Retrospective study recommends endoscopy when diagnosing lymphocytic colitis or eosinophilic gastrointestinal disorder in children with abdominal pain.

AIM: This study assessed the prevalence, clinical presentation and outcome of lymphocytic colitis (LC) and eosinophilic gastrointestinal disease (EGID) in children with severe, recurrent abdominal pain (RAP), by describing the predominant symptoms, diagnostic approaches and treatment options. METHODS: We performed a retrospective follow-up study at a Danish regional hospital by reviewing the histology reports of the children who had undergone gastrointestinal endoscopy for RAP. Data were retrieved from the medical records of those who met the diagnostic criteria for LC and, or, EGID from 2011 to 2016. The study population comprised 381 patients who underwent a diagnostic process to clarify RAP. RESULTS: A total of 74 patients (39 females) aged 2-17 years, with severe RAP as the most predominant symptom underwent gastrointestinal endoscopy. This identified 16/74 (21.6%) with LC (n = 6) and, or, EGID (n = 11), which equated to 4.2% with RAP. No biochemical patterns of abnormalities were found. Medical treatment and, or, diet generally induced and maintained clinical remission. CONCLUSION: We found 16 children with LC and, or, EGID. The predominant symptom was severe RAP. All patients had a macroscopically normal mucosa at endoscopy, a specific histopathological feature and no characteristic biochemical findings. Endoscopy should be considered in these cases.

[Fasciola hepatica infection acquired in Denmark].

In this case report, a 64-year-old woman with symptoms of lethargy, nausea, fluctuating temperature, and weight loss was suspected of a disease of cardiological or haematological aetiology. She was diagnosed with liver fluke infection based on serological evidence, eosinophilia, relevant exposure, and clinical presentation. High-dose triclabendazole led to symptom resolution. On several occasions, she had been eating watercress from a meadow with grazing sheep. The tendency of eating raw watercress and other green plants collected in nature confers an increased risk of developing liver fluke infections.

Early childhood-onset restless legs syndrome: symptoms and effect of oral iron treatment.

AIM: To describe symptoms of restless legs syndrome (RLS) in early childhood and the effect of oral iron treatment. METHODS: A study population comprising 22 children, 15 males and seven females referred for paediatric evaluation because of sleep disturbances. Presence of RLS was evaluated using the International RLS Study Group consensus criteria of RLS. In case of ferritin level below 50 ng/mL, oral iron treatment was initiated. Fourteen were examined by polysomnography as well, and periodic limb movement index during sleep (PLMSI) was calculated. Relief of symptoms was recorded by the parents and correlated with ferritin levels and PLMSI. RESULTS: Median age at onset of symptoms was 7.5 months (0-40 months). The most striking single symptom was awakening after 1-3 h of sleep followed by screaming, crying, kicking or hitting the legs. Oral iron supplementation had a positive ferritin-concentration-dependent clinical effect. A relation between high PLMSI and low ferritin levels was demonstrated. CONCLUSION: Symptoms of RLS may start as early as the first year of life, are accompanied by low ferritin levels and a high PLMSI and can be ameliorated by iron supplementation. An increased awareness and knowledge of RLS in early childhood are warranted.

[Periodic fever--two children with periodic fever, aphthous stomatitis pharyngitis, adenitis syndrome]. / Periodisk feber--to børn med periodisk feber, aftøs stomatitis, faryngitis, adenitis-syndrom.

PFAPA (periodic fever, aphthous stomatitis, pharyngitis, adenitis) syndrome is characterised by episodes of fever (>40 degrees C), lasting 4-5 days and recurring every 3-6 weeks, accompanied by aphthous stomatitis, pharyngitis or cervical adenitis. Between the episodes of fever there are no symptoms. Glucocorticoids are highly effective in controlling the symptoms, while tonsillectomy results in remission. We describe two children with PFAPA syndrome. Early diagnosis can significantly improve the patients' quality of life.

[Pyomyositis in children--a diagnostic challenge!]. / Pyomyositis hos børn--en diagnostisk udfordring!

This report describes two children with fever and musculoskeletal pain diagnosed as pyomyositis, an acute bacterial infection in skeletal muscles that produces diffuse inflammation and suppuration. The diagnosis is reported with increasing frequency in non-tropical areas. The condition should be kept in mind in cases of musculoskeletal pain, fever and general malaise, and MRI should be performed to verify the diagnosis. S. aureus is the most commonly responsible organism. Cure is usually achieved through relevant antibiotic therapy, combined with drainage in case of suppuration. Early diagnosis and treatment are crucial to a good prognosis.

[Rhabdomyosarcoma in the urogenital region of a child]. / Rabdomyosarkom i urogenitalregionen hos et barn.

We describe a relatively rare case of botryoid rhabdomyosarcoma (RMS) in a 15-month-old female presenting with fever, abdominal pain, urinary retention, haematuria and a tumour protruding through the urethra. The diagnosis was verified by cystoscopy with biopsy and MRI. She was treated with combined chemotherapy and surgery. Early diagnosis and treatment are crucial to the prognosis. RMS should be considered as a differential diagnosis in cases whose symptoms include urinary retention, haematuria, urinary incontinence and atypical abdominal pain, and a primary ultrasound scan should be done. Cystoscopy and MRI should be considered, especially in cases involving atypical urological symptoms.