Pages II - V
|5.||A Novel and Severe Clinical Picture Related to COVID-19: Multi-Inflammatory Syndrome in Children|
Fatih Haşlak, Mehmet Yıldız, Sezgin Şahin, Amra Adrovic Yıldız, Kenan Barut, Özgür Kasapçopur
doi: 10.5222/TP.2021.75047 Pages 51 - 59
Preliminary data have suggested that children have milder COVID-19 disease course compared to adults. However, pediatric cases with severe clinical findings caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) are being reported since April 2020. These children have been presented with significant hyperinflammatory states resembling Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome. However, they had several distinct features, as well. Therefore, this novel condition was considered a unique disease and named Multi-inflammatory syndrome in children (MIS-C). Thus, new concerns have been raised regarding the vulnerability of the children. However, it has been realized that this condition is extremely rare. Nonetheless, considering that it is a life-threatening disease and may cause devastating consequences, clinicians should be aware of MIS-C while evaluating children with persistent fever and history of COVID-19 contact or active infection.
|6.||The Effect of The Height of a Second-Degree Relative on Children with Short Stature|
Seda Yilmaz Semerci, Hasan Onal, Neval Topal, Rengin Siraneci
doi: 10.5222/TP.2021.18291 Pages 60 - 66
Objective: This study aimed to investigate the effect of the heights of second-degree relatives on adult height.
Methods: This was a cross-sectional study. Healthy children who applied to the general pediatric outpatient clinic to monitor the development of growth were considered as control group. Case group consisted of patients over 3 years of age with genetic, idiopathic short stature or without short stature but below the target height. All participants had either an uncle and an aunt with a short stature. Two groups were compared for their demographic characteristics and family information.
Results: The control group consisted of 43 children who were older than 3 years. A total of 101 cases of short stature were included in the study. Prevalence rates of idiopathic (39.6%: n=40), familial (36.6%: n=37), and constitutional (23.7%: n=24) short stature were as indicated. When the males included in the study were examined from different perspectives (case, control, presence of consanguineous marriage), the height of the uncle was predicted to be closer to or equal to the target height.
Conclusion: In case of short stature, the target height criterion alone is shown to be not reliable in the assessment of genetic compatibility as well as the deviation from the predicted final height. Predicted final height was demonstrated to be similar to aunt height for girls and uncle height for boys. Therefore, the height of a second-degree relative can be used as an aid in the estimation.
|7.||Prevalence of Allergic Rhinitis and Risk Factors in School Children|
Müge Ayanoğlu, Demet Can, Hikmet Tekin Nacaroğlu, Ilker Günay, Hacer Kamalı, Canan Karkiner, Ahmet Özdemir, Döne Doğan, Semiha Bahçeci Erdem
doi: 10.5222/TP.2021.21939 Pages 67 - 77
Objective: To evaluate the prevalence and the risk factors of allergic rhinitis in a particular area.
Methods: The main study group consisted of all school children in Kemalpasa district aged 13-14 years. Children with current rhinitis based on responses given in ISAAC questionnaire survey were further evaluated for confirmation. Parents responded to a more detailed questionnaire about allergic diseases and risk factors. Then peak nasal inspiratory flow (PNIF) was evaluated to objectively assess nasal patency. Skin-prick test was performed for ten common allergens.
Results: The questionnaire was answered by 90.8% (1373) of children. The prevalence of physician-diagnosed AR was 11.1%. Current rhinitis was found to be 31.3%. Of this group, 55.0% were admitted for the parent questionnaire and tests. Precisely, 90.3% of children accepted PNIF evaluation, and %10.1 of them had a nasal obstruction. Skin-prick tests revealed allergy for at least 1 allergen in 16.6% of children. The present study showed that the children with maternal allergic rhinitis history had 2,18 fold, and the children with seasonal allergic rhinitis had 2,11 fold higher possibility of sensitization to an allergen. The probability of perennial allergic rhinitis was 3,1 fold higher in the children who had siblings with allergic rhinitis.
Conclusion: We included all children in a specific age group living in an area in our survey. As well as we found the prevalence of current rhinitis with the ISAAC questionnaire; we also evaluated peak nasal inspiratory flow and used skin-prick tests that yielded objective results.
|8.||Domestic Lifestyle and Nutritional Status of Children During Covid-19 Pandemics|
Selda Bülbül, Aliye Gülbahçe, Nil Koç Gökşen, Ali Emrecan Ata, Sevim Gonca Kocagözoğlu
doi: 10.5222/TP.2021.41636 Pages 78 - 85
Objective: After Covid-19 pandemic was declared, a number of restrictions have been imposed all over the world. We aimed to detect changes in eating habits of children and adults during Covid-19 pandemic when lifestyle changes were inevitable due to these restrictions.
Methods: This is a descriptive cross-sectional study. The data collection process was completed by online questionnaire forms sent via mail system. There were questions about demographic characteristics of the participants and their children, lifestyle changes during the pandemic period and awareness of the pandemic. Participants with more than one child were asked to use the information of their youngest children. In statistical analyzes we used Statistical Package for Social Science (SPSS) 20.0 for Windows. Pearson Chi-square test was used for comparisons of categorical variables. The significance level was accepted as p≤ 0.05 in all statistical processes.
Results: A total of 327 people between 19-65 years of age participated in this study, and 174 of them had children with a mean age of 6.8 years, including 96 (55.7%) boys and 78 (44.3%) girls. Among all children, physical activity decreased in 101 (58%), screen time increased in 87 (50%) and 40 (23%) of them consumed their meals in front of the screen. The snacking habits of 130 (74.8%) children increased, 34 (19.5%) started consuming too much junk food and 12 of them (6.9%) gained weight. We observed that boys consumed more food than girls during their stay at home when compared to usual prerestriction days as they felt anxious and troubled (p=0.02).
Conclusion: Pandemics do not affect our lives not only with disease burden but also, have effects on daily lives of families and children. During this period, besides precautions against infection, special interest should be given to feeding, sleeping habits and physical activities that would boost immune system and measures should be taken to prevent harmful habits.
|9.||The Factors Affectıng The Effıcıency Of Contınuous Ambulatory Perıtoneal Dıalysıs In Chıldren|
Deniz Ökdemir, Nilgün Çakar, Irfan Oğuz Şahin
doi: 10.5222/TP.2021.55264 Pages 86 - 93
Objective: Peritoneal dialysis is a complex and variable process. Many factors can affect efficiency of dialysis, and relevant mortality and morbidity rates. Efficient dialysis is important in improving quality of life as well as reducing the morbidity and mortality rates. Dialysis fill volume, intraperitoneal pressure and ultrafiltration (UF) are important variables that determine dialysis efficiency. We aimed to investigate the factors affecting dialysis efficiency and to determine necessities to develop a more effective dialysis program.
Methods: Sixteen continuous ambulatory peritoneal dialysis (CAPD) patients between the ages of 7 and 19 years who were followed up in the Pediatric Nephrology Department were included in the study. Patients who had peritonitis, surgical or medical complications in the last 6 months were excluded from the study. Demographic data, duration of dialysis, hemogram, urea, creatinine, albumin, glucose levels, intraperitoneal pressures, peritoneal equilibration test (PET) and Kt/Vurea test results were recorded.
Results: Mean Kt /Vurea, dialysis fill volume, UF, intraperitoneal pressure, Hb and serum albumin were found as 2.5±0.93 (1.22-4.64), 1123.4±126.86 (875-1360) ml/m2, 600.1±382.15 (85 -1375) ml, 12.9±2.77 (8.5-19) cm/H2O, 9.0±1.54 (6.3-11.8) gr/dl and 3.6±0.61 (2.45-4.8) gr/dl, respectively. A statistically significant relationship was shown between UF and Kt/Vurea (p=0.04). The mean duration of dialysis was 54±36 months. The majority of the cases had high (37.5%) and medium-high (31.25%) peritoneal permeability. High permeability was found to have a significant relationship with the duration of dialysis (p=0.04).
Conclusion: Efficient peritoneal dialysis depends on preserved ultrafiltration. Therefore, the dialysate volume should be calculated according to the intraperitoneal pressure and dialysis should be adjusted according to the permeability properties of the peritoneal membrane.
|10.||A Newborn Admitted with Hyponatremia and Hyperkalemia Clinic and Diagnosed with Primary Hypoaldosteronism|
Merve Sakar, Semra Çetinkaya, Ilter Arifoğlu Barış, Ahmet Öktem, Aysegül Zenciroğlu, Rüveyde Bundak, Şenay Savaş Erdeve
doi: 10.5222/TP.2021.19483 Pages 94 - 98
Primary hypoaldosteronism is a rare autosomal recessive disorder that causes defects in aldosterone synthase enzyme activity due to an inactivating mutation in the CYP11B2 gene. Patients with primary hypoaldosteronism exhibit symptoms such as vomiting, dehydration, feeding problems, and failure to thrive. This disease is characterized by hyponatremia, hyperkalemia, metabolic acidosis, high renin, and low aldosterone levels. It also causes salt loss syndrome in the newborn period. In this article, we described a newborn with primary hypoaldosteronism who showed feeding problems and weight loss. Laboratory findings revealed hyponatremia, hyperkalemia, high plasma renin, and low aldosterone levels, while genetic analysis showed homozygous c.788T>A (p.Ile263Asn) variant in the CYP11B2 gene (NM_000498.3). Our patient responded well to oral salt and fludrocortisone treatments. Early diagnosis and treatment are particularly important because primary hypoaldosteronism causes life-threatening electrolyte disorders and salt loss syndrome.
|11.||Diagnostic Approach in Cystinuria: A Case Report|
Selda Bülbül, Aliye Gülbahçe, Sevim Gonca Kocagözoğlu
doi: 10.5222/TP.2021.44153 Pages 99 - 103
Cystinuria is an, inherited metabolic disorder progressing with recurrent kidney stones due to impaired reabsorption of dibasic amino acids and arises from mutations in the SLC3A1 and SLC7A9 on chromosome 2.
Cystine crystals were detected in the urinalysis of a 17-year-old male patient who was investigated for recurrent kidney stones. Because of demonstration of cystine excretion in the urinary amino acid analysis and having positive family history, we suspected Cystinuria Type B and initiated supportive therapy. However, based on the results of molecular analyses his diagnosis was changed as Cystinuria Type A.
In conclusion, our final diagnosis was changed according to the molecular analyses but our treatment approach did not change. Therefore we would like to emphasize that, prominent physical examination findings and supportive laboratory test results will be sufficient for the diagnosis of cystinuria.
|12.||Langerhans Cell Histiocytosis with Isolated Central Diabetes Insipidus, Low Grade Fever and Sellar Erosion|
Iclal Okur, Hasan Ari, Semra Çetinkaya, Betul Emine Derinkuyu, Gizem Çağlar, Hasibe Gökçe Çınar, Sule Yeşil, Senay Savaş Erdeve
doi: 10.5222/TP.2021.86580 Pages 104 - 108
Langerhans cell histiocytosis (LCH) is a rare disease of the monocyte-macrophage system. Although it is known that bone involvement is seen very frequently in cases with LCH, our case is the first case with a lytic-destructive lesion in the bone structure forming sella turcica.
A 4-year-old, 5-month-old male patient who applied to our outpatient clinic was diagnosed with Langerhans cell histiocytosis in further examination after the diagnosis of central diabetes insipidus (CDI) was made. On cranial magnetic resonance imaging (MRI), widespread lytic-destructive bone lesions were observed in the bone structure forming the sella (sphenoid bone), sellar destruction not previously described in the literature.
Sellar erosion has not been reported before in cases diagnosed with LCH in the literature. The presence of low-grade fever in a patient presenting with isolated CDI is a warning sign for the diagnosis of LCH.