Portal venous thrombosis after umbilical vein catheterization.

PURPOSE: Portal vein thrombosis has been associated with umbilical venous catheterization. This prospective study was done to determine the incidence of neonatal portal venous thrombosis associated with catheterization of the umbilical vein . METHODS: Neonates who had undergone umbilical vein catheterization for exchange transfusion between March 2003 and March 2004 in Children's Hospital of Tabriz, Iran, were included. Doppler ultrasonography was performed within 1-2 weeks after the removal of the catheter. In the cases with portal venous thrombosis, subsequent serial ultrasonography was performed at intervals of every 1-2 months until clot resolution. Risk factors, if any were identified and correlated with catheter-related thrombi. RESULTS: Ultrasonography detected clinically silent portal venous thrombosis in 17 (34%) of 50 neonates. Follow-up ultrasonography was available in 13 of 17 babies, and revealed complete or partial resolution in all the cases. Sepsis was identified as a significant risk factor (p < 0.001). CONCLUSION: Umbilical venous catheter-associated thrombosis is common, and spontaneous resolution occurs in most cases.

Autoimmune hepatitis in Iranian children.

OBJECTIVE: To evaluate the clinical and para-clinical presentation, including autoantibody pattern and response to treatment in Iranian children with autoimmune hepatitis (AIH). METHODS: Data of 60 children presenting with AIH (56 girls) were analyzed retrospectively for clinical, serological and histological profile. RESULTS: Clinical findings included jaundice (67%),hepatomegaly (50%) and ascites (30%). Forty children (38 girls) had type I AIH and 14 (12 girls) had type II AIH. Liver histology was comparable in the two groups and cirrhosis on initial biopsy was equally frequent in Types I and II AIH (63% vs 34%; p=ns). CONCLUSION: Our study describes the presentation and clinical course of Iranian children with AIH. Treatment with corticosteroids and/or azathioprine induces remission of autoimmune hepatitis clinically, biochemically as well as histologically.

Relationship between endoscopic nodular gastritis and Helicobacter pylori infection in children.

INTRODUCTION: The specificity of relationship of endoscopic evidence of nodular gastritis with Helicobacter pylori infection is unclear. AIM: To assess the relationship of endoscopic nodular gastritis and H. pylori infection among children. METHODS: 124 children (median age 8.2 years, range 1-15) undergoing upper GI endoscopy for abdominal pain underwent urease test and histological examination of gastric mucosa to determine the presence and density of H. pylori infection, and presence and severity of gastritis. RESULTS: H. pylori infection was detected in 57 (46%) children. Endoscopic nodular gastritis was present in 46 of these 57 patients (81%) and in 24 of 67 (36%) H. pylori-negative patients (36%). The frequency of endoscopic nodular gastritis was related to increasing age (p< 0.0001), presence of H. pylori, grade of histologic gastritis, and H. pylori density (p< 0.0001). CONCLUSION: Endoscopic finding of nodular gastritis is associated with presence of H. pylori infection and active chronic gastritis in children.