An interesting case of childhood brucellosis with unusual features.

Brucellosis is a zoonotic infection, which is still a major public health concern worldwide. Common clinical findings are usually nonspecific involving fever, arthralgia, myalgia, weakness and malaise. Since none of the symptoms of brucellosis is pathognomonic, it may have a similar course with various multisystemic diseases. In terms of focal involvement, sacroiliitis is the most common musculoskeletal manifestation in adult patients, while it is quite rare in pediatric patients. Blood culture is the gold standard in the diagnosis of brucellosis. In the absence of culture facilities, the diagnosis traditionally relies on serologic testing with a variety of agglutination tests such as the Rose Bengal test and the serum agglutination test. However, these agglutination tests are accompanied by frequent false negative results such as seen in prozone phenomenon, which may lead to diagnostic delays. In this article we present a rarely encountered pediatric brucellosis patient who had sacroiliitis-spondylitis, which are rarely reported in children, and exhibited prozone phenomenon in agglutination tests.

Tear and serum vitamin D levels in children with allergic rhinoconjunctivitis.

BACKGROUND: Although solid cohort studies confirmed a preventative role for the anti-oxidant vitamin D in allergic asthma, a limited number of studies focused on allergic rhinoconjunctivitis (ARC). Here, we aimed to determine 25-hydroxycholecalciferol levels in tear and serum in young allergic rhinoconjunctivitis patients as compared to their apparently healthy matched controls. METHODS: In total, 22 children with allergic rhinoconjunctivitis and 31 healthy control subjects underwent serum total IgE and 25-hydroxycholecalciferol measurements. Tear levels of 25-hydroxycholecalciferol were also determined in both groups. RESULTS: The mean serum total IgE level in the ARC group (143.6±132.8IU/ml) was significantly higher than that in the control group (54.8±44.1IU/ml; p=0.03). Serum 25(OH)D levels were significantly higher in the ARC group (34.1±12.7ng/ml) than in the healthy controls (21.8±11.3ng/ml; p=0.001). CONCLUSIONS: To our knowledge, this is the first reported study to show an association between serum 25-hydroxycholecalciferol and ARC in a childhood group. Higher levels of serum 25-hydroxycholecalciferol in children with allergic rhinoconjunctivitis may indicate a possible aetiopathogenic mechanism in the development of allergic rhinoconjunctivitis. This is also the first report to examine tear fluid vitamin D levels in paediatric ARC patients.

¿Existe una relación entre la gastroenteritis rotavirus positivo y los grupos sanguíneos ABO? Estudio retrospectivo de cohorte / Is there a relationship between rotavirus positive gastroenteritis and ABO blood groups?: A retrospective cohort study

Introducción. El rotavirus es la causa más frecuente de diarrea grave en los niños. Son pocos los estudios clínicos sobre la relación entre la gastroenteritis por rotavirus y los grupos sanguíneos ABO. Objetivo. La meta de este estudio fue investigar la función de los grupos sanguíneos, en la incidencia de la gastroenteritis por rotavirus y la gravedad de la gastroenteritis. Métodos. Se realizó la investigación retrospectiva de las historias clínicas de los bebés que nacieron en nuestro hospital y a quienes, durante el seguimiento, se les diagnosticó gastroenteritis aguda. Resultados. En el estudio, se incluyeron 219 (36,3%) pacientes rotavirus positivos y 383 (63,6%) pacientes rotavirus negativos. El grupo sanguíneo A se detectó más frecuentemente en el grupo rotavirus positivo que en el grupo rotavirus negativo (50,6% frente a 42,2%, p= 0,047). Las tasas de hospitalización de los casos con gastroenteritis por rotavirus en los niños con el grupo sanguíneo A (30,6% frente a 8%, p < 0,001) fueron significativamente más altas. Conclusiones. Se determinó que la gastroenteritis por rotavirus fue más frecuente en los niños con el grupo sanguíneo A. Se detectó que las tasas de hospitalización de estos pacientes fueron más altas. Por lo tanto, en los niños con el grupo sanguíneo A, podría ser necesario estudiar cuidadosamente la gastroenteritis por rotavirus.

Introduction. Rotavirus is the most common cause of severe diarrhea in children. There is only a few clinical studies about the relationship between rotavirus gastroenteritis and ABO blood groups. Objective. The aim of this study was to investigate the role of blood groups, if any present, in the incidence of rotavirus gastroenteritis, and the severity of the gastroenteritis. Methods. The file records of babies born in our hospital and diagnosed with acute gastroenteritis in their follow up were investigated retrospectively. Results. The study was conducted with 219 (36.3%) rotavirus positive and 383 (63.6%) rotavirus negative patients. The A blood group was detected more commonly in the rotavirus positive group compared to the rotavirus negative group (50.6 vs. 42.2%, p= 0.047). Hospitalization rates of the cases with rotavirus gastroenteritis among children with the A blood group (30.6 vs. 8%, p=˂0.001) were significantly higher. Conclusions. Rotavirus gastroenteritis was determined to be more common in children with A blood group. The hospitalization rates of such patients were detected to be higher. Therefore, rotavirus gastroenteritis among children with blood group A should be monitored closely.

Is there a relationship between rotavirus positive gastroenteritis and ABO blood groups?: a retrospective cohort study.

INTRODUCTION: Rotavirus is the most common cause of severe diarrhea in children. There is only a few clinical studies about the relationship between rotavirus gastroenteritis and ABO blood groups. OBJECTIVE: The aim of this study was to investigate the role of blood groups, if any present, in the incidence of rotavirus gastroenteritis, and the severity of the gastroenteritis. METHODS: The file records of babies born in our hospital and diagnosed with acute gastroenteritis in their follow up were investigated retrospectively. RESULTS: The study was conducted with 219 (36.3%) rotavirus positive and 383 (63.6%) rotavirus negative patients. The A blood group was detected more commonly in the rotavirus positive group compared to the rotavirus negative group (50.6 vs. 42.2%, p= 0.047). Hospitalization rates of the cases with rotavirus gastroenteritis among children with the A blood group (30.6 vs. 8%, p= 0.001) were significantly higher. CONCLUSIONS: Rotavirus gastroenteritis was determined to be more common in children with A blood group. The hospitalization rates of such patients were detected to be higher. Therefore, rotavirus gastroenteritis among children with blood group A should be monitored closely.

Retinal and choroidal thickness in children with familial Mediterranean fever.

PURPOSE: The aim of the present study was to evaluate retinal and choroidal thicknesses in children with familial Mediterranean fever (FMF). METHODS: Thirty patients with FMF and 28 healthy controls were included in the study. The thicknesses of the retina and choroid of each subject's right eye were measured at the fovea and horizontal nasal and temporal quadrants at 500-µm intervals to 1500 µm from the foveal center using spectral-domain optic coherence tomography. RESULTS: Retinal and choroidal thicknesses at the fovea did not differ between groups (p = 0.32 and p = 0.39, respectively). Horizontal nasal and temporal retinal and choroidal thickness measurements at 500-µm intervals to a distance of 1500 µm from the foveal center were also similar between the groups (all p > 0.05). CONCLUSIONS: The retinal and choroidal thicknesses of children with FMF do not differ from those of age- and sex-matched healthy controls.

Serum hepcidin levels and iron metabolism in obese children with and without fatty liver: case-control study.

UNLABELLED: Hepcidin is a regulator of iron balance that is increased in obesity. It reduces the absorption of iron, reduces the transfer of iron from macrophages to the plasma and/or prevents mobilisation of stored iron. Obese patients with non-alcoholic fatty liver disease (NAFLD) demonstrate adipokine and cytokine release promoting inflammatory response. We aimed to analyse the hepcidin levels and iron metabolism in obese children with and without NAFLD and non-obese healthy controls. The study population consisted of 110 children aged 7-18 years in three groups: 50 obese patients without NAFLD, 30 obese patients with NAFLD, and 30 non-obese healthy controls. Serum hepcidin, ferritin, and iron levels, iron-binding capacity, lipid profile, and liver function tests were measured, and hepatic ultrasonography was performed in all participants. Obese patients' white blood cell counts, total cholesterol, triglyceride levels, and homeostatic model assessment of insulin resistance (HOMA-IR) were significantly higher than those of the control group. Iron-binding capacity was significantly higher in obese patients without NAFLD compared with obese patients with NAFLD (p = 0.002). Hepcidin levels were not significantly different between obese patients and the control group. However, hepcidin levels in obese patients with NAFLD were significantly higher than those in obese patients without NAFLD (p < 0.001). CONCLUSIONS: Hepcidin levels were significantly higher in obese children with NAFLD than those without NAFLD. Obese children with NAFLD should receive attention regarding iron metabolism disorders. Serum hepcidin could be a marker of iron metabolism status and NAFLD in these groups of patients.

Vitamin D status in children with attention-deficit-hyperactivity disorder.

BACKGROUND: Attention-deficit-hyperactivity disorder (ADHD), one of the most common psychiatric disorders of childhood, has an early onset, affecting 2-18% of children worldwide. The etiopathogenesis of ADHD is obscure. In recent studies, a low level of vitamin D has been found in association with many disorders as well as in neuropsychiatric diseases. The aim of this study was therefore to investigate serum vitamin D level in pediatric ADHD patients. METHODS: A total of 60 ADHD patients and 30 healthy controls were included in the study. The age of both groups was in the 7-18-year-old range. Serum 25-OH-vitamin D, calcium, phosphorus and alkaline phosphatase were investigated. RESULTS: Serum 25-OH-vitamin D was found to be significantly lower in children and adolescents with ADHD compared to healthy controls, and no significant differences were found between the groups in terms of other variables. 25-OH-vitamin D level in the ADHD group and control group was, respectively, 20.9 ± 19.4 ng/mL and 34.9 ± 15.4 ng/mL (P = 0.001). CONCLUSION: There is an association between lower 25-OH-vitamin D concentration and ADHD in childhood and adolescence. To the authors' knowledge this is the first study to investigate the relationship between vitamin D and ADHD in children.

Is there a relationship between rotavirus positive gastroenteritis and ABO blood groups?: a retrospective cohort study. / Is there a relationship between rotavirus positive gastroenteritis and ABO blood groups?: a retrospective cohort study.

INTRODUCTION: Rotavirus is the most common cause of severe diarrhea in children. There is only a few clinical studies about the relationship between rotavirus gastroenteritis and ABO blood groups. OBJECTIVE: The aim of this study was to investigate the role of blood groups, if any present, in the incidence of rotavirus gastroenteritis, and the severity of the gastroenteritis. METHODS: The file records of babies born in our hospital and diagnosed with acute gastroenteritis in their follow up were investigated retrospectively. RESULTS: The study was conducted with 219 (36.3

) rotavirus positive and 383 (63.6

) rotavirus negative patients. The A blood group was detected more commonly in the rotavirus positive group compared to the rotavirus negative group (50.6 vs. 42.2

, p= 0.047). Hospitalization rates of the cases with rotavirus gastroenteritis among children with the A blood group (30.6 vs. 8

, p= 0.001) were significantly higher. CONCLUSIONS: Rotavirus gastroenteritis was determined to be more common in children with A blood group. The hospitalization rates of such patients were detected to be higher. Therefore, rotavirus gastroenteritis among children with blood group A should be monitored closely.

Molluscum contagiosum infection associated with pimecrolimus use in pityriasis alba.

Atopic dermatitis is an inflammatory, chronically relapsing, highly pruritic skin disorder that has considerable impact on the quality of life. As corticosteroids are not ideal for long-term control of the disease because of their potential side effects, steroid-free topical immunomodulators have recently been developed for the treatment of atopic dermatitis. Although clinical trials do not indicate an increased risk of cutaneous infection, the clinician must be careful about viral infections such as eczema herpeticum or molluscum eczema that can be observed during treatment with pimecrolimus and tacrolimus. We report molluscum contagiosum that developed on the preauricular area treated with topical pimecrolimus.

Actinomycotic suppurative thyroiditis in a child.

AIM: To present a rare case of actinomycotic suppurative thyroiditis in an infant with provision of the etiology, pathogenesis, clinical findings and treatment of this rare disease. DESIGN: A report of an 18-month-old female infant who presented with fever, erythema, induration and tenderness of the neck. The patient had the diagnosis of acute suppurative thyroiditis after a series of laboratory evaluation. RESULT: She was treated successfully with surgical debridement and intravenous penicillin G. CONCLUSION: Although rare, Actinomyces spp. should be considered in the etiology of acute suppurative thyroiditis. Because of its fastidious nature the probability of positive culture is low, thus, the microbiology laboratory should be called in advance to make preparations before culture and transport.