Peptic Ulcers and Erosions in Children at a Pediatric Unit in Turkey.

Objective: To study the characteristics of peptic ulcer and erosion in pediatric patients. Methods: Over a period of seven years, 1,026 children underwent upper gastrointestinal endoscopy in our pediatric gastroenterology unit. Results: Peptic ulcers and erosions were found in 59 (7.2%) patients [ulcers in 42 (5.1%) and erosions in 17 (2.1%)]. Thirty (50.9%) children presented with acute upper gastrointestinal bleeding. Helicobacter pylori positivity was found in 27 patients (45.8%), and ulcerogenic medication use was found in 13 (22%) patients. Conclusion: The main risk factors for childhood peptic ulcer and erosions were H. pylori infection and non-steroidal anti-inflammatory drug use.

Gastrointestinal Neuroendocrine Tumors in Two Children.

Background: Enterochromaffin-like cell hyperplasia and neuroendocrine tumors are relatively rare in childhood.Case characteristics: A 15-year-old girl who presented with epigastric pain and a 6-year-old boy who was admitted with hematochezia. Endoscopy revealed nodules in the stomach in Case 1, and polyploidy lesion in the rectum in Case 2. Outcome: Enterochromaffin-like cell hyperplasia in Case 1 and neuroendocrine tumor in Case 2. Message: A low index of suspicion for neuroendocrine tumors in children can result in delay in the detection of these rare but potentially malignant diseases.

Helicobacter pylori and Micronutrients.

Helicobacter pylori (HP) infection causes morbidity in several systems, especially in the gastrointestinal tract. The prevalence of disease is inversely related to social-economic and developmental status. It is more common in the developing than in developed countries. In the countries where social-economic status is low, not only HP infection, but also malnutrition and growth failure have a higher prevalence. According to these data, the relationship of nutrition and HP infection is still a question. Does HP infection affect nutritional status? On the contrary, does nutritional status affect HP infection? If so, how? This review was prepared after searching thoroughly almost all of the publications about relationship between HP infections and micronutrients, especially publications pertaining to childhood, from 1990 to 2009 in PubMed. Some valuable adult and experimental publications were also reviewed. These studies related H.pylori to iron, vitamin B12, vitamin C, vitamin A, vitamin E, folate, and selenium. Published studies reveal some evidence that HP has a negative effect on iron, vitamin B12 and vitamin C metabolism, but its influence on others is not clear.

An unusual cause of ascites: hemophagocytic lymphohistiocytosis.

Hemophagocytic lymphohistiocytosis is character-ized by fever, hepatosplenomegaly, cytopenia, hyper-triglyceridemia, hypofibrinogenemia, and hemophago-cytosis. Ascites is not mentioned as a symptom of hemophagocytic syndrome. We report a one month-old girl suffering from familial erythrophagocytic lympho-histiocytosis, who presented with ascites.

Bone mineral density in response to two different regimes in rickets.

The aim of this study was to compare the bone mineral density (BMD) of two different treatment regimens in infants with nutritional vitamin D deficient rickets (VDR). Ten patients (Group 1) were treated with a single dose of 600,000 IU of oral vitamin D3 and another ten patients (Group 2) were treated with 20,000 IU/day of oral vitamin D3 for 30 days. BMD was measured in the lumbar spine twice in all infants before the treatment and on the 31st day after initiating the treatment. The increases of BMD after treatment compared to pretreatment levels were statistically significant in both groups (P = 0.005 in Group 1 and P = 0.047 in Group 2). The increments of BMD were statistically similar between Group 1 and 2 (P = 0.096). The present study suggests that these two different treatment regimens bring about similar healing in BMD.