Background: Iron deficiency without anemia is the most common nutritional disorder in children. Iron balancing is provided by intestinal absorption and iron transfer mechanisms. The most common causes of anemia are chronic blood loss from the gastrointestinal tract (peptic ulcer, hemorrhoids, parasites), inadequate dietary intake, gynecological problems (menorrhagia), decreased gastrointestinal mucosal absorption (celiac disease), Helicobacter pylori (Hp) infection and autoimmune gastritis. In the literature, there are not many studies about iron deficiency without decreasing hemoglobin (Hg) levels in the early period of iron deficiency. Aims: In our study, we aimed to evaluate the lower and upper endoscopic findings of patients with normal Hg levels and low ferritin levels. Methods: A total of 2391 patients aged between 0‐18 years and had normal Hg levels were included into the study performing upper and lower gastrointestinal system (GIS) endoscopy by the pediatric gastroenterology‐hepatology department between 2009 and 2018. The patients were divided into two groups as Hb level was normal, ferritin level below 15 mg / dl (group 1; n = 549) and Hb level was normal, ferritin level was above 15 mg / dl (group 2; n = 1143). In group 1, upper GIS endoscopy was performed to 520 patients, lower GIS endoscopy to 56 patients. In Group 2, upper GI endoscopy was performed to 1095 patients and lower GI endoscopy to 120 patients. All endoscopy results of the patients were evaluated and compared. Results: The most common complaint was abdominal pain in both groups (63%, 67.4%, respectively). And the most common endoscopic findings in both groups were reflux esophagitis in the esophagus (9.6%, 9.1%, respectively, p>0.05), gastritis in the stomach (32.1%, 37.9%, respectively, p > 0.05). Hp gastritis was the second most common endoscopic finding in group 1. When the both groups were compared, there was a significant difference between group for Hp gastritis (24%, 27.6%, respectively, p = 0.002). In duodenum findings, celiac disease was higher in group 1 and there was a significant statistically between group for celiac disease (6%, 2.1%, respectively, p = 0.000). In colonoscopic examination, lymphoid nodular hyperplasia and polyp were higher in group 1 and there were statistically significant between groups (14.3%, 5%, and 10.7%, 3.3% respectively, p = 0.03, 0.04). Summary/Conclusion: In the literature, generally the studies are about anemia and upper GIS findings. In our study, the patients with decreased ferritin and normal Hg levels and undergoing upper and lower GIS endoscopy were investigated. The risk of Hp gastritis and celiac disease was found to be increased in patients with ferritin deficiency without anemia (group 1). In addition, lymphoid noduler hyperplasia and polyps were also caused ferritin deficiency.
Barth syndrome (BS) is a rare X-linked recessive metabolic disorder characterized by cardiomyopathy, hypotonia, neutropenia, growth retardation and 3-methylglutaconic aciduria type II. Cystic fibrosis is a common autosomal recessive genetic disorder in Caucasians. Herein, we reported a rare clinical association in an infant diagnosed based on clinical and genetic analysis. A six-month old boy admitted with chronic steatorrhea. The diagnosis of cystic fibrosis was made after clinical and laboratory examinations. Fifteen days later, the patient was presented with restlessness and moaning. He had hypoglycemia and lactic acidosis. The patient died three hours after the admission. Pedigree analysis revealed similar sudden infant deaths in close relatives. Postmortem genetic analysis revealed the diagnosis of Barth syndrome. This is the first case of the association of Barth syndrome with cystic fibrosis. Our case reinforces the importance of pedigree analysis and postmortem examinations.
Karaciğer Anatomisi Gülay Açar Karaciğer Histolojisi ve Embriyolojisi Gülsemin Çiçek Emine Utlu Özen Karaciğer Hastalıklarının Patolojisi Ruksan Çopuroğlu Buket Gedik Karaciğerin Benign Kitlelerinin Patolojisi Ganime Çoban Yeliz Arman Karakaya Karaciğer Prekürsör Lezyonlarının ve Malign Tümörlerinin Patolojisi Döndü Nergiz Hülya Tosun Yıldırım Karaciğerin Hücresel Hasarı ve Fibrozis Yeliz ARMAN KARAKAYA Şirin KÜÇÜK Harun KÜÇÜK Karaciğer Fizyolojisi Ve Hücresel Fonksiyonları Güven GÜVENDİ Saime ÖZBEK ŞEBİN Safra Oluşumu Ve Fizyolojisi Metin Yalaza Yavuz Çağır İntestinal Flora Ve Karaciğer Hastalıkları -1 Murat Deveci Hafize Kızılkaya İntestinal Flora Ve Karaciğer Hastalıkları - 2 Esma Eroğlu Arzu Tarakçı Karaciğer ve İmmünite Gökçe Kundakçı Gelir Berrin Yalınbaş Kaya Hepatosellüler Karsinomun Moleküler Mekanizmaları Levent Elmas Mücahit Seçme Hepatosit Transplantasyonu Ve Kök Hücre Gülsemin Çiçek Karaciğer Ve Sirkadiyen Ritim Volkan TEKİN Karaciğer Fonksiyon Testleri Ve Güncel Gelişmeler Türkan Güney Ali Karataş Sarılıkta Patofizyoloji Ve Klinik Değerlendirme Tuba Erürker Öztürk Gebelik ve Karaciğer Özlem Koşar Can Batuhan Başpınar Karacı̇ğer ve Beslenmeye Klı̇nı̇k ve Moleküler Açıdan Yaklaşım Hatice Hamarat Özge Alkan Tali Karaciğer Hastalıklarında Girişimsel Endoskopik Yöntemler Mehmet Alpua Karaciğer Hastalıklarında Görüntüleme Mustafa Devran Aybar Karaciğerin Benign ve Malign Hastalıklarında Görüntüleme Mahmut ÇORAPLI Kamil DOĞAN Karaciğer Tümörlerinde Girişimsel Yöntemlere Cerrahi Bakış Sait Tayfun Karaciğer Hastalıkları Ve Girişimsel Radyoloji Seda Nida Karaküçük Karaciğer Tümörleri Ve Girişimsel Radyoloji Muhammet ARSLAN Halil Serdar ASLAN Karaciğer Kitlelerinde Tanı Ve Semptomatoloji Yonca Yılmaz Ürün Ferhat Bacaksız Karaciğerin Benign Kitleleri Murat Pekgöz Sevil Özer Sarı Karaciğerin Malign Kitleleri Mustafa Gürkan Haytaoğlu Karaciğerin Malign Kitlelerinde Medikal Onkoloji Ve Tedavi Rejimleri Sabri Güncan Kronik Karaciğer Hastalıklarının Etiyolojisi ve Klinik Yaklaşım Barış Soydaş Viral Hepatitler İle İlgili Genel Bilgiler Sercan Kiremitçi Hepatit B Ve D Enfeksiyonlarına Yaklaşım ve Tedavi Berk Baş Ramazan Gözüküçük Hepatit C’ye Yaklaşım ve Tedavi Zuhal Yeşilbağ Murat Pekgöz Hepatit A Virüs Enfeksiyonu Esma Kepenek Kurt Mevlüt Kıyak Hepatit E Virüs Enfeksiyonu ve Klinik Yaklaşım Esma EROĞLU Mesut GÜMÜŞSOY Sistemik Viral Enfeksiyonlar ve Karaciğer Şaban İNCECİK Vedat KILIÇ Alkolik Hepatit Rahmi ASLAN Yaren DİRİK Non-Alkolik Yağlı Karaciğer Hastalığı Tanı ve Tedavi Yaklaşımı Yakup ÜLGER Derya ARI Otoimmün Hepatit Tanı Ve Tedavisi Yavuz ÇAĞIR Primer Biliyer Kolanjit, Sekonder Biliyer Siroz, Primer Sklerozan Kolanjit, Sekonder Sklerozan Kolanjit Çağdaş Erdoğan Mehmet Köroğlu Budd-Chiari Sendromu Ve Venookluziv Hastalıkta Tanı Ve Tedavi Fatih EREN Berrin YALINBAŞ KAYA İlaç İlişkili Karaciğer Yetmezliği: Etkenler, Tanı Ve Tedavi Filiz ARAZ Akut Karaciğer Yetmezliği Murat İSPİROĞLU Mesut AYDIN Kronik Karaciğer Hastalıklarında Akut Alevlenmeler ve Yaklaşım Mustafa AKAR Çınar YILDIRIM Siroz Tedavisinde Kullanılan Başlıca İlaçlar Elif Tuğba TUNCEL Karaciğer Sirozu Ve Dekompansasyon Bilal TOKA Salih TOKMAK Karaciğer Sirozu Ve Tüm Yönleriyle Laboratuvar Değerlendirme Berat EBİK Hüseyin KAÇMAZ Portal Hipertansiyon Kübra AKAN Portal Hipertansiyona Cerrahi Yaklaşım Ufuk ARSLAN Portal Ven ve Splenik Ven Trombozuna Klinik ve Cerrahi Yaklaşım Fatih KIVRAKOĞLU Murat GÜNER M.Fevzi CELAYİR Karaciğer Hastalıklarında Anamnez Ve Fizik Muayene Mehmet KÖROĞLU Karacığer Hastalıkları Ve Nörolojık Bulgular Güven ARSLAN Hepatorenal Sendrom Murat DEVECİ Vedat GENÇER Hepatopulmoner Sendrom, Portopulmoner Hipertansiyon Çağdaş Erdoğan Mehmet Fatih Elverişli Karaciğer Hastalıkları Ve Hematopoietik Sistem, Hemostaz Funda Pepedil Tanrıkulu Filiz Araz Karaciğerin Paraziter Hastalıkları Ve Medikal Tedavi Safiye Koçulu Demir Karaciğerin Paraziter Hastalıklarında Cerrahi Tedavi Özhan Albayrak Ali Sürmelioğlu Karaciğerin Bakteriyel ve Mantar Enfeksiyonları ve Apselerine Medikal Yaklaşım Suzan Şahin Nazım Ekin Karaciğerin Bakteriyel Ve Mantar Enfeksiyonlarına Ve Apselerine Cerrahi Yaklaşım Sami Benli Dursun Burak Özdemir Karaciğer Nakli Öncesi Hasta Ve Donör Hazırlığı Şencan Acar Karaciğer Naklinde Endikasyon ve Kontrendikasyonlar Muhammed Raşid Aykota Şencan Acar Karaciğer Nakli Sonrası Hasta Yönetimi Ümit Karaoğullarından Karaciğer Nakli Sonrası Hastalık Nüksü Ve Yönetimi Ayça Eroğlu Haktanır Şencan Acar Karaciğer Nakli Sonrası İmmunsupresyon Tedavileri Salih TOKMAK Bilal TOKA Karaciğer Naklinde Rejeksiyon ve Yaklaşım Ferhat BACAKSIZ Derya ARI Karaciğer Rejeksiyonlarında Patolojik Değerlendirme Şenay YILDIRIM Kronik Karaciğer Hastalıkları Ve Karaciğer Nakli Sonrası Kan Şekeri Regülasyonu Mustafa AYDEMİR Hafize Kızılkaya Karaciğer Naklinde Psikiyatrik Değerlendirme Berna Bulut Çakmak Elif Aktan Mutlu Karaciğer Hastalıkları Ve Fitoterapi Ali Özkeskin Karaciğer Hastalıklarında Ozon Terapisi Hatice Hamarat Ali Türeyen Erişkin Karaciğer Hastalıklarında Yoğun Bakım Desteği Ve Monitörizasyon Oya Ferah Erişkin Karaciğer Nakli Sonrası Yoğun Bakım Ve Monitorizasyon Elif Binboğa Karaciğer Hastalıkları Ve Cerrahi Prosedürler, Hangi Hastalık Hangi Prosedür? İmam Bakır Batı Umut Tüysüz Benign Karaciğer Tümörlerinin Cerrahi Tedavisi Kuntay KAPLAN Yusuf Murat BAĞ Karaciğer Malign Tümörlerinin Cerrahi Tedavisi Hüseyin Alakuş Ümit Özdemir Karaciğer Cerrahisine Bağlı Komplikasyonlar Ve Yönetimi Muzaffer Önder Öner Mehmet Caka Erişkin Canlı Vericili Karaciğer Naklinde Cerrahi Ender Anılır Birkan Bozkurt Kadaverik Karaciğer Naklinde Cerrahi Ender Anılır Ahmet Karayiğit Karaciğer Nakli Cerrahi Komplikasyonları Ve Yönetimi Yusuf Murat Bağ Kuntay Kaplan Karaciğer Hastalıkları Ve Cerrahisi Sonrası Ağrı Ve Yönetimi Pınar Kolusarı Pediatrik Karaciğer Hastalıklarında Fizik Muayene Ve Klinik Değerlendirme Hatice Bulut Çocuklarda Metabolik Karaciğer Hastalıklarına Yaklaşım Abdurrahman Akgün Halil Kocamaz Pediatrik İmmün Hepatitler Ve Yaklaşım Suna Selbuz Pediatrik İskemik Ve Vasküler Karaciğer Hastalıklarına Yaklaşım Semih Sandal Pediatrik Benign Ve Malign Karaciğer Tümörlerine Yaklaşım Arzu Aras Nurel İnan Aydemir Pediatrik Kolestatik Sendromlar Meltem Gümüş Pediatrik Wilson Hastalığı Nurel İnan Aydemir Arzu Aras Karaciğerin Fibrokistik Hastalığı Elif Sağ Çocuklarda Hepatotropik Viral Hepatitler Meryem Keçeli Başaran Viral Hastalıkların Çocuklarda Karaciğere Etkisi – 1 (Non-Hepatotropik Virüsler) Nilüfer Ülkü Şahin Viral Hastalıkların Çocuklarda Karaciğere Etkisi – 2 (Non-Hepatotropik Virüsler) Ülkü Şahin Tuğba Erat Çocukluk Dönemi Bilirubin Metabolizma Bozuklukları Ve Yaklaşım Esra Polat Çocuklarda Karaciğer Nakli Ve Cerrahi Teknikler Hayrettin Dizen Çocukluk Dönemi Karaciğer Hastalıklarında Radyoloji Sibel Saraçoğlu Çocukluk Dönemi Karaciğer Hastalıkları Ve Tümörlerinde Girişimsel Radyoloji Ümmihan Topal Çocukluk Dönemi Karaciğer Hastalıklarında Yoğun Bakım Ve Monitorizasyon Zafer Gökkaya Çocuk Karaciğer Naklinde Yoğun Bakım İzlemi Ve Monitorizasyon Banu Katlan Selman Kesici Pediatrik Karaciğer Nakli Sonrası İmmünsupresyon Tedavileri Ersin Sayar Çocuklarda Karaciğer Nakli Öncesi ve Sonrası Aşılama Meryem Keçeli Başaran Karaciğer Nakli Öncesi Ve Sonrası Dönemde Çocuklarda Psikiyatrik Değerlendirme Ve Müdahaleler Sefa Coşğun
<b><i>Objective:</i></b> We aimed to share our observations on the demographics, clinical characteristics, and outcomes of lymphonodular hyperplasia (LNH) in children. <b><i>Subjects and Methods:</i></b> The study included children on whom colonoscopy was performed between January 2015 and May 2018 (<i>n</i> = 361). Demographics, treatment modalities, and outcomes of the patients with LNH were recorded. <b><i>Results:</i></b> LNH was found in 66 patients (18.3%; mean age 8.6 ± 5.96 years, 59.1% male). We found that the etiologic factors were food hypersensitivity (FH) in 25 (37.8%), nonspecific colitis in 12 (18.2%), irritable bowel syndrome in 10 (15.2%), familial Mediterranean fever in 7 (10.6%), primary immunodeficiency in 4 (6.1%), and intestinal dysmotility, oxyuriasis, Crohn’s disease, and giardiasis in 1 (1.5%) patient. Additionally, in the genetic analysis of patients with idiopathic LNH (<i>n</i> = 4), we detected heterozygote <i>MEFV</i> mutations in all. Cow’s milk and egg (25%) were the most common allergens in patients with FH. Symptoms of all patients (<i>n</i> = 25) improved after an elimination diet. <b><i>Conclusions:</i></b> LNH is a common finding in pediatric colonoscopies with a variety of etiologies ranging from FH and familial Mediterranean fever to immunodeficiency.
This study aimed to investigate polymorphisms in the genes responsible for encoding cytokines interleukin-6 (IL-6) (-572G/C) (rs1800796) and IL-17 (-197A/G) (rs2275913) in patients with celiac disease (CD). We further aimed to investigate the relationship between CD symptoms and histopathological findings and the relationship between these polymorphisms.We compared the results with those of healthy control subjects to establish whether any of the polymorphisms are involved in the susceptibility to CD. Eighty-four patients with CD and 83 healthy controls were enrolled in this study. Children with CD were divided into two groups depending on whether their symptoms were typical or atypical. The IL-6 (-572G/C) and IL-17 (-197A/G) polymorphisms were genotyped based on a polymerase chain reaction coupled with restriction fragment length polymorphism.Significant differences for the IL-6 (-572G/C) polymorphism were observed between patients with CD and controls (p=0.018, odds ratio (OR): 5.47, 95% confidence interval (CI): 1.161-25.800). No statistically significant association was observed between the IL-17 (-197A/G) polymorphism and CD (p>0.05). In addition, the symptoms and histopathological findings of children with CD were not related to either of the polymorphisms.The results of our study indicate that the IL-6 (-572G/C) polymorphism may play a role in susceptibility to CD.
Objective: Fibrocystic liver disease (FLD) is a multisystemic disease that can be seen in a wide age range from intrauterine period to adolescent age. The aim of study is to evaluate the presenting symptoms, clinical-laboratory findings, treatment modality and results of the patients with FLD . Material and Methods: The demographic features, clinical-laboratory findings, treatment modality and results of patients with FLD followed up in our clinic between January 2008 and December 2019 were recorded retrospectively. Results: A total of 39 patients (56.4% male, median age; 53m years, age range: 10 days-16.8 years) were evaluated. Eight patients (20.5%) had Caroli’s disease (CD), 16 patients had congenital hepatic fibrosis (CHF) (41%), and 15 had choledochal cysts. The most common presenting symptoms were jaundice (n=8, 20.5%), chronic abdominal pain (n=6, 15.4%) and splenomegaly (n=4, 10.3%). Eight patients were detected after renal cyst detection and screening programme (20.5%), seven patients during intrauterine period (17.9%), and two patients incidentally (5.1%). PKHD1 gene mutation was deteceted in six patients with autosomal recessive polycystic kidney disease (ARPKD). Eighteen patients underwent surgical operation (46.2%, liver transplantation, left lobe segmental hepatectomy, mesocaval shunt, kidney transplantation, cystectomy). 25 patients (64.1%) had extrahepatic involvement [ ARPKD (n=18), mental motor retardation (n=2, methochromatic leukodystrophy, Arnold Chiari malformation in each one), nephrocalcinosis (n=1), juvenile nephronophytosis (n=1) acute pancreatitis (n=1), pulmonary hypoplasia + metacarpal distal phalanx hypoplasia (n=1) and medullary sponge kidney+pineal cyst (n=1)]. During the follow up of 39 patients; six patients had portal hypertension, five had chronic renal failure (12.8%), four had compensated chronic liver disease (10.3%) and one had recurrent cholangitis attacks (2.6%). Two patients underwent liver transplantation due to decompensated cirrhosis, and one patient underwent kidney transplantation due to end-stage renal failure. Conclusion: Early diagnosis, regular follow-up and treatment are important in patients with FLD because of the high risk of morbidity and complications.
Abstract Background Coronavirus disease 2019 (COVID-19) usually leads to a mild infectious disease course in children, while serious complications may occur in conjunction with both acute infection and neurological symptoms, which have been predominantly reported in adults. The neurological complications in these patients vary based on patient age and underlying comorbidities. Data on clinical features, particularly neurological features, and prognostic factors in children and adolescents are limited. This study provides a concise overview of neurological complications in pediatric COVID-19 cases. Materials and methods The retrospective study reviewed medical records of all patients who were admitted to our hospital and were diagnosed with COVID-19 by real-time reverse-transcription polymerase-chain-reaction (RT–PCR) assay between 11 March 2020 and 30 January 2021. Patients with a positive PCR result were categorized into two groups: outpatient departments patients and inpatient departments (IPD). Results Of the 2530 children who underwent RT–PCR during the study period, 382 (8.6%) were confirmed as COVID-19 positive, comprising 188 (49.2%) girls and 194 (50.8%) boys with a mean age of 7.14±5.84 (range, 0–17) years. Neurological complications that required hospitalization were present in 34 (8.9%) patients, including seizure (52.9%), headache (38.2%), dizziness (11.1%) and meningoencephalitis (5.8%). Conclusion The results indicated that neurological manifestations are not rare in children suffering from COVID-19. Seizures, headaches, dizziness, anosmia, ageusia and meningoencephalitis are major neurological manifestations during acute COVID-19 disease. Although seizures were the most common cause of hospitalization in IPD patients, the frequency of meningoencephalitis was quite high. Seizures were observed as febrile seizures for children under 6 years of age and afebrile seizures for those over 6 years of age. Febrile seizure accounted for half of all seizure children.
Recurrent acute pancreatic attacks is a rare clinical condition (2-5% of all acute pancreatis) in children and is mainly idiopathic in most cases. Sometimes it may be associated with congenital anomalies, metabolic diseases or hereditary conditions. Isovaleric acidemia (IVA) is a rare autosomal recessive amino acid metabolism disorder associated with isovaleryl coenzyme A dehydrogenase deficiency presenting the clinical findings such metabolic acidosis with increased anion gap, hyperammonemia, ketonemia, hypoglycemia, "the odor of sweaty feet," abdominal pain, vomiting, feeding intolerance, shock and coma. Recurrent acute pancreatitis associated with IVA have been rarely reported. Herein; we report a child who admitted with recurrent acute pancreatic attacks and had the final diagnosis of IVA. Mutation analysis revealed a novel homozygous mutation of (p.E117K [c.349G>A]) in the IVA gene. Organic acidemias must kept in mind in the differential diagnosis of recurrent acute pancreatic attacks in children.
We aimed to analyze the efficiency of a novel treatment approach, long-term synbiotic supplementation, in addition to lifestyle changes in children with non-alcoholic fatty liver disease (NAFLD).The study included children with NAFLD (n=28) and a healthy control group (n=30). Children with NAFLD were given 1 capsule/day of synbiotics. Anthropometric parameters; biochemical analysis, including ethanol, tumor necrosis factor-α (TNF-α), total oxidant status (TOS) and anti-oxidant status (TAS), zonulin, and fecal calprotectin; and ultrasonographic examination were performed at baseline and 4 months later.The grade of fatty liver was decreased (≥1 grade) in 19 of the 28 patients (67.8%) after synbiotic supplementation. Total cholesterol, low-density lipoprotein (LDL) levels, TNF-α, C-reactive protein (CRP), and ethanol were significantly decreased, and TAS levels were significantly increased at the end of treatment (p<0.05 for all). We found that the median decrease in CRP (-0.16 vs. -0.03 mg/dL, p=0.003) and LDL levels (-17 vs. -3 mg/dL, p=0.019) were higher in patients who responded to the supplementation.Synbiotic supplementation in addition to lifestyle changes is effective in children with NAFLD.
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