Peculiarities of crohn's disease in children - the way from diagnosis verification to the development of complications (clinical case).

OBJECTIVE: Introduction: Despite increasing frequency of inflammatory diseases of the intestine in the children worldwide, verification of Crohn's disease (CD) diagnosis in pediatric practice has not studied yet and it is difficult for clinician to determine the stage of the disease. The aim of our study was to analyze clinical case of Crohn's disease (CD) in a child based on literature data and own monitoring. PATIENTS AND METHODS: Materials and methods: 13 year old patient was involved in our examination who took complex lab and instrumental investigation, which allows verifying inflammatory intestinal pathology such as Crohn's disease. Clinical case of the disease demonstrates that clinical symptomatic picture, difficulties of differential diagnostics and the absence of effective interaction between relatives of the patient and doctor can't give the possibility to make correct diagnosis in pediatric practice and it can lead to complications of the development of disablement. CONCLUSION: Conclusions: Crohn's disease is a serious inflammatory intestinal disease that requires an interdisciplinary diagnostic approach for the successful verification of the diagnosis.

Role of genetic mutations in development of immunological and clinical disorders in children with chronic pyelonephritis.

INTRODUCTION: At the present time, the study of mechanisms of recognition of foreign agents, which is realized by means of Toll-like receptors (TLR) of the innate immune system, has become one of the main tasks of clinical immunology. The aim of our study was to investigate the prevalence of polymorphism of Toll-like receptor 4 (Asp299Gly, Gly299Gly) among children with chronic pyelonephritis (CP) and determine the association of this TLR4 polymorphism with phenotypic features of chronic pyelonephritis and level of interleukin-6 (IL-6). MATERIALS AND METHODS: The clinical and laboratory examination of 60 children with chronic pyelonephritis during the stage of exacerbation, who were under inpatient treatment at the pediatric department of Children's Regional Clinical Hospital in Poltava, was performed. The group of healthy patients included 95 people, living in the Poltava region. RESULTS: Significantly higher frequency of the mutant allele 299Gly among children with CP was revealed. Significant correlation between the presence of 299Gly TLR4, association of U. urealyticum and M. hominis in lower sections of urinary tract and highest levels of IL-6 concentration was reflected. Sick children with polymorphous locus of TLR4 gene had higher risk of CP early manifestation and formation of its recurrent course with protracted urinary syndrome and unstable remission in comparison with the carriers of "wild" genotype. CONCLUSIONS: Obtained results prove the important role of TLR4 in the realization of innate immune response in children with CP and allow considering the TLR4 polymorphism as an additional prognostic indicator in this category of patients.