Hemophagocytic Lymphohistiocytosis Associated With Hemolytic Uremic Syndrome in a Child: A Case Report and Systematic Literature Review.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder resulting from excessive activation and nonmalignant proliferation of T-lymphocytes and macrophages. Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Reports pertaining to the association between HLH and HUS are rarely published; however, we report on a 4-year-old boy who was diagnosed with both conditions and treated successfully with high-dose steroid and intravenous immunoglobulin. Differentiating HUS from HLH can be challenging because of their clinical similarities. Therefore, prompt diagnosis and immunosuppressive treatment are essential and life-saving to these patients.

Hepatitis A seroprevalence and demographics in Turkish children in Ankara.

BACKGROUND: Hepatitis A virus (HAV) is the most common cause of hepatitis in childhood and an important public health problem. The objective of the present study was to determine the seroprevalence of hepatitis A and patient demographics in children between 1 and 15 years old who were admitted to a pediatric outpatient clinic in Ankara, Turkey. METHODS: Hepatitis IgM and G antibodies were determined in the sera of children who attended the outpatient clinic. Informed consent was obtained from all subjects or their parents. RESULTS: The mean age of the children (n = 335) was 7.9 +/- 2.1 years; 47.5% of them were girls. The overall anti-HAV IgG prevalence in children aged 1-15 years was 47.2%. The positivity of hepatitis A IgM was highest in the 6-10 years age group (22.7%; P < 0.001). HAV IgG was highest in the 11-15 years age group (69.4%; P < 0.001). A total of 95.6% of the children had social insurance, 49.3% were living in poverty. The socioeconomic level of 82.4% of subjects was low. The history of hepatitis in their families was 6.9%. CONCLUSIONS: Hepatitis A is intermediate endemic in Ankara and children must be vaccinated before school age, in addition to health education and improved sanitation.