[Von Willebrand factor and thrombomodulin as markers of endothelial cell functions in children with chronic viral hepatitis]. / Czynnik von Willebranda i trombomodulina jako wskazniki czynnosci sródblonka naczyn u dzieci chorych na przewlekle wirusowe zapalenie watroby.

INTRODUCTION: Vascular endothelial cells play an important role in haemostasis. Similar to hepatocytes they synthesise many substances taking part in blood clotting and fibrinolysis. OBJECTIVE: The aim of the study was the evaluation of markers of endothelial cells: von Willebrand factor (vWf) and thrombomodulin (TM) in children with chronic viral hepatitis. MATERIAL AND METHODS: VWf and TM levels were measured using ELISA method. The examined group consists of 105 children with chronic viral hepatitis aged 2 to 18 years. RESULTS: The concentrations of vWf and TM were significantly higher in chronic viral hepatitis compared to controls. The values of TM were higher in chronic viral hepatitis B in comparison to hepatitis C and higher in boys than in girls. The markers of endothelial cells do not depend on the degree of inflammation and fibrosis. CONCLUSION: Increased levels of vWf and TM suggest stimulation of endothelial cells in children with chronic viral hepatitis B and C.

[Prevalence of soya allergy in children with cow's milk allergy]. / Czestosc wystepowania uczulenia na bialka soi u dzieci z alergia na bialka mleka krowiego.

UNLABELLED: Because of contradictory data about the prevalence of soya allergy in children recommendations for the use of the protein-based formulas are ambiguous. THE AIM of the study was to estimate the prevalence of soya allergy in children with IgE-associated cow's milk allergy. MATERIAL: Ninety seven patients aged from six months to four years with personal history suggestive of food allergy with specific IgE to cow's milk protein attending the Department of Pediatrics, Allergology and Gastroenterology between 2000-2002 were studied. In all patients specific IgE to soya protein were detected. RESULTS: In 45% children with IgE-associated cow's milk allergy specific IgE to soya protein were detected. Clinical manifestation in both groups of children with or without specific IgE to soya protein was similar. Gastrointestinal tract symptoms were observed more often in children with cow's milk and soya allergy than in children with cow's milk allergy (52 and 42% respectively) and atopic dermatitis was observed more often in children with cow's milk allergy than in children with cow's milk and soya allergy (81 and 74% respectively). The incidence of respiratory tract symptoms in both groups of children was similar. The differences were not statistically significant. CONCLUSION: It seems, that hydrolyzed formulas should be the preferred choice for children because of a high prevalence of soya protein allergy in children with IgE- associated cow's milk allergy.

[Antithrombin III, protein C and protein S in children with chronic viral hepatitis B or C]. / Antytrombina III, bialko C i S u dzieci z przewleklym wirusowym zapaleniem watroby typu B lub C.

Abnormalities of blood coagulation are a major part of acute and chronic viral hepatitis. In this study antithrombin III, protein C and protein S were determined in 100 children with chronic hepatitis B or C infection (range age 3-17) according to degree of hepatic histological activity and fibrosis. There was no statistically significant correlation between levels of examined parameters in children with chronic viral hepatitis compared with those in control group and between the degree of hepatic histological activity and fibrosis and coagulation parameters.

[Flow cytometric analysis of peripheral blood lymphocytes in children with chronic gastroduodenitis with and without Helicobacter pylori infection]. / Ocena cytofluorymetryczna wartosci odsetkowych subpopulacji limfocytów we krwi obwodowej u dzieci z przewleklym zapaleniem blony sluzowej zoladka i dwunastnicy ze wspólistniejacym zakazeniem oraz bez zakazenia Helicobacter pylori.

The immune system plays an important role in chronic gastroduodenitis. A group of 70 children with chronic gastroduodenitis were subjected to examinations, including 42 children with H. pylori infection (group I) and 28 children without H. pylori infection (group II). Applying the method of flow cytometry, the per cent values of peripheral blood lymphocytic subpopulations were determined before and after treatment. The obtained results of examinations in group I were compared with those obtained in group II and were also compared with the standards given by Zeman for healthy children. On the basis of analysis of own material it was found that in both studied groups before and after the treatment lower per cent values were observed of CD3 and CD8 T-cells, NK CD56 cells and higher value of CD4 to CD8 T-cell ratio was disclosed as compared to healthy children. Comparing the per cent values of lymphocytic subpopulations in children with and without H. pylori infection it was found that in group I a higher per cent of CD4 T-cells, lower per cent of CD8 T-cells and, therefore, higher value of CD4 to CD8 T-cell ratio were present.

[Delayed diagnosis of dermatitis herpetiformis as a silent form of coeliac disease--a case report]. / Opóznione rozpoznanie choroby Dühringa jako niemej postaci celiakii--opis przypadku.

We report a difficulty in the diagnosis of silent form of coeliac disease in adult first degree relative with enteral and parenteral symptoms. The aim of the report was to attract non-paediatrician's attention to more frequent occurrence of coeliac disease in adults.

Assessment of iron metabolism in children with chronic hepatitis B -- prognostic factor in interferon alpha therapy.

BACKGROUND: The aim of the study was to assess iron metabolism in children with chronic hepatitis B and to establish whether it had any influence on the results of interferon alpha therapy. MATERIAL/METHODS: The study was carried out in a group of 38 children aged from 2 to 16 years with chronic hepatitis B diagnosed according to serological, biochemical and histopathological criteria. All the patients were treated according to the commonly adopted schedule: interferon alpha administered subcutaneously three times a week at 3 MIU doses for 20 weeks. During the therapy and one-year follow-up after its completion, biochemical liver function parameters, serological HBV markers, and iron and ferritin levels were monitored. RESULTS: The therapy resulted in obtaining seroconversion in the HBe system in 9 patients (23.68%). Liver bioptates in that group of patients demonstrated more advanced changes due to inflammatory activity and fibrosis processes, significantly higher values of alanine aminotransferase, lower serum levels of iron and ferritin with more pronounced difference in ferritin levels, although the differences reached no statistical significance. CONCLUSIONS: No disturbances of iron metabolism were observed in children with chronic hepatitis B. In the group of patients with detectable seroconversion in the Hbe system resulting from interferon alpha therapy, lower serum levels of iron and ferritin were observed. Routine determinations of serum iron and ferritin levels as a prognostic factor for positive response to interferon alpha seem to be of little use, especially in children, in whom no iron accumulation in liver tissue is observed in histopathological assessment of liver bioptates

Assessment of correlation between the presence of antiendomysial antibodies and small intestine mucosal villous atrophy in the diagnostics of celiac disease.

BACKGROUND: The aim of the study was to analyze the degree of correlation between the presence of serum antiendomysial antibodies and villous atrophy in small intestine mucosa in patients with celiac disease. MATERIAL/METHODS: Retrospective analysis carried out in a group of 88 children and young adults (28 males, 60 females aged from 2 to 23) hospitalized in the Clinic from 1990 to the present with positive results of serum antiendomysial antibody test performed because of suspected celiac disease. The IgA - EmA test was performed after determination of whole IgA level in the serum using indirect immunofluorescence technique with monkey esophagus as an antigen. All patients underwent endoscopic small intestine biopsy with histopathological assessment of mucosal bioptates using standard hematoxylin and eosin staining. RESULTS: The serum levels of IgA in all investigated patients were normal. The levels of antiendomysial antibodies expressed in IF units ranged from 10 to 40960. Histopathological assessment of small intestine mucosal bioptates revealed partial (in 13.6% of patients) or total (in 86.4% of patients) villous atrophy. CONCLUSIONS: The study demonstrated complete correlation between the presence of serum antiendomysial antibodies and villous atrophy in the small intestine mucosa.