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Aim. To study the relationship between clinical, radiologic, and morphological features in nonfibrotic and fibrotic hypersensitivity pneumonitis.Materials and methods. Clinical symptoms, data of high-resolution computed tomography, parameters of external respiration, and histological changes in the lung tissue obtained via open and transbronchial biopsies were studied retrospectively in 175 patients with hypersensitivity pneumonitis (HP). Statistical analysis was performed using the Statistica software.Results. We found that the clinical error rate in the diagnosis of HP was 84.5%, among pathologists – 92%. Among all the variants of HP, the most common was fibrotic HP. It was shown that non-necrotizing granulomas and giant cells in the cavities of the alveoli, microcells, and interalveolar septa were more typical of nonfibrotic HP. In fibrotic HP, peribronchial fibrosis, smooth muscle metaplasia in fibrotic areas, and the presence of fibroblastic foci in the walls of terminal bronchioles are signs of differential diagnosis with usual interstitial pneumonia. The classical triad of histological signs was observed in 19.2% of patients with nonfibrotic HP and in 5.6% of patients with fibrotic HP.Conclusion. Diagnosis of HP is complex and should be based on a multidisciplinary approach involving clinicians (pulmonologists), radiologists, functional diagnostics specialists, and pathologists. In this case, it is imperative to take into account and identify factors causing development of the disease, as well as the age of patients.

Introduction. One of the urgent issues in the first stage of nursing premature infants is acute kidney injury. The incidence of neonatal acute kidney injury in developing countries is 3.9/1000 live births, with 34.5/1000 among neonatal intensive care patients.The aim of the study was to establish echographic signs of acute kidney injury in deeply premature infants in the neonatal period.Materials and methods. 24 children with clinical and laboratory signs of acute kidney injury “AKI+” and 76 children without signs of acute kidney injury “AKI-“. All the children included in the study were born with a body weight of less than 1500 g and a gestation period of less than 32 weeks and were in the neonatal intensive care unit. To clarify the nature of the detected changes, a scientific analysis of the results of pathoanatomic studies of 55 deceased preterm infants was carried out.Results. In all children from the “AKI+” group, there was a pronounced diffuse-uneven increase in the echogenicity of the parenchyma, there was a depletion of the vascular pattern in the subcapsular zone and/or in the cortical layer of the parenchyma, in 25% of patients on the 5th-15th day of life, anechogenic formations without signs of blood flow, with a diameter of 1-3 mm in the cortical layer were noted. The changes had a bilateral nature of the lesion, with further observation they were gradually reduced and by 3 ± 2 months of life they were not determined during ultrasound of the kidneys.Discussion. Acute kidney injury is an urgent problem of preterm infants born with very low and extremely low body weight. The article presents the results of ultrasound examination of the kidneys in comparison with clinical and laboratory indicators and the results of pathomorphological studies. As a result of the study, the most characteristic ultrasound signs of acute kidney injury were identified, which are an uneven diffuse increase in the echogenicity of the renal parenchyma, small anechoic avascular inclusions (cysts) of the parenchyma, depletion of renal blood flow.Conclusions. Renal ultrasonography is an informative method, but echographic changes may be labile depending on the clinical course of the disease, and the absence of anechogenic masses in the parenchyma may be due to technical limitations of the ultrasonography method. It requires further monitoring and continued vigilance of the pediatrician and pediatric nephrologist.

The article presents the results of clinical and laboratory studies of patients with influenza complicated by pneumonia. Peculiarities of clinical manifestations of pneumonia caused by influenza virus have been disclosed.

Aim: to determine characteristics of the hepatic morphology in children with I, III and VI types of glycogenosis. Patients and methods: 50 children with glycogenosis (6 with type I, 18 with type III and 26 with type VI) aged from 1 to 17 (6,5±0,6) years old were examined. All children were performed hepatobiopsy with determination of the histological activity index and histological index of sclerosis (Desmet). Results: in 100% of the patients hepatic parenchyma resembled «vegetative» tissue. Inflammatory changes in the liver were absent in 66,0% of the patients and were minimal in 18,0% of the children. Perihepatitis was observed in 14,0% of the patients. High degree of histological activity was found in 2,0% of the children. Portal and periportal fibrosis was detected in 100% of the patients, porto-portal bridges — in 54%, porto-central bridges — in 6,0%, hepatic cirrhosis — in 20% of the children. On PAS reaction in hepatocytes of 100% of the patients were found irregular lump-like deposits of glycogen, which was washed out on control tests with amylase. On assessment of progression of fibrosis in 3 children with VI type of glycogenosis different variants of the clinical course were observed. In 2 cases there was no progression of hepatic changes, in 1 case — there was worsening of the histological features. Conclusions: needle aspiration biopsy of the liver is very important in diagnostics of glycogenosis and allows to detect a number of specific changes, which is necessary for differential diagnosis, treatment choice and prognosis assessment.Key words: children, glycogenosis, liver, morphology.