Ferritin - novel uses of a well-known marker in paediatrics

Serum ferritin is one of the most widely used laboratory tests and is associated with both iron deficiency and iron overload. Currently, more and more attention is paid to the involvement of ferritin in processes other than iron metabolism. Low serum ferritin is unanimously associated with iron deficiency, while elevated serum ferritin may be a consequence of various medical conditions such as iron overload, an inflammatory process, SARS-CoV-2, organ failure, cancer, and endocrine disorders, including metabolic syndrome. We present a review of the literature on the role of ferritin in a variety of less obvious disease states in children.Copyright © 2023 Termedia Publishing House Ltd.. All rights reserved.

Diabetic ketoacidosis in children with new onset diabetes in Poland during COVID-19 pandemic

Introduction: The COVID-19 pandemic imposed a heavy burden on the healthcare systems worldwide, especially during initial outbreaks. The strain on medical systems, including human resources, as well as shift to telemedicine and pro-isolation policy may have delayed diagnosis and aggravated the outcomes of type 1 diabetes (T1D) in children, possibly increasing the incidence of diabetic ketoacidosis (DKA) at diabetes onset. Objectives: Compare the incidence of T1D in children and fraction of new T1D cases presenting with DKA among multiple pediatric diabetes care centres in Poland between a year before COVID-19 pandemic outbreak and after. Methods: We contacted 14 reference pediatric diabetes centres in Poland, which collectively provide diabetes care for a population of 6.2 MLN children. They were asked to provide a case-by case data concerning new cases of T1D diagnosed between 15th March 2019 and 15th Match 2021 in children <18 y.o., together with available clinical information. Collected data were divided into two year-long periods - before COVID-19 pandemic outbreak and after, with the division made on March 15 2020, when policy changes and lockdown was imposed. In addition, demographic data for each studied region was downloaded from central statistical office for years 2019 and 2020. Results: In the assessed period, we noted 2942 new cases of T1D (overall incidence rate 23.6 per 100000 patient-years) amongst 12 Poland regions (19.9 - 27.1), with a significant increase between pre-COVID- 19 and COVID-19 period across all regions (mean increase 4.8±4.2 per 100000, p=0.0002). Among new T1D cases, 1409 (47.9%) presented with DKA (38.8 to 72.1%). The first wave of COVID-19 was associated with a significant increase in fraction of DKA at T1D diagnosis across all regions (mean +8.4±10.5%, p=0.0175). Greatest increase was noted during the first 3 months after lockdown. Conclusions: In a multicentre national perspective, COVID-19 outbreak and related restrictions were associated with increased incidence of DKA at T1D presentation.