumbar puncture necessary? JNMA J Nepal Med Assoc 2008;47(171):109-112.Carrol W, Brookfield D. Lumbar puncture following febrile convulsion. Arch Dis Child 2002; 87:238-240.Laditan AA. Analysis of the results of routine lumbar puncture after a first febrile convulsion in Hofuf, Al-Hassa, Saudi Arabia. East Afr Med J 1995;72:376-Rossi LN, Brunelli G, Duzioni N, et al. Lumbar puncture and febrile convulsion. Helv Pediatr Acta 1986; 41(1-2):19-24.Mikati M A. Febrile seizures. In: Behrman RF, Kliegman RM, Jenson HB. (editors). Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders. 2011. Pp: 2017-19

Kleine-Levin Syndrome in an 8-Year-Old Girl with Autistic Disorder: Does Autism Account a Primary or Secondary Cause?

How to Cite This Article: Hakim Shoushtari M, Ghalebandi MF, Tavasoli A, Pourshams M. Kleine-Levin Syndrome in an 8 Year Old Girl with Autistic Disorder Does Autism Account a Primary or Secondary Cause? Iran J Child Neurol. Autumn 2015;9(4):61-64.AbstractObjectiveKleine–Levin syndrome (KLS) is a rare disorder with an unknown etiology. Autism spectrum disorder is characterized by various degrees of impairment in social communication, repetitive behavior and restricted interests. Only four patients of KLS with autistic spectrum disorder (ASD) have been reported so far. This report presents an 8-year-old girl with history of autistic disorder and epilepsy that superimposed KLS. Because of the rarity of KLS and related studies did not address whether autism accounts for a primary or secondary cause, the area required attention further studies

A rare case of Sjogren-Larsson syndrome with recurrent pneumonia and asthma

Sjogren-Larsson syndrome (SLS) is a rare autosomal recessive neurocutaneous disorder with worldwide incidence of 0.4 per 100,000 people. It is characterized by the triad of congenital ichthyosis, spastic diplegia or quadriplegia, and mental retardation. Herein we report a 2-year-old male child with SLS, asthma, and recurrent pneumonia. SLS was confirmed by a molecular genetics study that revealed a deletion mutation in the ALDH3A2 gene. An ALDH3A2 gene mutation results in dysfunction of the microsomal enzyme fatty aldehyde dehydrogenase and impaired metabolism and accumulation of leukotriene B4, which is a key molecule and a pro-inflammatory mediator in developing allergic diseases, especially asthma. An increased level of leukotriene B4 has been reported in SLS patients. As far as we are aware, this is the first report of SLS associated with asthma and recurrent pneumonia. In conclusion, pediatricians should be aware of and evaluate patients with SLS for possible associated asthma and allergic disorders

Neuroimaging Findings in First Unprovoked Seizures: A Multicentric Study in Tehran

How to Cite This Article: Molla Mohammadi M, Tonekaboni SH, Khatami AR, Azargashb E, Tavasoli A, Javadzadeh M, Zamani GR. Neuroimaging Findings in First Unprovoked Seizures: A Multicentric Study in Tehran. Iran J Child Neurol. 2013 Autumn; 7(4):24-31.ObjectiveSeizure is an emergency in pediatrics. It really matters to the parents of the involved child to have information about the causes, management and prognosis.First unprovoked seizures (FUS) are seizures that occur in patients without fever, trauma or infection. Due to the rapid improvement in diagnostic techniques in the last few decades, the etiology will be revealed and this term will no longer exist. This Study was designed to evaluate brain imaging findings in FUS patients. Materials & MethodsNinety-six children with FUS, who were admitted in three major children’s hospitals in Tehran, underwent brain imaging and were enrolled into the study.The decision about the type of imaging (CT or MRI) was based on the patient’s medical and financial conditions. An expert radiologist in the field of pediatric neuroimaging interpreted the images. ResultsAltogether, 27.1% had abnormal findings of which 29.2% were in the brain MRI group and 14.3% were in the brain CT scan group.Abnormal results were gliosis (10.4%), hemorrhage (4.2%), dysgenesis (2.1%), dysmyelination (7.3%), encephalomalacy (1%), atrophy (5.2%) and infarction (2.1%). In some patients, the lesions were in 2 or 3 sites and some had more than one type of lesion.There was no association between the duration, age and type of seizure and imaging abnormlities. However, we found an association between the location of the lesion and the type of seizure. ConclusionWe recommend brain imaging in all patients with FUS and apart from some exceptions, brain MRI is superior to CT. ReferencesJohnston MV. Siezure in childhood. In: Kliegman RM, Behrman RE, editors. Nelson text book of pediatrics. 18th ed. Philadelphia: Saunders; 2010. p. 2457-70.Bluestein JS, Moshe SL. First unprovoked seizure. In: Maria BL, editor. Currents in management in child neurology. 3rd ed. Hamilton: BC Decker; 2005. p. 89-92.Khodapanahandeh F, Hadizadeh H. Neuroimaging in children with first afebrile seizures: to order or not to order? Arch Iran Med 2006 Apr;9(2):156-8.Alawaneh H, Bataineh HA. Urgent neuroimaging in children with first nonfebrile seizures. Middle East JFam Med 2008 Feb;6(1):24-6.Shinnar S, O’Dell C, Mitnick R, Berg AT, Moshe SL. Neuroimaging abnormalities in children with an apparent first unprovoked seizure. Epilepsy Res 2001 Mar;43(3):261-9.Kalnin AJ, Fastenau PS, deGrauw TJ, Musick BS, Perkins SM, Johnson CS, et al. Magnetic resonance imaging findings in children with a first recognized seizure. Pediatr Neurol 2008 Dec;39(6):404-14.King MA, Newton MR, Jackson GD, Fitt GJ, Mitchell LA, Silvapulle MJ et al. Epileptology of the first-seizure presentation: a clinical, electroencephalographic, and magnetic resonance imaging study of 300 consecutive patients. Lancet 1998 Sep 26;352(9133):1007-11.Pohlmann-Eden B, Beghi E, CarnfieldC, Carnfield P. The first seizure and its management in adults and children. BMJ 2006 Feb;332(11):339-34.Raman S, Susan K, Joyce W. Paroxysmal disorders.In: Menkes J, editor. Child neurology. 7th ed. Philadelphia: Lipincott; 2006. p. 857-942.Wical B. The first unprovoked seizure.Gillette Children’sSpecialty Healthcare. A PediatricPerspective 1999 Mar;8(3).Bano S, Yadav SN.Neuroimaging in epilepsy.Medi-Focus2010 Apr-Sep;9(3&4):2-4.Rauch DA,Carr E, Harrington J.Inpatient brain MRI for new-onset seizures: utility and cost effectiveness.Clin Pediatr (Phila) 2008 Jun;47(5):457-60.Gaillard WD, Chiron C, Cross JH, Harvey AS, Kuzniecky R, Hertz-Pannier L et al. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia 2009 Sep;50(9):2147-53.Barkovich AJ. Techniques and methods in pediatric neuroimaging. 4thed. Philadelphia: Lippincott Williams &Wilkins; 2005. p. 4-7.Doescher JS, deGrauw TJ, Musick BS, Dunn DW, Kalnin AJ, Egelhoff JC et al. Magnetic resonance imaging and electroencephalic findings in a cohort of normal children with newly dignosed seizures. J Child Neurol 2006 Jun; 21(6):490-5. 

Učestalost hipertenzije i kardiovaskularnih rizika u djece s ožiljcima na bubrežnom tkivu nakon mokraćne infekcije

Hypertension is a late outcome of refl ux nephropathy and renal parenchymal scar secondary to urinary tract infection (UTI). We presumed that it might be detected much earlier after episodes of UTI and the associated cardiovascular risk factors assessed. Between 2009 and 2011, 85 (67 female and 18 male) children aged 5-15 years with a history of febrile UTI, followed-up for at least one year from the fi rst episode of febrile UTI, were enrolled in the study. The variables included 24-hour ambulatory blood pressure monitoring (ABPM), echocardiography, carotid sonography, renal 99mcTc-DMSA, glomerular fi ltration rate, and microalbuminuria. Masked hypertension was detected in 18.8%, hypertension in 7.1% and white coat hypertension in 9.4% of cases. Prehypertension was seen in 20% of children. Out of 85 cases, 43.5% were non-dippers. Out of 56 children with hypertensive and prehypertensive parameters on ABPM, 9.1% showed left ventricular mass index >51g/m2.7 (p>0.05). Signifi cant correlation was only recorded between abnormal blood pressure and the severity of renal parenchymal scar (p<0.05). In conclusion, ABPM is suggested for early detection of masked hypertension and abnormal blood pressure pattern in all normotensive children with a history of recurrent UTI.Hipertenzija je kasni ishod refl uksne nefropatije i ožiljaka na bubrežnom parenhimu koji nastaju nakon mokraćne infekcije. Pretpostavili smo da bi se to moglo otkriti znatno ranije nakon epizoda mokraćne infekcije te procijeniti pridružene kardiovaskularne čimbenike rizika. Od 2009. do 2011. godine, u ispitivanje je uključeno 85 (67 Ž, 18 M) djece u dobi od pet do 15 godina s anamnezom febrilne mokraćne infekcije koja su bila praćena najmanje jednu godinu od prve epizode febrilne mokraćne infekcije. Praćene su sljedeće varijable: 24-satno ambulatorno praćenje krvnog tlaka (ambulatory blood pressure monitoring, ABPM), ehokardiografi ja, karotidni ultrazvuk, 99mcTc-DMSA bubrega, glomerularna stopa fi ltracije i mikroalbuminurija. Maskirana hipertenzija otkrivena je u 18,8%, hipertenzija u 7,1% i hipertenzija “bijele kute” u 9,4% slučajeva. Prehipertenzija je zabilježena u 20% djece. Od 85 slučajeva 43,5% ih nije pokazalo odgovarajući pad krvnog tlaka tijekom noći (non-dipper). Od 56 djece s hipertenzivnim i prehipertenzivnim parametrima na ABPM 9,1% ih je imalo indeks lijeve ventrikularne mase veći od 51g/m2.7 (p>0,05). Značajna korelacija zabilježena je između nenormalnog krvnog tlaka i težine ožiljka na bubrežnom parenhimu (p<0,05). U zaključku, ABPM se može preporučiti za rano otkrivanje maskirane hipertenzije i nenormalnog kretanja krvnog tlaka kod sve normotenzivne djece s anamnezom opetovane mokraćne infekcij