Pubertal status of children with congenital heart disease.

BACKGROUND: CHD influences many aspects of life in affected individuals. Puberty, a major aspect of development, is a concern for patients and families. OBJECTIVES: We investigated pubertal status in children and adolescents with CHD. METHODS: Patients with CHD aged 6-18 were enrolled. Cardiac diagnoses were confirmed using history, examination, and paraclinical tools including echocardiography. An endocrinologist determined pubertal stages, and the second Tanner stages for pubarche (P2), thelarche (B2), and gonadarche (G2) were considered as the pubertal onset. A study with a large sample size on pubertal onset in a normal population was used for comparison. RESULTS: Totally, 451 patients (228 girls and 223 boys) at a median (10th-90th percentile) age of 10.79 (8.02-14.28) years for the girls and 10.72 (8.05-14.03) years for the boys were enrolled. The median (10th-90th percentile) ages at B2 and P2 in the girls with CHD were 10.77 (9.55-12.68) and 10.53 (9.39-12.28) years, respectively, which were higher than the median ages of 9.74 (8.23-11.94) and 10.49 (8.86-12.17) years in the normal girls.The median (10th-90th percentile) ages at G2 and P2 in the boys with CHD were 11.04 (8.85-13.23) and 11.88 (9.78-13.46) years, correspondingly, which were higher than the median ages of 9.01 (6.00-11.84) and 10.34 (6.84-13.10) years in the normal boys. CONCLUSIONS: Pubertal onset could be delayed in children with CHD when compared with the normal population.

Comparison of tuberculin skin test and interferon gamma release assay in pediatric candidates of heart transplantation and a 2-year follow-up.

BACKGROUND: Currently, tuberculin skin test (TST) and interferon gamma release assay (IGRA) are used to find the latent tuberculosis infection (LTBI) cases in the candidates of heart transplantation. Therefore, this study aimed to compare TST and IGRA to diagnose LTBI in pediatric heart transplant candidates. METHODS: This cross-sectional study was performed on 50 children, who were candidates for heart transplantation, of whom 42 cases underwent heart transplantation in Shahid Rajaie Cardiovascular, Medical, and Research center, Tehran, Iran, from 2016 to 2017. RESULTS: Participants of the study included 24 male patients (%48) (p-value = 0.67). The mean age of the patients was 8.18 ± 4.27 years (1-16 years). According to the results, IGRA was negative in all patients, and no indeterminate result was reported, while the purified derivative test (PPD) was positive in three (6%) cases. In comparison with QFT, an accuracy of 94% was achieved for TST to diagnose Mycobacterium tuberculosis infection. CONCLUSIONS: It seems that TST can still be used as an accurate test for screening LTBI in pediatric candidates for heart transplantation.