Short-term effects of ketogenic diet on anthropometric parameters, body fat distribution, and inflammatory cytokine production in GLUT1 deficiency syndrome.

OBJECTIVE: The aim of this study was to evaluate the effects of a 12-wk ketogenic diet (KD) on inflammatory status, adipose tissue activity biomarkers, and abdominal visceral (VAT) and subcutaneous fat (SAT) in children affected by glucose transporter 1 deficiency syndrome GLUT1 DS. METHODS: We carried out a short-term longitudinal study on 10 children (mean age: 8.4 y, range 3.3-12 y, 5 girls, 5 boys) to determine fasting serum proinflammatory cytokines (high sensitivity C-reactive protein, tumor necrosis factor-α interleukin-6), adipocyte-derived chemokines (leptin and adiponectin), lipid profile, homeostatic model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity index (QUICKI), anthropometric measurements, and VAT and SAT (by ultrasonography). RESULTS: Children showed no significant changes in inflammatory and adipose tissue activity biomarkers, blood glucose, lipid profile, anthropometric measurements, VAT, and SAT. Fasting insulin decreased (6 ± 3.2 µU/mL versus 3 ± 2 µU/mL; P = 0.001), and both HOMA-IR and QUICKI indexes were significantly modified (1.2 ± 0.6 versus 0.6 ± 0.4; P = 0.002; 0.38 ± 0.03 versus 0.44 ± 0.05; P = 0.002, respectively). CONCLUSIONS: Only HOMA-IR and QUICKI indexes changed after 12 wk on a KD, suggesting that over a short period of time KD does not affect inflammatory cytokines production and abdominal fat distribution despite being a high-fat diet. Long-term studies are needed to provide answers concerning adaptive metabolic changes during KD.

A case of Kawasaki disease with anasarca and concomitant rotavirus infection.

We present the case of a child who initially presented with gastrointestinal symptoms suggestive of severe rotavirus gastroenteritis complicated by hyponatraemic dehydration. Appropriate intravenous fluid therapy was administered but the patient, still feverish, developed anasarca probably due to hyperpermeability of microvessels following massive inflammation. Atypical Kawasaki disease was diagnosed on the basis of the clinical findings and laboratory tests. An echocardiogram performed on the 14th day showed a coronary artery aneurysm of the right coronary artery and a generalised dilation of left coronary artery without pericardial effusion. Anasarca in Kawasaki disease has never been reported before in the literature. A rotavirus infection probably triggered the severe and atypical signs in the case reported here.