Brucella infection in a child with progressive familial intrahepatic cholestasis type 2 who had undergone liver transplantation.

Brucellosis is considered the most widespread zoonosis in the world. In endemic regions of brucellosis, childhood brucellosis includes up to one-third of all cases of human brucellosis. Brucellosis constitutes a public health problem in Turkey. A boy aged 12 yr who had PFIC2 had undergone deceased-donor liver transplantation in 2008 at the age of seven. The boy presented with fatigue, fever, and pain in the right leg and hip and was admitted to the hospital. Brucella melitensis grew in the blood culture, and the SAT was positive at a titer of 1:640. The patient was treated with oral doxycycline and rifampicin for eight wk. After treatment, the patient recovered and his blood cultures became negative. The patient's mother also had a high Brucella agglutination titer of 1:320 positive and was treated in the internal medicine department with spiramycin and doxycycline. Brucella infection should be suspected in liver transplant recipients with fever of unknown origin, especially in recipients who live in an endemic area.

Hepatoportal sclerosis in childhood: descriptive analysis of 12 patients.

Hepatoportal sclerosis (HPS) is defined as sclerosis of portal areas in the absence of cirrhosis. There is little information about HPS in children in the literature. The aim of this study was to describe the clinical presentation, associated disorders, laboratory characteristics and outcome of children who were diagnosed as HPS. This study included 12 children diagnosed as HPS by the Pathology Department between 2005 and 2011. Data were collected from the gastroenterology clinic charts retrospectively, including demographics, presentation characteristics, laboratory data and recent status of patients. Twelve patients were enrolled (6 girls, 6 boys). The median age of patients was 13.5 yr. Median age at the time of biopsy was 11 yr. Four patients had splenomegaly, 3 had esophageal varices, one had hepatopulmonary syndrome and had been transplanted. Smooth muscle antibody was found positive in 4 patients, without autoimmune hepatitis findings in liver biopsy. One patient had celiac disease and another patient had positive celiac disease serology but pathology findings. Another patient had Turner's syndrome. Mean follow-up time was 39 months (3.3 yr) after biopsy. Hepatoportal sclerosis does not necessarily present with portal hypertension in children.

Documented 2009 H1N1 Influenza A infection in pediatric liver transplant patients--description and follow-up of 7 patients.

BACKGROUND/AIMS: There is a paucity of data regarding pediatric liver transplant patients from Turkey and less so globally. We report here 7 pediatric cases with documented H1N1 nove Influenza A infection. MATERIAL AND METHODS: 7 pediatric liver transplant patients on immunesuppression, tested positive with PCR for 2009 H1N1 Influenza A, have been analyzed retrospectively. All patients were commenced oseltamivir treatment and 6 patients continued to take their immunosuppressive treatment. RESULTS: All patients (n=7) survived H1N1 novel Influenza A infection without any sequela. 1 patient has been admitted to Intensive Care Unit and has been discharged without any sequela. There was no graft dysfunction or loss during the infection episode. CONCLUSION: 2009 H1N1 Influenza A infection did not cause any mortality among our patients. Oseltamivir treatment may have played a role for improving in our patients' condition. Immunosuppression can be continued in pediatric liver transplant patients with close monitoring of vital signs and graft function.