We report the case of a 20‐month old boy with markedly elevated serum alkaline phosphatase (ALP) levels, documented during an episode of acute laryngotracheobronchitis. Biochemical investigations and imaging studies revealed no evidence of bone or liver disease. Transient hyperphosphatasemia (TH) was confirmed when serum ALP levels normalized within 2 months. Several theories were suggested for TH pathophysiology, viral infections among them; the exact causes, however, remain unclear. It is important to recognize TH and avoid misdiagnosis and unnecessary investigations.
Introduction
Obesity associated asthma has been proposed as a distinct phenotype but the links between asthma and obesity are unclear. Bronchial Hyperresponsiveness (BHR) is a cardinal feature of asthma.
Objectives
The objective of this study was to evaluate BHR in obese asthmatic children in comparison with asthmatic chlidren of normal weight and obese non asthmatic children of prepubertal age.
Methods
We have studied 35 children of pre-pubertal age (6-11 yrs) divided in three groups. The first group consisted of 7 obese asthmatic children (BMI>95th percentile, according to the United States Centers for Disease Control and Prevention-CDC- growth charts for children 2 years and older), the second group consisted of 14 normal-weight asthmatic children and the third group consisted of 14 obese but not asthmatic children. As asthmatic, we categorized the children with a doctor-diagnosed asthma. To all children, airway function (spirometry) and BHR (inhaled dry powder mannitol) tests were performed, after being depleted from corticosteroid medication for a period of at least three weeks.
Results
We found a significant difference (p<0.001) between the BHR measurements of the children in the obese-asthmatic group and those of the normal-weight asthmatic group and the obese but not asthmatic group. The PD15 (Provoking Dose of mannitol, required to cause a 15% fall in FEV1) measurements were significantly lower in obese-asthmatic children.
Conclusion
Obesity seems to have a boosting effect on the Bronchial Hyperresponsiveness of asthmatic children. Addressing obesity could be a therapeutic measure.
Objective: Second-hand smoke exposure in children is a recognized risk factor for asthma/wheezing. Even brief exposure can be harmful. Adult smoking prevalence in Greece is of the highest worldwide and pediatric asthma rates are raising. Our objective was to investigate parental smoking habits in homes of children with and without bronchial asthma/wheezing disorders. Methods: This is a case-control study that included 90 children aged 1, 5-17 years old subdivided into two groups: 51 children with asthma/wheezing and 39 healthy peers. SHS exposure was estimated by both questionnaires on smoking habits reported by parents and urinary nicotine and cotinine levels in children. Results: Based on both questionnaires and urinary biomarkers, smoking habits between two groups were not significant (p=0.291). Urinary cotinine assays unveild more children to be exposed to SHS (98% in cases and 89.4% in controls) than reported by their parents (62.75% in cases and 66.6% in controls). More cases were heavier exposed to SHS than controls (>10 ng/ml). Home smoking restrictions between two groups didn’t reach statistical significance though they were found to affect urinary cotinine levels in children. Conclusions: Parental smoking habits do not differ between families of children with and without asthma/ wheezing disorders. Parents, especially those nurturing a child with respiratory tract disease, tend to underreport SHS exposure.
Dermatological conditions may be associated with serious underlying medical conditions which require urgent treatment. We describe the case of a 6-year-old boy with erythematous vesicles with erosion and crusting on face, cheeks, and forehead. Due to the medical history of atopic dermatitis, eczema herpeticum was suspected and appropriate treatment was immediately initiated. This resulted in significant improvement of skin lesions.
The purpose of this study was to determine whether local anti-inflammatory therapy with inhaled beclomethasone dipropionate is effective in the outpatient management of acute viral croup.Children six months to five years of age, presenting to the Emergency Department (ED) with a croup score of at least 2 participated in the study. All children were assigned in a randomised double-blind fashion to receive either nebulized L-epinephrine (LE), a single intramuscular injection of dexamethasone (D) 0.6 mg/kg, or inhaled beclomethasone dipropionate (BD) 200 mg, via aerochamber. Croup score (CS), heart rate (HR), blood pressure, respiratory rate (RR) and oxygen saturation were recorded at study entry and at 15, 30, 60, 90 and 120 minutes after treatment.Sixty-four patients were enrolled into the study. Significant improvement of the croup score was noticed at the end of observation time in all groups. The LE group showed significant improvements of CS, HR and RR in comparison to the other two groups. Inhaled BD was as effective as intramuscular D in the treatment of mild to moderate croup in the ED.The use of inhaled beclomethasone in the outpatient management of croup was associated with a significant reduction in the severity of illness within 24 h after treatment.
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