Optical densitometric measurements of the cornea and lens in children with allergic rhinoconjunctivitis.

BACKGROUND: Our aim was to investigate the impact of allergic rhinoconjunctivitis on corneal and lenticular optical densitometry, pachymetry and anterior chamber depth in children. METHODS: Fifty-four patients who had allergic rhinoconjunctivitis (study group) and 54 age-matched healthy children (control group) were recruited in this cross-sectional and comparative study. Corneal and lenticular optical densitometry, pachymetry, corneal volume and anterior chamber depth measurements were taken with the Scheimpflug imaging system. RESULTS: The lens density and anterior chamber depth were similar between the groups (p > 0.05), while corneal density and thickness were significantly higher in the study group (p < 0.05). Although the corneal volume was higher in children with allergic rhinoconjunctivitis, the difference was not statistically significant (p = 0.07). CONCLUSIONS: The cornea is affected in allergic rhinoconjunctivitis in respect to optical density and thickness, while the anterior chamber and lens are not influenced.

Pertussis-like syndrome associated with adenovirus presenting with hyperleukocytosis: Case report.

Adenovirus is an infectious viral agent that causes variety of clinical presentations such as respiratory disease, conjunctivitis, and gastroenteritis. Hepatitis, pancreatitis, myocarditis, encephalitis, and disseminated infection are primarily seen in immunocompromised patients. Rarely, adenovirus infection can present with pertussis-like syndrome. Described here is case of pertussis-like syndrome associated with adenovirus presenting with hyperleukocytosis.

Exantema macular en un niño con gastroenteritis por rotavirus: informe de caso / Macular exanthema in a child with rotavirus gastroenteritis: a case report

Aparte de la gastroenteritis, raramente se ha implicado al rotavirus en otros trastornos cutáneos como el exantema maculopapular generalizado, el edema hemorrágico agudo del lactante y el síndrome de Gianotti-Crosti. Comunicamos el caso de un niño de 30 meses de edad que presentó erupciones cutáneas maculares eritematosas mientras cursaba una gastroenteritis por rotavirus. En nuestro conocimiento, este es el primer caso en la bibliografía en el que se informan lesiones maculares eritematosas asociadas a rotavirus en un paciente pediátrico. En consecuencia, deseamos compartir nuestra experiencia para que se considere la infección por rotavirus dentro del diagnóstico diferencial de los niños que presenten gastroenteritis y erupción eritematosa.(AU)

Apart from gastroenteritis, rotavirus has been rarely implicated with some cutaneous disorders such as generalized maculo-papular exanthema, infantile acute hemorrhagic edema and Gianotti-Crosti syndrome. We report a 30-month old toddler boy who developed erythematous macular skin eruptions during the course of rotavirus gastroenteritis. To our knowledge, this is the first case in the literature reporting rotavirus-related macular erythematous lesions in a pediatric patient. We therefore would like to share our experience, to keep ro-tavirus infection in the differential diagnosis of children with gastroenteritis and erythematous eruption.(AU)

Exantema macular en un niño con gastroenteritis por rotavirus: informe de caso / Macular exanthema in a child with rotavirus gastroenteritis: a case report

Aparte de la gastroenteritis, raramente se ha implicado al rotavirus en otros trastornos cutáneos como el exantema maculopapular generalizado, el edema hemorrágico agudo del lactante y el síndrome de Gianotti-Crosti. Comunicamos el caso de un niño de 30 meses de edad que presentó erupciones cutáneas maculares eritematosas mientras cursaba una gastroenteritis por rotavirus. En nuestro conocimiento, este es el primer caso en la bibliografía en el que se informan lesiones maculares eritematosas asociadas a rotavirus en un paciente pediátrico. En consecuencia, deseamos compartir nuestra experiencia para que se considere la infección por rotavirus dentro del diagnóstico diferencial de los niños que presenten gastroenteritis y erupción eritematosa.

Apart from gastroenteritis, rotavirus has been rarely implicated with some cutaneous disorders such as generalized maculo-papular exanthema, infantile acute hemorrhagic edema and Gianotti-Crosti syndrome. We report a 30-month old toddler boy who developed erythematous macular skin eruptions during the course of rotavirus gastroenteritis. To our knowledge, this is the first case in the literature reporting rotavirus-related macular erythematous lesions in a pediatric patient. We therefore would like to share our experience, to keep ro-tavirus infection in the differential diagnosis of children with gastroenteritis and erythematous eruption.

Macular exanthema in a child with rotavirus gastroenteritis: a case report.

Apart from gastroenteritis, rotavirus has been rarely implicated with some cutaneous disorders such as generalized maculo-papular exanthema, infantile acute hemorrhagic edema and Gianotti-Crosti syndrome. We report a 30-month old toddler boy who developed erythematous macular skin eruptions during the course of rotavirus gastroenteritis. To our knowledge, this is the first case in the literature reporting rotavirus-related macular erythematous lesions in a pediatric patient. We therefore would like to share our experience, to keep ro-tavirus infection in the differential diagnosis of children with gastroenteritis and erythematous eruption.

Decreased mean platelet volume in children with acute rotavirus gastroenteritis.

BACKGROUND: The contribution of platelets to the inflammatory response via several platelet derived mediators is well recognized. The role of mean platelet volume (MPV) in infectious and inflammatory disorders, however, has not yet been well-established. While some of the previous studies demonstrated that MPV acted as a positive acute phase reactant, several others suggested its role as a negative acute phase reactant. In the current study, we aimed to assess the role of MPV as an acute phase reactant in children with rotavirus gastroenteritis. METHODS: We undertook a prospective, randomized, controlled, cross-sectional study and enrolled children diagnosed with acute rotavirus gastroenteritis and healthy controls (HC), between August and November 2012. Children with acute gastroenteritis were assigned either in the rotavirus-positive acute gastroenteritis (RPAG) or in the rotavirus-negative acute gastroenteritis (RNAG) group depending on their stool antigen results. Patients were also classified into two groups based on their Vesikari score (< 11: non-severe and ≥ 11: severe). Complete blood count and C-reactive protein (CRP) levels were assessed for all patients. We compared MPV between RPAG, RNAG and HC groups and investigated the association, if any, among MPV, platelets, white blood count and CRP. RESULTS: In total 100 RPAG (54 males; mean age: 38.74 ± 41.45 months), 100 RNAG (58 males; mean age: 32.84 ± 29.64 months) children and 100 HC (43 males; mean age: 33.21 ± 32.55 months) were enrolled into the study. Mean platelet counts were well-matched among groups (p > 0.05). We observed a steady decline in MPV (fL) in the HC, RPAG and RNAG groups (median 7.80, 7.35 and 7.30, respectively; p < 0.0001). We did not find an association between MPV and the clinical score of gastroenteritis (p > 0.05). CONCLUSION: We found that MPV could be used as an acute phase reactant in children with rotavirus gastroenteritis. We believe that the current study will contribute to our understanding of MPV as an inflammatory marker.

Macular exanthema in a child with rotavirus gastroenteritis: a case report. / Macular exanthema in a child with rotavirus gastroenteritis: a case report.

Apart from gastroenteritis, rotavirus has been rarely implicated with some cutaneous disorders such as generalized maculo-papular exanthema, infantile acute hemorrhagic edema and Gianotti-Crosti syndrome. We report a 30-month old toddler boy who developed erythematous macular skin eruptions during the course of rotavirus gastroenteritis. To our knowledge, this is the first case in the literature reporting rotavirus-related macular erythematous lesions in a pediatric patient. We therefore would like to share our experience, to keep ro-tavirus infection in the differential diagnosis of children with gastroenteritis and erythematous eruption.

Is PFAPA syndrome really a sporadic disorder or is it genetic?

Periodic fever syndromes are a group of disorders sharing similar symptoms, characterized primarily by regularly recurring fevers. PFAPA syndrome, one of the members of this group of disorders, is a clinical entity of unknown etiology which is frequently seen in the early childhood. Currently, the pathogenesis and the genetic basis of most of the disorders in the periodic fever spectrum are known, other than that of PFAPA syndrome. Although, classically PFAPA syndrome is known as a sporadic disease, we propose that it is not sporadic. We think that PFAPA syndrome may be an inherited disease and this hypothesis is supported by the clinical mimicry of PFAPA syndrome with other periodic fever syndromes with well-known genetic transmissions, frequent occurrence of the condition in members of the same family and emergence of common genetic mutations in the periodic fever syndrome spectrum. Moreover, our clinical observation that most of the patients diagnosed with PFAPA syndrome were of the same families strongly suggest a probable genetic transmission of this disorder. We have decided to discuss this hypothesis to contribute to the literature and assist our colleagues who are dealing with this commonly overlooked and often misdiagnosed disorder.

Serum transaminase elevation in children with rotavirus gastroenteritis: seven years' experience.

BACKGROUND: There are no studies on clinically significant transaminase elevation due to rotavirus gastroenteritis in the literature. Also, there are significant discrepancies among previous studies regarding the prevalence of increased serum transaminase levels in rotavirus infection. METHODS: Patients investigated for rotavirus by stool antigen testing, who were followed between January 2005 and May 2012, were retrospectively enrolled in this study. Patients were divided into 2 groups according to their rotavirus results: rotavirus-positive acute gastroenteritis (RPAG) and rotavirus-negative acute gastroenteritis (RNAG) groups. RESULTS: A total of 4317 children who presented with acute gastroenteritis were assessed. The study was completed with 642 patients who met the inclusion criteria. In the RPAG group (n = 272), elevated alanine aminotransferase (ALT) was found in 42 (15.4%) patients and elevated aspartate aminotransferase (AST) in 69 (25.4%), while in the RNAG group (n = 370), these numbers were 25 (6.8%) and 44 (11.9%), respectively. The elevated ALT and AST levels were found to be significantly higher in the RPAG group than in the RNAG group (both p < 0.001). The prevalence of elevated transaminase levels was found to be similar with respect to gastroenteritis severity score (p > 0.05). The high serum transaminase levels normalized uneventfully in all patients in the RPAG and RNAG groups during follow-up. CONCLUSIONS: In this study, our results clearly signify a liver influence in rotavirus infections. Therefore, rotavirus infections should be kept in mind when evaluating the aetiology of transaminase elevation in patients with acute gastroenteritis.

Frequency of pleural effusion in acute bronchiolitis and its effect on prognosis.

AIM: To analyze the frequency of pleural effusion and the effect on prognosis in children with acute bronchiolitis. METHODS: A total of 69 infants aged 1-24 months with acute bronchiolitis were studied between September 2009 and December 2010. All patients'age, sex, breastfeeding duration, exposure to smoking, history of using vitamin D, symptoms duration, physical examination and laboratory findings were recorded. Bronchiolitis score and predisposing factors that influence the disease process were determined. Thorax ultrasonography was carried out in all patients, who were evaluated on the 3rd and 7th day of the treatment. RESULTS: Mean age of patients (43 boys, 26 girls) was 11.97 ± 0.69 months (median 11 months). Breastfeeding duration was 8.26 ± 0.56 months (median 8 months). According to bronchiolitis score, 52 patients (75.4%) had mild and moderate bronchiolitis and 17 (24.6%) had severe bronchiolitis; 34 patients (49.2%) had pleural effusion. There was no relation between pleural effusion and symptoms. Frequency of pleural effusion was significantly higher in patients with risk factors. CONCLUSIONS: This study demonstrated that most of the acute bronchiolitis cases in the infants studied were accompanied by pleural effusion. Pleural effusion in acute bronchiolitis had no effects on prognosis.