Health-Related Quality of Life in Pediatric Liver Transplant Recipients.

BACKGROUND: Health-related quality of life (HRQoL) of liver transplantation (LT) recipients has been widely studied because of increased patient longevity. However, studies in developing countries are scanty. We aimed to evaluate psychometric properties of the Thai version of the PedsQL Transplant Module and used it to determine the HRQoL in LT children. METHODS: We included children aged 2 to 18 years who underwent LT more than 1 year previously. The phase 1 study included a cognitive interview with 20 LT children and their parents using the Thai version of PedsQL Transplant Module and revised the module accordingly. Then, the finalized version was evaluated for psychometric properties in 50 LT children. In phase 2, HRQoL was evaluated in 52 LT children who did not participate in the phase 1 study. RESULTS: In the Thai PedsQL Transplant Module, both parent report and child self-report had good internal consistency (α = 0.94 and 0.93, respectively) and substantial reliability (interclass correlation coefficient = 0.82 and 0.77, respectively). Median HRQoL scores from the parent report and child self-report were 80 (interquartile range [IQR], 70, 88) and 77 (IQR, 71, 88), respectively. From the parent report, lower HRQoL was associated with opportunistic viral infection (P = .004) and correlated with a greater number of immunosuppressive agents (ρ = -0.346, P = .014). However, none of these factors were significant according to the child self-report. CONCLUSIONS: The Thai PedsQL Transplant Module has satisfactory psychometric properties. Post-LT children have good HRQoL. To improve their HRQoL, specific attention should be focused on managing viral infection and optimizing immunosuppressive therapy.

First pediatric case of Chromobacterium haemolyticum causing proctocolitis.

Bloody diarrhea in children is usually due to either infectious or inflammatory etiology, but infection is far more common than inflammatory bowel disease in children worldwide. If, however, the patient has unfavorable response to antibiotics and a definite infectious agent has yet to be identified; colonoscopy should be performed. The current patient presented with acute onset of mucous bloody diarrhea. Stool culture was initially identified as Vibrio mimicus and later identified as Aeromonas schubertii but the biochemistry did not fit well with either organism. After a prolonged course of hematochezia despite i.v. antibiotics, colonoscopy was performed that showed inflammation in the rectosigmoid area. Meanwhile, the final biochemistry tests and 16s rRNA sequencing of the organism confirmed Chromobacterium haemolyticum infection. Twelve weeks after the initial colonoscopy, repeat colonoscopy showed post-infectious colitis. Herein we report on the first pediatric case of C. haemolyticum infection causing proctocolitis.