Role of Soluble Adiponectin Receptor 2 in Non-Alcoholic Fatty Liver Disease in Children.

PURPOSE: The incidence of non-alcoholic fatty liver disease (NAFLD) in children is gradually increasing. The aim of this study was to investigate the use of serum adiponectin and soluble adiponectin receptor 2 (soluble Adipo R2) levels for the diagnosis of fatty liver disease in obese and overweight children. METHODS: The study included 51 obese and overweight children between the ages of 6 and 18 years diagnosed with NAFLD using ultrasonography and 20 children without fatty liver disease. Patients whose alanine transaminase level was two times higher than normal (≥80 U/L) were included in the non-alcoholic steatohepatitis (NASH) group. RESULTS: NASH was observed in 11 (21.6%) of the patients with NAFLD. The incidence of obesity was higher in patients with NASH (80% and 45%, p=0.021). While the adiponectin levels were similar in patients with NAFLD and those without, they were below the normal level in the whole study group. Adiponectin and soluble Adipo R2 levels of patients with NASH were lower than those in patients without NASH; however, this difference was not statistically significant (p=0.064 and p=0.463). Soluble Adipo R2 levels in obese patients with NAFLD were higher than those in obese children without NAFLD (p<0.001). CONCLUSION: Soluble adiponectin receptor 2 level is a noninvasive marker that can be used for the diagnosis of NAFLD in obese children.

Superficial temporal artery pseudoaneurysm: ultrasonographic diagnosis in the ED.

Superficial temporal artery pseudoaneurysm (STAP) is an uncommon complication of blunt and penetrating trauma. It accounts for only 1% of all traumatic aneurysms. Superficial temporal artery pseudoaneurysm usually has the characteristic appearance of a cystic pulsatile mass in the region of the superficial temporal artery. Here we present a case of posttraumatic STAP detected by US in the emergency department (ED). A 58-year-old woman presented to our ED with a tender right frontoparietal mass. Two weeks before presentation, the patient was involved in a motor vehicle accident (MVA) and was taken to the state hospital where the result of a computed tomography scan of the head was shown to be normal except for right frontoparietal soft tissue swelling and hematoma formation. A few days after discharge, the diameter of the soft tissue swelling decreased and the patient was well.However, 2 weeks after the MVA, the patient presented to our ED with a throbbing headache and dramatic increase in the diameter of the lesion. Examination showed a 5 x 5-cm swelling, which was soft, tender, and fluctuant on palpation. The swelling was not pulsatile. Ultrasound was performed using a 7.5-MHz probe and demonstrated a well-defined, pulsatile, anechoic mass measuring approximately 50 x 50 mm in diameter. Ultrasound is a valuable and readily available tool in the ED to confirm the diagnosis.