Growth charts of Turkish children with Down syndrome

We present growth curves of 1,726 Turkish children with Down syndrome (DS) between 0 and 18 years of age and investigate the factors that affect growth including congenital heart disease (CHD) and hypothyroidism. Longitudinal measurements of height, weight, and head circumference (HC) were assessed and accompanying major malformations were recorded. Growth curves were monitored using Cole's LMS method. The mean birth length was reduced by -0.5 standard deviation (SD) for Turkish standards in both boys and girls. Pubertal growth spurt of the girls with DS started 1 year earlier, their puberty duration was short and pubertal annual growth rate was inadequate, and as a result the final height was -3.06 SD for Turkish standards. Although the age at onset of pubertal growth spurt and puberty duration of the boys were similar to normal population, their pubertal annual growth rate was inadequate; thus the final height was -2.56 SD for Turkish standards. The final weight values were similar to normal population. The mean HC values of DS children were corresponded to -0.9 SD for Turkish standards at birth; however after 6 months values were below -2 SD. The final HC values were -1.02 SD for boys and -2.21 SD for girls for Turkish standards. We observed that weight was decreased in DS children with severe CHD during first 4 years of life. However, there is no statistically significant difference in values of height and head circumference between patients with or without severe CHD group. In addition, hypothyroidism had no effect on growth in DS patients. (c) 2012 Wiley Periodicals, Inc

Ceftriaxone-induced hemolytic anemia in a child successfully managed with intravenous immunoglobulin

Drug-induced hemolytic anemia is an immune-mediated phenomenon that leads to the destruction of red blood cells. Here, we present a case of life-threatening ceftriaxone-induced hemolytic anemia (CIHA) in a previously healthy 3-year-old girl. We also reviewed the literature to summarize the clinical features and treatment of hemolytic anemia. Acute hemolysis is a rare side effect of ceftriaxone therapy associated with high mortality. Our patient had a sudden loss of consciousness with macroscopic hematuria and her hemoglobin dropped from 10.2 to 2.2 g/dl over 4 hours, indicating that the patient had life-threatening hemolysis after an intravascular dose of ceftriaxone who had previously been treated with ceftriaxone in intramuscular form for six days. CIHA is associated with a positive direct antiglobulin test, revealing the presence of IgG in all cases and C3d in most cases. Our patient's direct antiglobulin test was positive for IgG (3+) and for C3d (4+). The case was managed successfully with supportive measures and intravenous immunoglobulin therapy. Ceftriaxone is used very frequently in children; an early diagnosis and proper treatment of hemolytic anemia are essential to improve the patient outcome. The pathophysiological mechanism is the same as for non-drug autoimmune hemolytic anemia. However, there is still no consensus treatment for CIHA. Intravenous immunoglobulin can be used in clinical emergencies, such as our case, or in refractory cases

A Case of Kawasaki Disease with Initial Presentation of Arthritis and Icterus

Kawasaki disease is a systemic vasculitis that generally affects infants and children. Its diagnosis depends on clinical findings. Early diagnosis and treatment are important for the prevention of coronary dilatations. Late diagnosis due to different presentations can result in diagnostic difficulties and increased mortality. In this case report, we present the case of a 3-year-old boy who was admitted to our clinic with arthritis and icterus and who was diagnosed with Kawasaki disease

A Case of Kawasaki Disease with Initial Presentation of Arthritis and Icterus

Kawasaki disease is a systemic vasculitis that generally affects infants and children. Its diagnosis depends on clinical findings. Early diagnosis and treatment are important for the prevention of coronary dilatations. Late diagnosis due to different presentations can result in diagnostic difficulties and increased mortality. In this case report, we present the case of a 3-year-old boy who was admitted to our clinic with arthritis and icterus and who was diagnosed with Kawasaki disease

A difficult case of Hodgkin Lymphoma with differential diagnosis of tuberculosis and sarcoidosis

We report here the case of a 14-year-old boy with history of fever, weight loss, and mediastinal lymphadenopathy. The clinical symptoms and laboratory findings mimicking tuberculosis and sarcoidosis complicated the diagnostic process. He was diagnosed with Hodgkins lymphoma after several X-rays, computed tomography, positron emission tomography-computed tomography, laboratory tests and three lymph node biopsy. Clinicians should be alerted on new lesions and symptoms in high risk patients and should repeat diagnostic tests and lymph node biopsies as indicated

Association between myeloperoxidase gene polymorphism and familial mediterranean fever in Turkish Children

Background: Familial Mediterranean Fever (FMF) is the most common autoinflammatory disease. Autoinflammatory disorders are characterized by exaggerated immune system responses. Neutrophils and their byproduct, myeloperoxidase, are important components of the innate immune system. In the present study, we searched for myeloperoxidase gene polymorphisms in FMF patients. Methodology/Principal Findings: We evaluated 83 children diagnosed with FMF by their physicians and 93 controls without any family history of FMF. MPO gene polymorphisms were detected using polymerase chain reaction (PCR)-based methods. We genotyped all samples in terms of the -463G/A single-nucleotide polymorphism, the most extensively studied MPO polymorphism. Allelic and genotypic frequencies were calculated, and possible associations with FMF explored. The frequencies of MPO polymorphisms differed significantly between the study and control groups (P = 0.003). The AA and AG gene polymorphisms were more prevalent in the FMF group than in the controls. The A allele was more prevalent in the FMF group (P = 0.001), and the frequency of the G allele was similar between the two groups (P = 0.128). Conclusion: MPO gene polymorphisms and allelic differences may be important in the pathogenesis of FMF

Who Should We Trust in Screening for Lower Urinary Tract Dysfunction in Children: The Parents or the Child?

OBJECTIVE To investigate whether the child's and the parents' reports about lower urinary tract symptoms (LUTS) are reliable and correlate with each other