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Amaç: Obeziteye bağlı görülen metabolik sendrom, insulin direnci ve non-alkolik yağlı karaciğer hastalığı (NAYKH)gibi komplikasyonlar çocukluk çağında da sıklığı giderek artmaktadır. Bu çalışmanın amacı, NAYKH ile ilişkili obez çocuklarda açlık c-peptit, c-peptit-glukoz ve c-peptit-HbA1C oranlarını araştırmaktır.Yöntemler: Bu vaka-kontrol çalışması Ağustos-Kasım 2018 arasında gerçekleştirildi. Çalışmaya 40'ı NAYKH ile ilişkili ve 20'si NAYKH olmayan toplam 60 obez çocuk alındı. VKİ> 2 z-skoru olan hastalar obez olarak kabul edildi. NAYKH’nin ultrasonografik özellikleri, karaciğer kontrastı ve ekojenitede parlaklık olarak tanımlandı. Hastaların serum açlık c-peptit düzeyleri karşılaştırıldı.Bulgular: Çalışmaya dahil edilen 60 hastanın 37'si (%61,7) erkekti ve ortalama yaş 11,9 (2,9) yıldı. NAYKH'li hastalarda ortalama ALT, ağırlık, BMI, bel çevresi, bel çevresi-boy oranı, serum c-peptit, açlık c-peptit-glikoz oranı, açlık c-peptit-HbA1C oranı ve insülin seviyeleri, NAYKH olmayan obez çocuklara göre anlamlı olarak daha yüksekti. (her biri için P, Aim: Obesity-related complications such as metabolic syndrome, insulin resistance and non-alcoholic fatty liver disease (NAFLD) have increased in childhood. The aim of this study is to investigate the fasting c-peptide, c-peptide to glucose and c-peptide to HbA1C ratios in obese children with NAFLD.Methods: This case-control study was conducted from August through November 2018. A total of 60 obese children, 40 with and 20 without NAFLD, were included in the study. Patients with BMI > 2 z-score were considered obese. The ultrasonographic characteristics of NAFLD were identified with liver contrast and brightness in echogenicity. Serum fasting c-peptide levels of patients were compared.Results: Of the 60 patients included in the study, 37 (61.7%) were male and the mean age was 11.9 (2.9) years. The mean ALT, weight BMI, waist circumference, waist to height ratio, serum c-peptide, fasting c-peptide to glucose ratio, fasting c-peptide to HbA1C ratio and insulin levels were considerably higher in patients with NAFLD (P

Objective: Celiac disease (CD) is a systemic autoimmune disease that develops as a result of permanent sensitivity to gluten in individuals with a genetic predisposition. The aim of this study is to retrospectively evaluate the clinical, laboratory features and HLA tissue types of patients followed up with the diagnosis of CD. In addition, to examine the differences and similarities between patients with HLA types by region in Turkey.Methods: Totally 104 children, diagnosed as CD and genetically studied, were followed up between July 2017-October 2018.The studies of CD and HLA genotyping were scanned from Google Scholar (n=11) and divided into regions. Results: Of the 104 patients included in the study, 67 were female (64.4%) and the mean age of diagnosis was 7.9±2.38 years (10months-17.2years). HLA groups of our patients were 59.6% DQ2, 26.9% DQ8 and 13.4% DQ2+DQ8. When the studies of literature evaluated according to the regions, frequency of HLA DQ2 and HLA DQ8 in the Black Sea region, where our study located too, are found to be 63.7% and 12.8%, respectively. The genotype frequency at rates similar to our region are observed in the Mediterranean and Eastern, Anatolian regions. In the Central Anatolian HLA DQ2 was seen 87.4% and Marmara region, HLA DQ2 was seen with a higher frequency of 83.6%. In our study, the frequency is inferred 65.4% for DQA1*05, and 12.5% for DQB1*02 allele. According to the studies in Turkey (Marmara, Black Sea, Central, Eastern, and Southeastern Anatolia Regions), the average frequencies of DQA1*05 and DQB1*02 are 69.8% and 27.7%, respectively.In our study, patients with HLA DQB1*02 homozygous alleles (12.5%) had a higher rate of occurrence of shorter height, diarrhea, iron deficiency anemia, Marsh stage 3, and the risk of CD in their relatives.Conclusion: Determining the regional frequency of HLA-DQ analysis in CD reduces the cost of genetic analysis and provides the convenience of early diagnosis especially in screening patients without symptoms, according to the regional distribution., Amaç: Çölyak hastalığı (ÇH), genetik yatkınlığı olan bireylerde, glutene kalıcı duyarlılık sonucu gelişen, otoimmün, sistemik hastalıktır. Bu çalışmanın amacı, ÇH’nin klinik, laboratuar özellikleri ve HLA doku tiplerinin geriye dönük değerlendirilmesidir.Ayrıca lieratür taramasıyla HLA doku tipleri açısından Türkiye’de bölgelere göre farklılık ve benzerliklerin incelenmesidir. Yöntem: Çalışmaya, Temmuz 2017- Ekim 2018 tarihleri arasında ÇH tanısıyla izlenen ve genetik çalışması uygulanan 104 çocuk alındı. Google Scholarda Türkiye’de ÇH ve HLA genotiplendirme ile yapılan çalışmalar tarandı (n=11 çalışma) ve bölgelere ayrıldı.Bulgular: Çalışmaya alınan 104 hastanın 67’si kız (%64,4) ve ortalama tanı yaşı 7,9±2,38 yıl(10ay-17,2yıl) idi. Hastalarımızın HLA grupları %59,6 DQ2, %26,9 DQ8 ve %13,4 DQ2+DQ8 saptandı. Literatürdeki çalışmalar bölgeler göre değerlendirildiğinde bizim de içinde bulunduğumuz Karadeniz bölgesinde HLADQ2 %63,7 ve HLADQ8 %21,1 sıklıkla görülürken, bölgemize benzer oranlarda genotip sıklığı Akdeniz ve Doğu Anadolu bölgelerinde görülmektedir. İç Anadolu HLADQ2 %87,4 ve Marmara bölgesinde %83,6 ile daha yüksek frekansta görülmektedir. Çalışmamızda, DQA1*05 %65,4 ve DQB1*02 %12,5 oranında bulundu. Türkiye’deki diğer çalışmalarda (Marmara, Karadeniz, İç, Doğu ve Güneydoğu Anadolu Bölgeleri) görülme sıklığı DQA1*05%69,8 ve DQB1*02 %27,7 idi. Çalışmamızda HLA DQB1*02 homozigot olan hastalarda (%12,5) boy kısalığı, ishal, demir eksikliği anemisi, Marsh3 evre ve akrabalarında ÇH daha yüksekti.Sonuç: Çölyak hastalığında HLA-DQ analizi bölgesel sıklığın belirlenmesi genetik analiz maliyetini azaltmak ve bölgesel dağılıma göre özellikle semptomsuz tarama hastalarında genotiplenme yapılması erken tanı kolaylığı sağlayabilir.

Objectives: Evidence suggests that lysosomal acid lipase deficiency (LAL-D) is often underdiagnosed because symptoms may be nonspecific. We aimed to investigate the prevalence of LAL-D in children with unexplained liver disease and to identify demographic and clinical features with a prospective, multicenter, cross-sectional study., Methods: Patients (aged 3 months-18 years) who had unexplained transaminase elevation, unexplained hepatomegaly or hepatosplenomegaly, obesity-unrelated liver steatosis, biopsy-proven cryptogenic fibrosis and cirrhosis, or liver transplantation for cryptogenic cirrhosis were enrolled. A Web-based electronic data collection system was used. LAL activity (nmol/punch/h) was measured using the dried blood spot method and classified as LAL-D(0.37). Asecond dried blood spot sample was obtained from patients with intermediate LAL activity for confirmation of the result., Results: A total of 810 children (median age 5.6 years) from 795 families were enrolled. The reasons for enrollment were unexplained transaminase elevation (62%), unexplained organomegaly (45%), obesity-unrelated liver steatosis (26%), cryptogenic fibrosis and cirrhosis (6%), and liver transplantation for cryptogenic cirrhosis (, Conclusions: Overall, the frequency of LAL-D patients in this study (0.1%) suggests that LAL-D seems to be rare even in the selected high-risk population., C1 [Kuloglu, Zarife; Kansu, Aydan; Selbuz, Suna] Ankara Univ, Sch Med, Dept Pediat Gastroenterol Hepatol & Nutr, Ankara, Turkey., [Kalayci, Ayhan G.] Ondokuz Mayis Univ, Sch Med, Dept Pediat Gastroenterol Hepatol & Nutr, Samsun, Turkey., [Sahin, Gulseren] Dr Sami Ulus Childrens Hosp, Dept Pediat Gastroenterol Hepatol & Nutr, Ankara, Turkey., [Kirsaclioglu, Ceyda Tuna] Haematol Oncol Training & Res Hosp, Ankara Child Hlth Dis, Turkish Republ Hlth Minist, Dept Pediat Gastroenterol Hepatol & Nutr, Ankara, Turkey., [Demiroren, Kaan] Yuzuncu Yil Univ, Fac Med, Dept Pediat Gastroenterol Hepatol & Nutr, Van, Turkey., [Dalgic, Buket] Gazi Univ Univ, Dept Pediat Gastroenterol Hepatol & Nutr, Ankara, Turkey., [Kasirga, Erhun] Celal Bayar Univ, Fac Med, Dept Pediat Gastroenterol Hepatol & Nutr, Manisa, Turkey., [Onal, Zerrin] Univ Med Sci, Bakirkoy Dr Sadi Konuk Res & Training Ctr, Dept Pediat Gastroenterol Hepatol & Nutr, Istanbul, Turkey., [Islek, Ali] Ataturk Univ, Fac Med, Dept Pediat Gastroenterol Hepatol & Nutr, Erzurum, Turkey., [Eren, Esra] Ondokuz Mayis Univ, Sch Med, Samsun, Turkey., [Hosnut, Ferda Ozbay] Dr Sami Ulus Childrens Hosp, Ankara, Turkey., [Urganci, Nafiye; Usta, Ayse Merve] Sisli Etfal Training & Res Hosp, Istanbul, Turkey., [Yaman, Aytac] Haematol Oncol Training & Res Hosp, Ankara Child Hlth Dis, Turkish Republ Hlth Minist, Ankara, Turkey., [Ozkan, Tanju] Uludag Univ, Fac Med, Bursa, Turkey., [Bozbulut, Eksi] Gazi Univ, Fac Med, Ankara, Turkey., [Dogan, Guzide] Celal Bayar Univ, Fac Med, Manisa, Turkey., [Arslan, Duran] Erciyes Univ, Fac Med, Kayseri, Turkey., [Akcam, Mustafa] Suleyman Demirel Univ, Sch Med, Isparta, Turkey., [Isik, Ishak Abdurrahman] Antalya Training & Res Hosp, Antalya, Turkey., [Ecevit, Cigdem Omur; Erdemir, Gulin] Dr Behcet Uz Children Dis & Surg Training & Res H, Izmir, Turkey., [Usta, Yusuf] Mersin Univ, Fac Med, Mersin, Turkey., [Ozgur, Taner] Uludag Univ, Fac Med, Bursa, Turkey., [Ozcay, Figen; Gulsan, Meltem] Baskent Univ, Fac Med, Ankara, Turkey., [Balamtekin, Necati] Guhane Training & Res Hosp, Ankara, Turkey., [Ozturk, Yesim] Dokuz Eylul Univ, Fac Med, Izmir, Turkey., [Cantez, Serdar] Istanbul Univ, Istanbul Fac Med, Istanbul, Turkey., [Gulerman, Fulya; Guven, Burcu] Kirikkale Univ, Fac Med, Kirikkale, Turkey., [Ustundag, Gonca Handan] Bulent Ecevit Uni, Fac Med, Zonguldak, Turkey., [Emiroglu, Halil Haldun] Selcuk Univ, Fac Med, Konya, Turkey., [Karacabey, Neslihan] Erciyes Univ, Fac Med, Kayseri, Turkey., [Comba, Atakan] Hitit Univ, Fac Med, Corum, Turkey., [Aydogan, Aysen Uncuoglu] Kocaeli Univ, Sch Med, Kocaeli, Turkey., [Gokce, Selim] Bezmialem Univ, Fac Med, Istanbul, Turkey., [Kuyum, Pinar] Dokuz Eylul Univ, Fac Med, Izmir, Turkey., [Tosun, Mahya Sultan] Denizli State Hosp, Denizli, Turkey., [Tokgoz, Yavuz] Adnan Menderes Univ, Fac Med, Adnan, Turkey., [Yuksekkaya, Hasan] Necmenttin Erbakan Univ, Fac Med, Ankara, Turkey., [Tumgor, Gokhan; Agin, Mehmet] Cukurova Univ, Fac Med, Ankara, Turkey., [Eren, Makbule] Eskisehir Osmangazi Univ, Fac Med, Eskisehir, Turkey., [Baran, Masallah] Izmir Tepec Training & Res Hosp, Izmir, Turkey., [Gumus, Meltem] Konya Egitim Konya Training & Res Hosp, Konya, Turkey., [Canan, Oguz] Adana Baskent Univ, Adana, Turkey., [Kocamaz, Halil] Pamukkale Univ, Fac Med, Denizli, Turkey., [Cakir, Murat] Karadeniz Tech Univ, Fac Med, Trabzon, Turkey., [Hizli, Samil; Balci Sezer, Oya] Kecioren Training & Res Hosp, Ankara, Turkey., [Dogan, Yasar; Deveci, Ugur] Firat Univ, Fac Med, Elazig, Turkey., [Celtik, Coskun] Sifa Univ, Izmir, Turkey.

Amaç: Henoch-Schönlein Purpurası (HSP) olan çocuk hastalarda Helikobakter Pilori (HP) enfeksiyonunun sıklığının araştırılması amaçlanmıştır.Gereç ve Yöntemler: Haziran 2009 - Aralık 2011 tarihleri arasında HSP tanısı alan 61 hasta ve benzer yaşlarda 62 sağlıklı çocuktan oluşan kontrol grubunda ELISA yöntemi ile HP IgG ve IgA serolojisi çalışıldı.Bulgular: HSP’li 61 hastanın (yaş ort: 8.53±3.8 yıl, K/E: 32/29) 34’ünde (%55.7) HP IgG, 37’sinde (%60.6) HP IgA tipi antikor varlığı saptandı. Kontrol grubunda (yaş ort: 9.16±3.3 yıl, K/E: 30/32) HP IgG antikor pozitifliği %61.3 saptandı. Hasta ve kontrol grupları arasında HP IgG pozitifliği açısından istatistiksel anlamlı bir fark yoktu. Karın ağrısı olanlarda HP IgG pozitifliği %64.5, IgA pozitifliği %71 idi. Mide ağrısı (epigastik ağrı) tarif edenlerde HP IgG pozitifliği %60’dı. HP IgG pozitifliği ile GİS bulgularının şiddeti arasında istatistiksel olarak anlamlı bir fark saptanmadı.Sonuç: Sonuç olarak sağlıklı çocuklarda bile %60’lara varan HP seropozitivitesinin görülmesi, toplumumuzda HP ile erken yaşta karşılaşmanın iyi bir göstergesidir. Bu enfeksiyonun gastrointestinal yakınmalar dışında da birçok hastalığa neden olabileceği düşünüldüğünde çok önemli bir toplum sağlığı sorunu olduğu açıktır. HSP’li hastalarda HP seropozitivitesi yüksek bulunmakla beraber sağlıklı çocuklardan farklı bulunmamıştır., Objective: We investigated the frequency of Helicobacter Pylori (HP) infection in children with Henoch-Schönlein purpura (HSP).Material and Methods: The study involved 61 patients with HSP and 62 healthy controls of similar age between July 2009 and December 2011. HP IgG and IgA levels were evaluated by the ELISA method in all patients and controls. Results: The HP IgG and IgA seropositivity rates were 55.7% and 60.6% in HSP patients (mean age 8.53±3.8 years, F/M: 32/29) and HP IgG seropositivity was 61.3% in normal controls (mean 9.1±3.3 years, F/M: 30/32). There was no statistical difference between the two groups. The HP IgG seropositivity rate was 64.5% in patients with abdominal pain and 60% in those with epigastric pain. There was no signifi cant relationship between HP seropositivity and the degree of abdominal complaints. Conclusion: HP seropositivity was found in up to 60% percent of healthy control subjects, indicating that HP infection begins in early childhood. It is an important public health problem as it can cause many other disorders in addition to its effects on the gastrointestinal system. The HP seropositivity rate was high in HSP patients but not different from healthy controls

WOS: 000373721600003 Objective: To investigate the presence of genotoxicity in intestinal epithelial cells and lymphocytes in celiac patients and to assess DNA repair capacity. Material and Method: The study comprised 15 newly diagnosed celiac patients, 14 celiac patients receiving gluten-free diet, and 9 non-celiac patients who had undergone endoscopy for various reasons (control group). Comet assay was performed to detect DNA injury. DNA injury was measured both after being exposed to stress by hydrogen peroxide and 20 minute regeneration period to measure DNA repair capacity. Results: DNA injury in the intestinal epithelial cells was significantly higher in the newly diagnosed celiac patients than that in the controls (Tail DNA%: 25.9 +/- 1.5 and 15.7 +/- 0.9, respectively, p

Serum fibronectin, haptoglobin, ceruloplasmin, and transferrin concentrations were measured in 44 term neonates with culture proven sepsis and a control group of 37 normal neonates of similar age, sex and weight. The white blood cell count, total neutrophil count, and the ratio of band to neutrophils were also determined. While the serum fibronectin and haptoglobin concentrations were significantly different (P

Glutaric aciduria type 1 is a rare metabolic disease and an inborn error of lysine hydroxylysine and tryptophan metabolism caused by deficiency of glutaryl coenzyme A dehydrogenase The clinical picture typically shows varying degrees of muscular hypotonia motor delay dystonia and dyskinesia beginning acutely or gradually in the first few years of life in often macrocephalic children Patients with glutaric aciduria type 1 appear to have a bitemporal arachnoid cysts Here we present glutaric aciduria type 1 in a 6 month old boy with bilateral temporal cysts and macrocephaly Turk Arch Ped 2008; 43: 102 4 Key words: Glutaric aciduria type 1 temporal arachnoid cyst macrocephaly, Olgu bildirisi

One hundred patients 41 females and 59 males with viral hepatitis and 25 healthy children 8 females and 17 males aged 2 13 years were included in this study In patients with viral hepatitis serum mucoprotein levels were 59 5±12 8 mg dl on admission 88 3±13 3 mg dl 20 days later and 99 7±12 4 mg dl 3 months later; HDL cholesterol levels were 28 7± 3 79 mg dl on admission 35 92±4 51 mg dl 20 days later and 40 23±4 75 mg dl 3 months later In healthy children serum mucoprotein and HDL cholesterol levels were 105 4±8 6 mg dl and 46 62±3 85 mg dl respectively Serum mucoprotein and HDL cholesterol values in patients with viral hepatitis on admission were lower than those of healthy children p lt;0 001 There were negative correlations in serum mucoprotein ALT serum mucoprotein AST HDL cholesterol ALT and HDL cholesterol AST values in patients with viral hepatitis We concluded that serum mucoprotein and HDL cholesterol may be of diagnostic and prognostic value as well as serum aminotransferases for the diagnosis and prognosis of viral hepatitis Key words: Serum Mucoprotein Hdl Cholesterol Viral Hepatitis, Çalışma 2 13 yaşları arasında 41 i kız 59 u erkek toplam 100 viral hepatitli çocuk ve 8 i kız 17 si erkek toplam 25 normal çocuk üzerinde yapıldı Akut viral hepatitli hastalarda serum mukoprotein ilk müracaatta 59 5±2 8 mg dl 20 gün sonra 88 3±13 3 mg dl ve 3 ay sonra 99 7±12 4 mg dl idi HDL kolesterol ilk müracaatta 28 7±3 79 mg dl 20 gün sonra 35 92±4 51 mg dl ve 3 ay sonra 40 23±4 75 mg dl idi Kontrol grubunda ise serum mukoprotein 105 4±8 6 mg dl HDL kolesterol 46 62±3 85 mg dl olarak bulundu Kontrol grubuyla kıyaslandığında viral hepatitli hastaların ilk müracaatlarındaki serum mukoprotein ve HDL kolesterol değerleri düşük bulundu p lt;0 001 Viral hepatitli hastalarda serum mukoprotein ve HDL kolesterol değerleri ile AST ve ALT değerleri arasında önemli negatif korelasyon vardı nbsp; Sonuçta viral hepatitin tanı ve prognozunda serum mukoprotein ve HDL kolesterolun aminotransferazların yanı sıra yararlı parametreler olabileceği kanaatine varıldı Anahtar kelimeler: Serum Mukoprotein Hdl Kolesterol Viral Hepatit

Pyogenic granuloma is a polypoidous shaped capillary hemangioma It is oftenly observed in the skin but also can be found on nasal or oral mucosa Pyogenic granulomas that are accepted as benign granulomas are rarely observed in the gastrointestinal tract Reported cases of gastrointestinal pyogenic granulomas in childhood are few in number There fore we wanted to present a patient who referred with rectal bleeding and the diagnostic of pyogenic granuloma in the rectum was made Turk Arch Ped 2008; 43: 146 7 Key words: Child gastrointestinal bleeding pyogenic granuloma, Piyojenik granülom PG polipoid şekilli kapiler hemanjiyomdur Sıklıkla deride görülmekte ağız ve burun mukozasında da bulunabilmektedir Benin olarak kabul edilen piyojenik granülomlar sindirim sisteminde nadiren görülür Çocukluk yaş grubunda sindirim sisteminde bildirilmiş piyojenik granülom olgu sayısı oldukça azdır Bu nedenle rektal kanama yakınması ile başvuran ve rektumda piyojenik granülom saptanan hastayı sunmak istedik Türk Ped Arş 2008; 43: 146 7 Anahtar kelimeler: Çocuk piyojenik granülom sindirim sistemi kanaması

Amaç: Birimimize sevk edilen yenido¤an bebeklerin nakil koflullar›n› de¤erlendirmek Gereç ve Yöntem: Bu ileriye dönük çal›flma, birimimize sevk edilen 216 yenido¤anda önceden haz›rlanm›fl olan formlar doldurularak gerçeklefltirildi. ‹statistiksel analiz için ki-kare testi veya Fisher exact testi ve Mann-Whitney U testi uyguland›. Etik kurul onay› al›nd›. Bulgular: Çalışma grubunu; 154’ ü haber verilerek, 62’si habersiz olmak üzere toplam 216 yenido¤an oluflturdu. Haber verilerek gönderilen olgular›n en s›k sevk nedeni, erken do¤um ve/veya mekanik ventilasyon gereksinimi (%71,4) idi. Habersiz gönderilen olgularda ise en s›k sevk nedeni, yenido¤an hiperbilirübinemisi (%46,8) idi. Tüm olgular›n %69’u ambulansla, nakil kuvözünde ve sa¤l›k çal›flan› eflli¤inde sevk edilmifllerdi. Olgular›n %57’sinde asidoz, %16’s›nda siyanoz, %15’inde yetersiz solunum deste¤i, %12’sinde hipoglisemi, %8’inde hipotermi, bradikardi veya hipotansiyon saptand›. Nakil öncesinde ve nakil sürecinde en s›k yap›lan hatalar; intravenöz s›v› yoklu¤u, s›v› miktar›n›n ve/veya cinsinin uygun olmamas› idi. Çıkarımlar: Bu sonuçlar; yenido¤anlar›n nakil öncesi ve nakil s›ras›ndaki stabilizasyonunun ve nakil öncesi merkezler aras›ndaki haberleflmenin yetersiz oldu¤unu göstermektedir. Her bölgenin kendi içinde iyi bir iletiflim a¤› oluflturularak bölgesel nakil ekipleri kurulmal› ve gereksiz sevkler önlenmelidir. (Türk Ped Arfl 2011; 46: 42-8), @font face { font family: Times ; }p MsoNormal li MsoNormal div MsoNormal { margin: 0cm 0cm 0 0001pt; font size: 12pt; font family: Times New Roman ; }div Section1 { page: Section1; }

WOS: 000341415700017 PubMed: 24577989 Ascites and abdominal pseudocysts (APC) are two rare complications that can occur following placement of a ventriculoperitoneal (VP) shunt. Both complications are characterized by abnormal intraperitoneal cerebrospinal fluid (CSF) collections. Although various factors have been implicated, the exact pathogenesis of the two conditions remains elusive. This paper presents two cases of VP shunt placement resulting from hydrocephaly. The first patient presented with generalized ascites and the other with APC, both of whom were six years old. APC and ascites after VP shunt placement are rare and distinct conditions; therefore, they may require different management strategies.

WOS: 000304110800018 PubMed: 22484746 The combination of idiopathic pulmonary hemosiderosis (IPH) and celiac disease (CD) is rare. The clinical importance of this association is that a significant improvement can be obtained with gluten free diet not only in intestinal but also in pulmonary symptoms. A four and half-years old girl was admitted with complaints of cough, difficulty in breathing and paleness. She had intermittent episodes of abdominal pain and diarrhea. She had dyspnea and tachycardia, and oxygen saturation 88%. The patient was diagnosed with CD and concomitant IPH. With gluten-free diet and corticosteroid treatment, both intestinal and pulmonary symptoms were controlled.

ozkaya, ozan/0000-0002-0198-1221; WOS: 000307274100258 …

WOS: 000292569800013 PubMed: 21623080 Aims: Duodenal nodularity is an uncommon endoscopic appearance of numerous visible mucosal nodules in the proximal duodenum. In this retrospective study we aimed to determine the clinical significance and histopathologic features of duodenal nodularity in children. Materials and Methods: The medical records of the patients who were defined to have duodenal nodularity by endoscopy were reviewed. Statistical Analysis Used: The data were expressed as mean SD and percentages (%). Results: Seventeen patients with endoscopically defined duodenal nodularity were chosen. The mean age at diagnosis was 12.1 years (range: 6-17 years), 9 males. Abdominal pain (47%) was the most common clinical symptom and antral nodularity (41%) was the most common endoscopic finding in children with duodenal nodularity. Histopathologic evaluation of duodenal nodules revealed chronic inflammation in all patients, increased intercryptal and intraepithelial numbers of eosinophils in 70.5%, and villous atrophy in 47% of patients. Giardia infestation was demonstrated in 6 patients by histologic examination and/or Giardia lamblia-specific antigen positivity in stools. The clinical diagnoses of the patients have shown variations, such as celiac disease, giardiasis, secretory IgA deficiency, and Helicobacter pylori gastritis, and some of them were associated with the others. Conclusions: Although the endoscopic appearance is similar, clinical spectrum and pathologic features are not so similar and there are no specific histomorphologic findings for nodularity. The most demonstrative findings we observed in children were increased lymphocyte and/or eosinophil infiltration in the duodenal mucosa. We suggested that care should be taken in the evaluation of microbiological and immunologic etiologies causing this prominent inflammatory reaction.

WOS: 000288576600009 Aim: Pancreatitis rarely occurs in childhood and the underlying causes differ from adults. The aim of this study is to evaluate the documentation of characteristics of our cases diagnosed as pancreatitis. Material and Method: Of the 20 patients (19 acute, one chronic) who diagnosed as pancreatitis in our clinic during a five year period were analyzed retrospectively, considering clinical and laboratory findings, underlying risk factors and outcome of the illness. Data were analysed with SPSS 16.0 computer package programme. Results: Of the 20 patients 14 were female and 6 were male. The mean age was 11.4 +/- 3.62 (2-18) years. The most common risk factors were systemic diseases (15%), drugs (15%), biliary diseases (15%) and trauma (10%). Nine of cases (45%) were idiopathic. One patient with chronic pancreatitis was defined as cystic fibrosis. Two patients had acute recurrent pancreatitis (one with mumps infection). Twenty-two episodes of 19 patients with acute pancreatitis were documented. The serum amylase and lipase were elevated in 81.8% and 90.9% of patients respectively. Pseudocysts (10%), venous thrombosis (10%) and necrotising pancreatitis (5%) were the major complications. None of the patients died. Conclusions: Systemic illnesses, drugs, biliary diseases and trauma are the major risk factors in childhood pancreatitis. Although the mortality rate is low in children, the patients should be considered by means of complication such as pseudocyst and venous thrombosis, especially in severe pancreatitis. (Turk Arch Ped 2011; 46: 49-54)

BEK, KENAN/0000-0002-1005-2379 WOS: 000278668700014 PubMed: 20560258 Dinler G, Bek, K, Acikgoz Y, Kalayci AG. Acute pancreatitis as a presenting feature of Henoch-Schonlein purpura. Turk J Pediatr 2010; 52: 191-193. Henoch-Schonlein purpura (HSP) is the most common small vessel vasculitis of childhood. It is characterized by nonthrombocytopenic palpable purpura, abdominal pain, arthritis, and glomerulonephritis. Although HSP is typically known to be self-limited, serious complications can occur. Acute pancreatitis rarely presents as a complication of HSP. It is even rarer as an initial presenting feature of HSP, before the occurrence of characteristic palpable purpura. Herein, we report a 12-year-old girl with HSP who atypically presented with acute pancreatitis.

WOS: 000277927100008 Aim: The purpose of this study was to documentation of the characteristics of children with cholelithiasis by means of age, sex, clinical manifestations and risk factors. Material and Method: Sixty cases (aged 0-18 years) with ultrasonographic evidence of cholelithiasis were enrolled in the study. Results: Mean age of the patients was 7.8 +/- 5.1 years (range: 0.25-18 years), 38 (63.3%) of them were females. Underlying risk factors were identified in 34 (56.7%) of cases (15 ceftriaxone use, six hemolytic diseases, five Down's syndrome, four obesity, two total parenteral nutrition and sepsis, one inflammatory disease and one chronic cholestatic liver disease). No etiology could be found in 26 (43.3%) patients who were defined as idiopathic. Of 46 patients who were followed at least for three months, eight (17.4%) had cholecystectomy, 16 (34.8%) showed differences in stone size and the stones were resolved in 24 patients (52.2%). When the cases related to ceftriaxone use were excluded, the percentage of the disappaerance of the stones was found to be 28.3%. Ursodeoxycolic acid was effective on resolution of symptoms in 69.2% of patients. The complications of gallstones were recorded in five (8.3%) patients. Conclusions: Cholelithiasis is more common in children than previously thought. The most common risk factors are ceftriaxone use and hemolytic diseases but about half of the cases are still idiopathic. There is a need for close monitoring of patients in especially risk groups because of gallstone development and its complications. (Turk Arch Ped 2010; 45: 119-23)

Karaciğer protein, karbonhidrat ve yağ metabolizmasında önemli rolü olan kompleks bir organdır. Safra yapımı ve salınımından sorumludur. Aynı zamanda lipoproteinleri ve plazma proteinlerini sentezler. Glikojenez, glikojenoliz ve glikoneojenez ile normal kan glukoz düzeyini sağlar. Metabolizmanın artık ürünleri yine karaciğer tarafından zehirsizleştirilir. Anormal karaciğer enzim düzeyleri karaciğer hasarını gösterebilir. Karaciğer enzim düzeylerindeki değişiklikler klinikte en sık karşılaşılan problemlerden biridir. Karaciğer enzimlerinin patofizyolojisini bilmek değişikliklerini anlamak için önemlidir.Liver Function TestsThe liver is a complex organ that has crucial role in protein, carbonhydrate and fat metabolism. It is responsible for synthesizing and secreting bile. It also synthesizes lipoproteins and plasma proteins. By glycogenesis, glycogenolysis and gluconeogenesis it maintains normal blood glucose level. Waste products of metabolism are also detoxified by liver. Abnormal liver enzyme levels may signal liver damage. Alterations in liver enzyme levels are one of the most common problems in clinical practice. Knowledge of the pathophysiology of liver enzymes is an essential guide to understanding their alteration.

WOS: 000271486400015 PubMed: 19950850 Plummer-Vinson syndrome presents as a classical triad of dysphagia, iron deficiency anemia and upper esophageal web(s). The syndrome usually occurs in adults, and is rare in childhood. We report a case of this syndrome occurring in a 15-year-old boy. He presented with dysphagia and anemia. Radiological examination showed the presence of webs at the cervical esophagus. The boy was treated with endoscopic balloon dilation and iron supplementation and remains in good general condition six months after the treatment.

WOS: 000253432300008 PubMed: 18365591 The aim of this study was to investigate the presence and distribution of developmental enamel defects and caries in children with celiac disease (CD) and compare the results obtained with those of a control group of children without CD. A total of 64 subjects (mean age 8.2 years) selected from patients diagnosed and treated for CD were studied. Sixty-four age/ sex-matched healthy children were enrolled as a control group. Permanent dentition enamel defects were recorded according to Aine's classification. The caries experience of the children was recorded according to the criteria of the World Health Organization (WHO). The prevalence of enamel defect in CD subjects was found to be significantly higher (42.2%) than in healthy subjects (9.4%) (p