Prevalence of atopic dermatitis in infants during the first six months of life: authors' observations.

INTRODUCTION: Atopic dermatitis (AD) is a frequent chronic skin disease in infants. It creates great difficulties, both diagnostic and therapeutic. AIM: To assess the prevalence of atopic dermatitis in infants during the first 6 months of life. MATERIAL AND METHODS: The analysis comprised 2256 children at the age of not more than 6 months, treated at the 2(nd) Department of Paediatrics and Allergology of the Polish Mother's Memorial Hospital in Lodz, Poland, during seven years. Out of all the patients, children with cutaneous changes were isolated, and the location, type and aetiology of changes were assessed. RESULTS: Dermal changes were diagnosed in 471 children, including 391 (17.3% of all the patients) with atopic dermatitis. Out of the children with AD, IgE-dependent allergy was identified in 39.9%. Cow's milk protein was the most frequent sensitising allergen. In 71.6% of the infants, cutaneous changes were disseminated and involved at least two areas of the body. All of them were strongly itching. An applied elimination diet, together with anti-allergic medications in some of the children, provided a clear clinical improvement. CONCLUSIONS: Performed studies demonstrated the prevalence of atopic dermatitis in 17.3% of examined children. The changes in children with AD were disseminated, what was confirmed already at the infantile age. The obtained clinical improvement after the applied therapy indicates a relationship between the observed symptoms and allergic disease.

The usefulness of soluble transferrin receptor (sTfR) in differentiating anemia occurring in young children.

We evaluated the usefulness of soluble transferrin receptor (sTfR) and of the sTfR/log ferritin index(sTfR/logF) in the differentiation of anemia in young children. 96 children, aged 6-36 months, were examined.From these, four groups were distinguished: 1 - (IDA): 33 children with anemia due to iron deficiency; 2 -(IA): 19 children with infectious anemia without iron deficiency; 3 - (IA + ID): 16 children with infectious anemia and iron deficiency; and 4 - a comparator group (CG): 28 healthy children without iron deficiency. The soluble transferrin receptor, hematological indices and iron balance were evaluated and the sTfR/logF was calculated for each examined child. It was proved that the mean values of sTfR and sTfR/logF were substantially higher in children with anemia due to iron deficiency, and in those with infectious anemia and iron deficiency,vs. those with infectious anemia or in healthy children. This suggests that both sTfR and the sTfR/logF are good indicators of iron deficiency and could be useful in the differential diagnostics of anemia, especially in young children.

[Food allergy as a cause of constipation in children in the first three years of life - own observations]. / Alergia pokarmowa jako przyczyna zaparc u dzieci w pierwszych trzech latach zycia na podstawie obserwacji wlasnych.

BACKGROUND: Constipation is a frequent cause of seeking paediatric advice and concerns up to 15% of the child population. AIM OF THE STUDY: Estimation of the role of allergy in the etiology of constipation in children during the fi rst three years of life. MATERIAL AND METHODS: Retrospective analysis was performed in 9489 children treated in 2nd Department of Pediatrics and Allergology of the Polish Mother's Memorial Hospital in Lodz in the years 1998- 2008. Among them there was a group of children with constipation diagnosed according to the Rome III Criteria. Anamnesis, course of disease and physical examination performed of each child guided further differential diagnosis Confirmation of food allergy diagnosis was positive result of provocation-elimination challenge with harmful food, and in case of some children additionally increased serum concentrations of allergenspecific IgE antibodies. In children with food allergy elimination diet was implemented. RESULTS: Chronic constipation was diagnosed in 136 children (1.43%). The most frequent cause of constipation in the examined children was allergy to cow's milk proteins, (n=99; 72.8%). The others were: psychogenic factors (n=10; 7.3%), dysbacteriosis of digestive system (n=7; 5.1%), anatomical defects of digestive tract (n=6; 4.4%), disorders of nervous system (n=6; 4.4%), overdose of Vit. D3 (n=3; 2.2%), Down Syndrome (n=2; 1.4%), celiac disease (n=1; 0.7%), abdominal tumour (neuroblastoma) (n=1; 0.7%) and cystic fibrosis (n=1; 0.7%). Clinical improvement after introduction of the elimination diet was observed in all children with food allergy. CONCLUSIONS: 1. In the fi rst three years of life cow milk allergy was the most frequent cause of constipation; 2. Incidence of food allergy as the reason of constipation decreased with age of the examined children.

[Prolonged icterus as a difficult diagnostic problem in small children--own observations]. / Przedluzajaca sie zóltaczka jako trudny problem diagnostyczny w klinice malego dziecka--obserwacje wlasne.

UNLABELLED: THE AIM of the study was the retrospective evaluation of causes of prolonged icterus in children treated in the Second Department of Peadiatrics and Allergology in Lódz during the last 16 years. MATERIAL AND METHODS: 361 children aged 3 weeks to 15 months of 12650 patients hospitalised in our Clinic were analysed. All the examined children were divided into two groups group I consisted of 314 children with unconjugated hyperbilirubinemia and group II of 47 patients with cholestasis Additionally the cholestatic group was divided into two subgroups: IIa consisted of 41 children with intrahepatic cholestasis and IIb--six children with extrahepatic cholestasis. RESULTS: The most common reasons of icterus in groups I and IIa were respiratory tract infections and cytomegalovirus infections All of these children recovered. Metabolic diseases were diagnosed in 4 children (galactosemia, fructosemia and in two children mucoviscidosis) in 5 children other genetic syndromes (Crigler-Najjar, Allagille and in three Byler disease). Six children from group IIb with extrahepatic biliary atresia were transferred to the Department of Paediatric Surgery. All of them underwent Kasai operation. CONCLUSIONS: Small children's prolonged icterus needs immediate and intense investigations to set as fast as possible the correct diagnosis of its cause. Early diagnosis of its cause increases the prospect of effective treatment and prevents the child from potential development of hepatic failure.

[Soluble transferrin receptor's value in diagnosis infants and small children iron deficiency]. / Znaczenie rozpuszczalnego receptora transferyny w diagnostyce niedoboru zelaza u niemowlat i malych dzieci.

UNLABELLED: Iron deficiency is the most frequent deficiency in people, especially in infants and small children. To obtain a correct diagnosis there is need to perform complex hematological and biochemical tests. In recent years studies on soluble transferrin receptor (sTfR) as an index of iron deficiency have been carried out, but mainly in adults. THE AIM OF THESE STUDIES: To estimate usefulness of signification sTfR level for iron deficiency anaemia diagnosis in children up to three years. MATERIAL AND METHODS: The study group comprised 98 children aged 6 to 36 month. Depending on haematological and biochemical results 5 groups of examined children were separated: (1) with iron deficiency anaemia, (2) with latent iron deficiency, (3) with iron deficiency and chronic diseases anaemia, (4) with periinfections anaemia and (5) control. In all examined children the level of sTfR were estimated and its specificity, sensitivity and soundness was evaluated. RESULTS: Average levels of sTfR in children with iron deficiency were significantly higher compared to results in groups without iron deficiency. Specificity, sensitivity and soundness of sTfR were higher than 90% in all examined groups. CONCLUSION: An analysis of results showed that sTfR level seems to be a test which results correlate with iron status in infants and small children well.