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Copyright of Celal Bayar Üniversitesi Saglik Bilimleri Enstitüsü Dergisi is the property of Celal Bayar University Health Sciences Institute Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Antenatal hydronephrosis (ANH) is one of the most common abnormalities detected during prenatal ultrasound. There is significant variability in the postnatal management of ANH. Our objective was to report the outcomes of patients with ANH, spontaneous resolution rates, surgical intervention rates, and factors contributing to these parameters. Methods: A total of 227 patients and 264 renal units with ANH were included in this study. We used the renal pelvis anteroposterior diameter and the Society for Fetal Urology grading system to classify and compare ANH as mild, moderate, and severe. Results: The patients' median follow‐up period was 48 months (with a minimum of 6 months and a maximum of 136 months). Of the 264 renal units, 123 (46.6%) had mild, 101 (38.26%) had moderate, and 40 (15.15%) had severe antenatal hydronephrosis. The spontaneous resolution rate was 91.9% in the mild hydronephrosis group (n = 113), 81.2% (n = 82) in the moderate hydronephrosis group, and 37.5% (n = 15) in the severe hydronephrosis group. The patients with higher hydronephrosis grades required a longer time to resolve. Only one patient with a posterior urethral valve had reduced estimated glomerular filtration. None of the patients had proteinuria or hypertension. Conclusion: Although the outcome of the patients with mild hydronephrosis was excellent, there was a progression of the disease, especially within the first 6 months, and 6% of our cases required surgical intervention. Additional prospective studies are needed to define the risk of urinary tract abnormalities with any degree of ANH. [ABSTRACT FROM AUTHOR]

CONCLUDING REMARKS In this widespread tragic disaster, the TSPN was a part of the national/international collaborative effort to save patients' lives and to decrease crush injury and resultant acute kidney injury-related morbidity. NATIONAL COLLABORATIONS By cooperation with the Turkish Society of Nephrology, continuity of care was assured by contacting adult nephrologists when necessary, especially in centers without pediatric nephrologists. Since an earthquake should be considered a "kidney disaster" because of crush injuries and resultant acute kidney injury [[7]], the Turkish Society of Pediatric Nephrology (TSPN) took primary responsibility during the immediate and early phases of earthquake. Disasters from the perspective of pediatric nephrologist - 9 February 2023 Crush syndrome Disaster preparedness in pediatric nephrology centers Study suggestions After the earthquake - 16 February 2023 "How should I approach pediatric earthquake victims?". [Extracted from the article]

Aim: Familial Mediterranean Fever (FMF) is the most frequent monogenetic autoinflammatory disorder. It is characterized by fever and serositis. The first line treatment of FMF is colchicine. Adherence to colchicine is one of the main factors affecting colchicine response. In this study, we aimed to evaluate drug adherence in children with FMF using the medication adherence scale in FMF (MASIF). We also assessed the clinical characteristics of drug-adherent patients and factors affecting drug adherence. Materials and Methods: Eighty-two children with FMF under colchicine therapy were included in this cross-sectional observational study. The patients were divided into two groups according to medication adherence and compared according to their demographic and clinical data. Results: According to MASIF, 31 (38%) patients had non-adherence to colchicine. There was a significant difference between the colchicineadherent and non-adherent groups in terms of age, disease severity according to the International severity score for FMF, attack rate, colchicine dosage, M694V homozygosity, and family type (p=0.005, p=0.04, p=0.025, p=0.045, p=0.04, and p=0.046, respectively). Conclusion: Patients with FMF should be questioned about their medication adherence at every visit, and children with a high risk of colchicine non-adherence should be followed up more closely. [ABSTRACT FROM AUTHOR]

Background: Solitary kidney (SK) affects 1/1000 people worldwide, and there are controversies concerning renal outcomes in these patients. This study aimed to investigate clinical findings and renal outcomes in children with SK and to compare the results for congenital (CSK) and acquired SK (ASK) groups. Methods: The study included patients that presented to our pediatric nephrology department with SK between January 2010 and January 2021. Demographic and clinical data were recorded retrospectively. Results: Of the 101 patients with SK, 71 had CSK (55 had unilateral renal agenesis and 16 had a multicystic dysplastic kidney) and 30 had ASK (17 had previously undergone unilateral nephrectomy due to a renal tumor and 13 had urological structural anomalies). There were nine patients (9%) with renal injury. The serum uric acid level was significantly higher and the estimated glomerular filtration rate was significantly lower in the patients with ASK compared with those with CSK (p = 0.005 and p < 0.001, respectively). There was a positive correlation between renal injury and the uric acid level (p < 0.001, r = 0.45). Conclusion: In addition to the management of blood pressure and proteinuria, it is important to control uric acid levels in patients with SK, especially those with ASK, to prevent renal injury. The ASK group has a greater risk of renal injury than the CSK group. There is a need for new markers to predict early stage renal damage in SK. [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus 2019 pandemic has become a serious threat to the global health and spreading rapidly. Dialysis patients may have developed anxiety because of their disease characteristics during this pandemic. The aim of this study was to assess the reliability and quality of the most viewed English‐language YouTube videos on COVID‐19 and dialysis link. Methods: A YouTube search was achieved using the key words "COVID‐19 dialysis," "SARS CoV‐2 dialysis," "coronavirus hemodialysis," and "COVID peritoneal dialysis." Results: Among the 43 videos analyzed, 24 (55.8%) were high quality, 11 (25.6%) were moderate quality, and 8 (18.6%) were of low quality according to global quality score. Significant differences were found between the groups in modified DISCERN scores and the number of views, likes, comments. Conclusion: The most reliable sources such as universities, governments, professional societies should better use YouTube for dissemination of accurate, reliable, and useful health‐related information to the general public. [ABSTRACT FROM AUTHOR]

Background Renoprotective effects of vitamin D analogues have been shown in several experimental and clinical studies. The exact mechanism of the therapeutic effectiveness of these analogues in nephrotic syndrome remains unclear, and these are relatively few studies on potential treatment roles for vitamin D analogues in nephrotic-range proteinuria. İndicate similar efficacy of the vitamin D analogues calcitriol and paricalcitol in time-limited amelioration of proteinuria in nephrotic syndrome, yet suggest the likelihood of mechanisms other than direct upregulation of nephrin and podocin in podocytes underlie the renoprotective effects of vitamin D analogues. Objective To investigate the effect of vitamin D analogues calcitriol and paricalcitol on urinary protein/creatinine ratio (UPCR) and renal podocin and nephrin expression in a rat model of puromycin aminonucleoside (PAN)-induced nephrotic syndrome (NS). Methods A total of 28 male Wistar Albino rats were separated into 4 groups (n=7 for each) including CON [control; intraperitoneal (IP) saline injection], PAN (NS + IP saline injection), PAN-C (NS + IP 0.4 µg/kg/day calcitriol injection), and PAN-P (NS + IP 240 ng/kg/day paricalcitol injection). Nephrotic syndrome was induced via intravenous (IV) administration of 10mg/100gr PAN. The UPCR as well as histopathological, immuno-histochemical, and real time PCR analyses of kidney tissue specimens were recorded and analyzed among the 4 groups. Results Median UPCR (Day 4) was significantly lower in both the PAN-C [1.45 (range 1.20-1.80)] and PAN-P [1.40 (range 1.10- 1.80)] groups than in the PAN group [2.15 (range 2.00-2.40)] (P<0.01 for each). The PAN group had significantly higher mean UPCR than the CON group [1.75 (range 1.40-2.00); P<0.05]. No significant difference in UPCR was noted between groups on Day 7. Median podocin mRNA expression was significantly higher in the PAN-P group compared to the PAN group [22.55 (range 22.42-23.02) vs. 22.06 (range 21.81-22.06), respectively; (P<0.01)]. Conclusion Seven-day calcitriol and paricalcitol supplementation in a rat model of PAN-induced nephrotic syndrome have similar efficacy, in terms of temporary amelioration of proteinuria. [ABSTRACT FROM AUTHOR]

The most common type of nephrotic syndrome in children is minimal change disease (MCD), which is usually responsive to steroid therapy. Steroid dependency is one of the handicaps in the management of these children. Thus, the early prediction of the disease course may improve treatment strategy. Demographic characteristics and laboratory parameters of 35 patients at the time of MCD diagnosis were retrospectively obtained from the hospital records. There were 23 (65%) patients with steroid sensitive (SSNS) and 12 (35%) with steroid dependent nephrotic syndrome (SDNS). There was a significant difference between the patients with SSNS and SDNS in terms of age at diagnosis, remission time, and mean values of platelet volume, low density lipoprotein cholesterol, uric acid, urine protein-to-creatinine ratio, total cholesterol and creatinine (p=0.003, p<0.001, p=0.013, p=0.006, p=0.036, p=0.02, p=0.003, and p=0.034, respectively). The prediction of early markers of steroid dependency can reduce the side effects of steroids and facilitate the use of appropriate drugs. [ABSTRACT FROM AUTHOR]

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Neutrophil gelatinase-associated lipocalin (NGAL) is one of the new biomarkers for detecting acute renal injury. There are studies showing the relationship between NGAL and renal injury in obese children. The aim of this study was to investigate whether urinary levels of NGAL, kidney injury molecule-1, and serum cystatin C are increased in insulin resistance (IR) patients before the development of diabetes. Methods: Cross-sectional, case-controlled study that included non-diabetic obese children and adolescent patients with IR and a nondiabetic obese control group with no IR, who attended a tertiary center pediatric endocrinology outpatient clinic between 2016-2018. Those with diabetes mellitus and/or known renal disease were excluded. NGAL and creatinine (Cr) levels were evaluated in the morning spot urine from all participants. Serum renal function was evaluated. Results: Thirty-six control and 63 IR patients were included in the study, of whom 68 (68.7%) were girls. The mean age of all participants was 13.12±2.64 years and no statistically significant difference was found between the two groups in terms of age or gender distribution. Median (range) spot urinary NGAL (u-NGAL) values in the IR group were significantly higher at 26.35 (7.01-108.7) ng/mL than in the control group at 19.5 (3.45-88.14) ng/mL (p=0.018). NGAL/Cr ratio was also significantly higher in the IR group compared to the control group (p=0.018). Conclusion: Obese pediatric patients with IR were shown to have elevated levels of u-NGAL, a marker of renal injury. u-NGAL examination may show early renal injury before development of diabetes. [ABSTRACT FROM AUTHOR]

Background/aim: Nephrocalcinosis (NC) is defined as calcium deposition in the kidney parenchyma and tubules. This study aims to determine the etiology, risk factors, and follow-up results of patients with NC in Turkey. Materials and methods: Patients diagnosed with NC in the pediatric nephrology Department Units of 19 centers from all geographical regions of Turkey over a 10-year period (2010–2019) were included in the study. The medical records from the centers were reviewed and demographic data, admission complaints, medical history, systemic and genetic disorders, risk factors for NC, treatment details, and presence of NC after one-year follow-up, were recorded retrospectively. Results: The study sample included 195 patients (88 females, 107 males). The mean age at diagnosis was 39.44 ± 47.25 (0.5–208) months; 82/190 patients (43.2%) were diagnosed incidentally; 46/195 patients (23.6%) had an underlying disease; idiopathic hypercalciuria was detected in 75/195 (38.4%) patients. The most common systemic diseases were distal renal tubular acidosis in 11/46 patients (23.9%), primary hyperoxaluria in 9/46 patients (19.6%) and Bartter syndrome in 7/46 patients (15.3%). After one year of follow-up, NC resolved in 56/159 patients (35.2%) and they all did not have an underlying systemic disease. Conclusion: The most common presentation of NC was incidental. Distal renal tubular acidosis and primary hyperoxaluria were the main systemic diseases leading to NC, while hypercalciuria was the most common metabolic risk factor. Nephrocalcinosis was found to remain in most of the patients at a one-year follow-up. It may resolve particularly in patients with no underlying systemic disease. [ABSTRACT FROM AUTHOR]

Abstract Henoch-Schonlein Vasculitis (HSV) is systemic small vessel vasculitis involving the skin, kidney, joints, and gastrointestinal tract. The proportion of patients reported to have renal involvement varies between 20% and 80%. Rapidly progressive glomerulonephritis (RPGN)is rare syndrome in children, characterized by clinical features of glomerulonephritis (GN) and rapid loss of renal function. We present a severe kidney involvement in a 14 year old boy with HSV in who is carring MEFV mutation. A 14 year old boy had developed sudden onset of palpable purpuric rash on his extensor surfaces of lower extremities. He had elevated an erythrocyte sedimentation rate (ESR) (45 mm/h), C-reactive protein (3.74 mg/dl), serum urea 66 mg/dl, serum creatinine 1.8 mg/dl. Also, he had hypocomplementemia. Antinuclear antibody, anti ds DNA, antineutrophil cytoplasmic antibody, anticardiolipine antibodies were negative. Urinalysis revealed macroscopic hematuria and proteinuria with a 24-h urinary protein excretion of 55 mg/m2/h. The renal biopsy specimen showed crescentic and necrotizing glomerulonephritis. He had also M694V/E148Q compound heterozygote mutation. Clinical symptoms and renal failure resolved with intermittant hemodialysis and medical therapy.

Byline: Mutlu. Çoban, Engin. Kocabas, Peyker. Temiz, Pelin. Ertan, Aylin. Ermertcan A 14-month-old male child presented to our outpatient clinic with pruritic vesicles that had started a month ago, first [...]

Byline: Aylin. Ermertcan, Pelin. Ertan Child abuse is a major public health problem all over the world. There are four major types of abuse: physical abuse, sexual abuse, emotional abuse [...]

Transfusion-related acute lung injury (TRALI) is a non-cardiac pulmonary edema presenting with severe dyspnea, hypoxia and bilateral diffuse infiltrates on chest X-ray. It usually occurs within the first 6 hours following the administration of plasma and plasma rich blood products. Herein, we present a patient who developed TRALI shortly after plasmapheresis due to Hemolytic Uremic syndrome and exhibited a dramatic response with early systemic steroid treatment. [ABSTRACT FROM AUTHOR]

Objective: In this study, it was aimed to compare the sleep quality of healthy children with the actigraphic evaluation and quality of life of monosymptomatic enuresis children of similar age groups. Materials and Methods: This prospective study was conducted in Celal Bayar University Faculty of Medicine and has been submitted to the Department of Pediatric Nephrology. Patients included in the study were suffering from urinary incontinence for two years and only from monosymptomatic enuresis nocturna. The study group consisted of healthy children with monosymptomatic enuresis nocturna who volunteered to participate and those who did not have any systemic disease of similar age and sex. The demographic data, quality of life and activity of all the cases that were taken into the study were tried to be evaluated with sleep quality. Results: Forty children with 40 monosymptomatic enuresis nocturna diagnoses matching the study criteria were included. The control group consisted of 20 healthy children. There were no difference in demographic characteristics between the groups (p>0.05). The Kid-KINDL total score was 59.6±12.9 in children with monosymptomatic enuresis nocturna and 74.8±6.3 in healthy children (p=0.001). The effective sleep duration was statistically lower in children with monosymptomatic enuresis nocturna, and the effective duration of wakefulness, number of naps and fragmentation index were found to be higher in children with monosymptomatic enuresis nocturna (p=0.001). Conclusion: This is the first study in the literature to compare actigraphic analysis and quality of life of healthy children with enuretic children. We think that children with monosymptomatic enuresis nocturna have a significant deterioration in their quality of life compared to healthy children in sleep quality and this leads to an effect on the quality of life. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Research is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Our aim is to determine the rational usage of imaging techniques in order to prevent or minimize permanent renal damage in recurrent urinary tract infections (UTIs). This study was enrolled children aged between 2 and 36 months, following-up with the diagnosis of recurrent UTI. All children had ultrasonography (USG) and dimercaptosuccinic acid scanning, 39 of them had underwent on voiding cystourethrography. There were 133 children (87 girls, 46 boys) with the mean age of 32.82 ± 38.10 months included into the study. Forty-three kidney units were normal in ultrasonogram of which seven units had reflux whereas among 35 units with hydronephrosis 22 units had reflux. Sensitivity and specificity presence of hydronephrosis in ultrasonogram for prediction of reflux was 75.9% and 73.5%, respectively. There were 19 dilated ureters in ultrasonogram, and among them 14 had reflux. Sensitivity and specificity of presence with ureteral dilatation in ultrasonogram for prediction of reflux was found as 48.3% and 89.8%, respectively. The sensitivity of parenchymal thinning seen in ultrasonogram for the evaluation of renal parenchyma was 15.9%, whereas specificity was 98.2% .Sensitivity and specificity of dimercaptosuccinic acid for prediction of reflux was 51.6% and 72.3%, respectively. The normal ultrasonogram findings cannot rule out neither possibility of reflux presence nor development of renal scarring. Therefore, DMSA scanning has major role both in determination of parenchymal damage and prevention of scarring. Also we get an important result as ureteral dilatation seen in USG, related to presence of reflux. [ABSTRACT FROM PUBLISHER]

Objective: Children with an inadequate number of nephrons have an increased risk of developing hypertension, proteinuria and chronic kidney disease in later life. This renal injury is caused by glomerular hyperfiltration. The aim of this study is to evaluate clinical characteristics and follow-up results of the children with unilateral renal agenesis and hypoplasia. Methods: We evaluated the clinical, radiological, and nuclear medicine findings of the children with unilateral agenetic or hypoplastic kidneys who were followed at Celal Bayar University School of Medicine and Dr. Behcet Uz Children's Hospital between 2005 and 2012. Results: The study consisted of 30 (60%) males and 20 (40%) females with a mean age of 8.9±4 years. A total of 25 patients were with renal agenesis and 25 with renal hypoplasia were diagnosed. On laboratory evaluation, mean serum creatinine level was 0.45±0.22 mg/dl and the mean estimated glomerular filtration rate (eGFR) was 144±30.3 ml/min. 29 patient (58%) had hyperfiltration according to an eGFR. Proteinuria and hypertension were noted in 1 (4%) patient. Urological anomalies were found in 15 patients (30%). Conclusion: Our study has determined that children with unilateral renal agenesis and hypoplasia had normal serum creatinine values. Howewer 29 patients (58%) had hyperfiltration according to eGFR. Because many children with hiperfiltration develop renal injury in later life, we emphasize the need for clinical follow- up in these patients starting at birth. [ABSTRACT FROM AUTHOR]

Besides association with acute rheumatic fever (ARF) and acute glomerulonephritis (APSGN), in up to 40% of cases, Group A β-haemolytic streptococcal (GABHS) infections are also implicated as a trigger for Henoch–Schonlein purpura (HSP). A 7-year-old girl with GABHS throat infection who developed HSP, APSGN and rheumatic carditis is reported. She presented with palpable purpura and arthritis in both ankles and later developed carditis characterised by mitral/aortic regurgitation and glomerulonephritis characterised by mixed nephritic/nephrotic syndrome. She had a raised anti-streptolysin titre (ASOT), blood urea nitrogen and creatinine and hypocomplementaemia (C3), and renal biopsy demonstrated endocapillary and extracapillary proliferative glomerulonephritis with crescents. Immunofluorescence microscopy demonstrated a ‘full house’ of immunoglobulin and complement,viz. IgA + 2, IgG + 3, IgM + 2, C3c + 1, Clq + 2 with predominantly IgG deposition. One week earlier, her 4-year-old sister had presented to another hospital with HSP complicated by microscopic haematuria, nephrotic-range proteinuria and gastro-intestinal involvement, and with raised ASOT and low C3levels. Although HSP has been associated with either ARF or APSGN, this is the first case of a child with HSP, ARF and APSGN in combination. [ABSTRACT FROM AUTHOR]

Background: Nephropathic cystinosis is an autosomal recessively inherited metabolic disorder presenting with metabolic acidosis, Fanconi syndrome and renal failure. Case Presentation: We present a 6-year-old girl with severe growth failure, hyponatremia and hypokalemia. Her parents were 4th degree relatives. Two relatives were diagnosed as end stage renal failure. She also had persistant hypokalemic hypochloremic metabolic alkalosis. Her renal function was normal at presentation. She was thought to have Bartter syndrome with supporting findings of elevated levels of renin and aldosterone with normal blood pressure, and hyperplasia of juxtaglomerular apparatus. Her metabolic alkalosis did not resolve despite supportive treatment. At 6th month of follow-up proteinuria, glucosuria and deterioration of renal function developed. Diagnosis of cystinosis was made with slit lamp examination and leukocyte cystine levels. At 12th month of follow-up her metabolic alkalosis has converted to metabolic acidosis. Conclusion: In children presenting with persistant metabolic alkalosis, with family history of renal failure, and parental consanguinity, cystinosis should always be kept in mind as this disease is an important cause of end stage renal failure which may have features mimmicking Bartter syndrome. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association between SPP1 gene polymorphisms and nephrolithiasis. Materials and Methods: A total of 65 pediatric patients and 50 healthy controls were enrolled in this study. Two known polymorphisms of the SPP1 gene, c.240T > C and c.708C > T nucleotide substitutions, both of which were also known as synonymous aminoacid polymorphisms, D80D and A236A, respectively, at SPP1 gene cDNA level, were investigated. SPP1 gene polymorphism was evaluated using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism method. Results: In c.240T > C polymorphism, C allele frequency [Odds Ratio (OR), 2.13; 95% Confidence Interval (CI), 1.170 to 3.880; P = .013] and CC genotype distribution (OR, 2.946; 95% CI, 0.832 to 10.431; P = .094) and in c.708C > T polymorphism, T allele frequency (OR, 2.183; 95% CI, 1.197 to 3.980; P = .011) and TT genotype distribution (OR, 3.056; 95% CI, 0.861 to 10.839; P = .084) were found to be higher in the patient group. Conclusion: SPP1 polymorphisms were found to be associated with nephrolithiasis and it may be suggested that SPP1 gene polymorphism could be a useful marker for evaluation of the early genetic risk factor in childhood nephrolithiasis. [ABSTRACT FROM AUTHOR]

Enuresis Nocturna is the most common urologic problem in childhood. There is not a consensus about terminology. Terminology identified by The International Children's Continence Society (ICCS) is recommended. Bed-wetting at night during sleep (incontinence) in children above 5 years of age who don't have congenital or acquired central nervous system defect is defined as enuresis nocturna. There are two groups monosymptomatic (simple) and non-monosymptomatic (complicated). Monosymptomatic enuresis nocturna (MNE) has no symptoms other than bed-wetting at night during sleep. Various theories concerning etiology of MNE has been suggested; one or more of genetic, hormonal, bladder associated and sleep disorders are stated to play a role. Self-improvement can be achieved each year by 15% increasing maturity. Under pinning treatment and in addition to this unique treatment must be done by considering the factors in the pathophysiology. The success of the treatment and roadmap to be followed must be arrange with child and family. The purpose of this eclectic is; evaluation of correct diagnosis, differential diagnosis, patient follow-up and treatment options of the cases applicant with nocturnal enuresis based on the current knowledge of ICCS and Turkey Enuresis Treatment Guide. [ABSTRACT FROM AUTHOR]

Background: Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. HSP can affect multiple organs presenting with a characteristic rash in most of the patients. Familial Mediterranean Fever (FMF) is an inherited inflammatory disease common in mediterranean populations. HSP is the most common vasculitis seen in children with FMF. Case Presentation: A 16 year old boy was referred with history of abdominal pain lasting for 20 days. He was hospitalized and had appendectomy. Due to the persistence of his abdominal pain after surgery he was admitted to our hospital. His physical examination showed palpable purpuric rashes symmetrically distributed on lower extremities. Abdominal examination revealed periumbilical tenderness. Laboratory tests showed elevated erythrocyte sedimentation rate, C-reactive protein and fibrinogen. Urinalysis revealed microscopic hematuria and severe proteinuria. The fecal occult blood testing was positive. Based on these clinic findings, the patient was diagnosed as HSP with renal, gastrointestinal tract and skin involvement. We performed DNA analysis in our patient because he had diagnosis of vasculitis with severe symptoms and found that he was carrying heterozygote P369S mutation. Conclusion: Our case is noteworthy as it indicates that it may be important not to overlook presence of FMF mutations in patients with a diagnosis of severe vasculitis. [ABSTRACT FROM AUTHOR]