Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis.

BACKGROUND: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. OBJECTIVES: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. METHODS: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. RESULTS: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. CONCLUSION: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

Most frequent causes of urinary tract infections in children.

AIM: to determine the most frequent causes of urinary tract infection (UTI) amongst children according to gender and age. METHODS: 299 children with urinary tract infections were evaluated. All of the cases were clinically evaluated and quantitative and qualitative examinations of the urine (culture with antibiogram) were done. RESULTS: There were 54.58% males and 45.15% females in the research group. Similar distribution was present in age groups: 1-28 days (67.86% male, 32.14% female), 1 month up to 1 year (64.56% male, 35.44% female), 2-6 years (55.29% male, 44.71% female). The only difference was found in the age group of 7-16 years where there were more female patients (56.07% female, 43.93% male). Based on microbiological findings, in 91.3o% of the cases only one species was isolated, and more than one species was isolated in 8.70% of cases. Escherichia coli was the most common cause of urinary tract infection (62.88%), the second most common was Klebsiella (23.080/%), followed by Proteus mirabilis (7.02%), Citrobacter(5.35%), Staphylococcus saprophyticus (1.34%) and Candida albicans (0.33%). E. coli was the most frequent causative of UTI amongst children of all ages. In the age group of newborns, E. coli was isolated as the etiological causative of UTI in 57.14% of cases. In the age group ofi month-1 year, E.coli was the most frequent cause of urinary tract infection (60.76%). In the age group of 2-6 years, E.coli was the most frequent cause of urinary tract infection (74.12%). In the age group of 7-16 years, E. coli was isolated in 59.81% of cases. Klebsiella was the second most frequent causative (23.08%) and with a higher incidence in the age group of newborns (42.86%). CONCLUSION: UTI was generally more present in male patients. E. coli was the most frequent cause of UTI in children of all age, while the second most frequent cause of UTI in children was Klebsiella.