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BACKGROUND: Recurrent aphthous stomatitis (RAS) is one of the most common diseases of the oral mucosa and may be related to vitamin deficiencies or systemic diseases such as celiac disease (CD). The aim of this study was to investigate the frequency of hematinic deficiency and CD in children with RAS. METHODS: The medical records of patients diagnosed with RAS were reviewed for the presence of hematinic deficiencies (hemoglobin, mean corpuscular volume, ferritin, vitamin B12 , folic acid), and CD. The study group included 108 children with RAS and 57 healthy children who were evaluated for hematological abnormalities in routine evaluation. RESULTS: The frequency of a family history of RAS was significantly higher in the RAS group compared to the control group (34.2% vs 7%, respectively; P < 0.001). A hematological abnormality was detected in 32.4% of the RAS group and 10.5% of the control group (P = 0.02). The prevalence of iron deficiency anemia was significantly higher in the RAS group (P = 0.037). Three (2.7%) patients with RAS were diagnosed with CD, which is a significantly higher frequency than that observed in healthy children in Turkey (P < 0.01; OR 6.03, 95% CI [2.37, 4.56]). These children had mild malnutrition, iron deficiency, and iron deficiency anemia. CONCLUSIONS: Children with RAS should be evaluated for nutritional status and hematological indices, and in the case of hematological abnormalities and malnutrition screening for CD should be considered.
Assuntos
Anemia Ferropriva/epidemiologia , Doença Celíaca/epidemiologia , Deficiência de Ácido Fólico/epidemiologia , Estomatite Aftosa/epidemiologia , Deficiência de Vitamina B 12/epidemiologia , Adolescente , Doença Celíaca/sangue , Criança , Pré-Escolar , Índices de Eritrócitos , Feminino , Ferritinas/análise , Hemoglobinas/análise , Humanos , Lactente , Masculino , Estado Nutricional , Estomatite Aftosa/sangue , Turquia/epidemiologiaRESUMO
OBJECTIVE: Cytomegalovirus (CMV) infection may rarely lead to protein-losing gastropathy that presents with nausea, vomiting, abdominal pain, and edema in immunocompetent children, but extremely rarely with only generalized edema. CLINICAL PRESENTATION AND INTERVENTION: A previously healthy 5-year-old boy presented with generalized edema without any other symptoms. He had hypoalbuminemia but no proteinuria. He was evaluated for gastrointestinal protein loss, and hypertrophic gastropathy was revealed on esophagogastroduodenoscopy. Meanwhile, CMV infection was detected by serologic tests and polymerase chain reaction in the blood. He recovered spontaneously within a week. CONCLUSION: CMV-related protein-losing gastropathy may present with generalized edema without any gastrointestinal symptoms.
Assuntos
Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/diagnóstico , Edema/complicações , Criança , Citomegalovirus/isolamento & purificação , Humanos , MasculinoRESUMO
BACKGROUND: We aimed to evaluate children who presented with electrical injury to the emergency department. We tried to reveal the complications of these patients and the measures to be taken in this regard. METHODS: Medical records of pediatric patients who were admitted with electrical injury to emergency department between January 2007 and January 2012 were retrospectively reviewed. An information form was completed about demographic data, clinical features, exposure place, electrical current type, clinical course, duration of hospitalization, electrocardiography, echocardiography and other systems findings. RESULTS: Children who were the most exposed to electrical injury were children 4 years and under. While low-voltage current exposure was more common in younger ages, high-voltage current exposure was more common in older ages. Most of our patients (%72) were exposed to low voltage. Patients who exposed to high-voltage electricity had significantly higher levels of CPK, CK-MB, LDH, AST, and ALT compared to patients who were exposed to low voltage electricity. None of the patients have died. CONCLUSION: Young children are often exposed to electric shock at home. Increasing precautions to be taken at home reduces electrical shock injuries. Children and especially families should be educated in this regard.
Assuntos
Traumatismos por Eletricidade/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Prontuários Médicos/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Ecocardiografia , Traumatismos por Eletricidade/diagnóstico , Eletrocardiografia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Índices de Gravidade do Trauma , Turquia/epidemiologiaRESUMO
Immunoglobulin therapy can be used to treat a wide variety of diseases. However, intravenous immunoglobin products can cause several adverse reactions, including hemolysis. The objective of this study was to determine the extent of anemia and hemolysis after high dose intravenous immunoglobin (2g/kg) and its relationship to the ABO blood type system and hemolytic anemia blood parameters in pediatric patients. Incidence of 'Intravenous immunoglobulin related hemolysis' was %19 (6/31) after high dose intravenous immunoglobulin therapy. The blood parameters were measured before IVIG infusion (1-24h before infusion) and 3-10 days after the first day of infusion. In terms of decrease in Hb levels; decline of <1g/dL was detected in 25 patients (80.6%), ≥1g/dL in 2 patients (6.5%) and >2g/dL (severe hemolysis) in 4 patients (12.9%) after infusion. The decrease in hemoglobin, haptoglobin levels, the increase of reticulocyte count or direct bilirubin were statistically significant after infusion. Five of 6 hemolysis patients had non-O blood group, however statistically significant difference was not noted between these two groups. Also, intravenous immunoglobulin-related hemolysis was determined significantly higher in female than male patients. CONCLUSION: Mild to moderate hemolysis may be undetected after infusion and the true incidence of such reactions is difficult to document without careful clinical and laboratory follow-up. A careful risk assessment analysis should be performed before intravenous immunoglobulin infusion.
Assuntos
Sistema ABO de Grupos Sanguíneos/sangue , Anemia , Hemólise/efeitos dos fármacos , Imunoglobulinas Intravenosas/efeitos adversos , Adolescente , Anemia/sangue , Anemia/induzido quimicamente , Anemia/epidemiologia , Anemia/terapia , Criança , Pré-Escolar , Feminino , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Incidência , Masculino , Estudos ProspectivosRESUMO
UNLABELLED: Castleman disease (CD) is a rare poorly understood lymphoproliferative disorder. Pediatric onset CD has been reported before. However, most of them have benign unicentric pattern. Multicentric CD (MCD) is quite rare in children. Herein, we report a 13-year-old adolescent boy with MCD of the hyaline vascular variant presenting with pleural and pericardial effusion, which is an uncommon presentation. CONCLUSION: MCD should be considered in the differential diagnosis of pleural and/or pericardial effusion with unexplained lymph nodes in children. What is Known â¢Pediatric Castleman disease (CD) most commonly occurs in the unicentric form, which typically is asymptomatic and cured by lymph node excision. â¢The diagnosis of MCD can be difficult owing to the heterogeneity of presentation and potential for nonspecific multisystem involvement. What is New â¢A 13-year-old adolescent boy was diagnosed with MCD of the hyaline vascular variant presenting with pleural and pericardial effusion, which is an uncommon presentation. â¢In a pediatric patient with fever, pleural-pericardial effusion and multiple lymph nodes, MCD should be considered in differantial diagnosis.
Assuntos
Hiperplasia do Linfonodo Gigante/complicações , Derrame Pericárdico/etiologia , Derrame Pleural/etiologia , Adolescente , Hiperplasia do Linfonodo Gigante/diagnóstico , Diagnóstico Diferencial , Ecocardiografia , Humanos , Masculino , RadiografiaRESUMO
CDA are a group of inherited, rare diseases that are characterized by dyserythropoiesis and ineffective erythropoiesis associated with transfusion dependency in approximately 10% of cases. For these latter patients, the only curative treatment is HSCT. There are very limited data on HSCT experience in this rare disease. Herein, we report a five-yr six-month-old girl with compound heterozygous mutations in SEC23B gene, who was diagnosed to have CDA type II and underwent successful HSCT from her matched sibling donor.
Assuntos
Anemia Diseritropoética Congênita/terapia , Transplante de Células-Tronco Hematopoéticas , Anemia Diseritropoética Congênita/genética , Pré-Escolar , Feminino , Marcadores Genéticos , Heterozigoto , Humanos , Mutação , Irmãos , Proteínas de Transporte Vesicular/genéticaAssuntos
Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Intoxicação por Monóxido de Carbono/sangue , Intoxicação por Monóxido de Carbono/terapia , Oxigenoterapia Hiperbárica/métodos , Imageamento por Ressonância Magnética/métodos , Acidentes Domésticos , Carboxihemoglobina/análise , Criança , Seguimentos , Escala de Coma de Glasgow , Humanos , Masculino , Medição de Risco , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Ocular findings are rarely the initial symptom of leukemia, although up to 90% of all leukemia patients have fundus changes during the course of the disease. Herein we report a relapsing acute lymphoblastic leukemia patient with thesole presentation of sudden visual loss and exudative retinal detachment. An 8-year-old boy with acute lymphoblasticleukemia developed sudden visual loss during his first remission period. Bullous retinal detachment with total afferentpupillary defect was observed. Orbital magnetic resonance imaging revealed an intraocular mass lesion; simultaneouslyobtained bone marrow and cerebrospinal fluid samples showed no evidence of leukemic cells. Following local irradiation,and systemic and intrathecal chemotherapy the mass disappeared. Local irradiation, and systemic and intrathecalchemotherapy effectively controlled the isolated ocular relapse of acute lymphoblastic leukemia and eliminated the needfor enucleation.
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BACKGROUND: Iron deficiency anemia causes a decrease in immune response to infections, physical working capacity and response to metabolic stress. It also causes behavioral, perceptual and cognitive disorders. Therefore, as soon as iron deficiency anemia is diagnosed, it should be treated immediately. In this study, it was investigated retrospectively whether there was a difference in treatment efficacy between the administration of oral ferrous or ferric iron and vitamin D at the same time and at different time. METHODS: A total of sixty patients under 1 year who attended the pediatrics outpatient clinic for pale and diagnosed with iron deficiency anemia. Patients were randomly divided into 4 groups. Anemia was defined as hemoglobin below <2 SD according to age and gender. Iron deficiency was definied with serum iron, iron-binding capacity, ferritin and transferin saturation below the range for age and gender appropriates. All patients were seen at the outpatient clinic for 1st, 3rd month of the treatment. RESULTS: There were statistically significant differences between the groups in terms of increase in Hb values according to time (1st month, 3rd month, 1st and 3rd month). There was no statistically significant difference between the groups in terms of the recovery of anemia after treatment. CONCLUSIONS: It was concluded that iron treatment in babies with iron deficiency anemia is not affected by the administration of vitamin D prophylaxis at the same time or at different times, and therefore both treatments can be administered at the same time to increase drug compliance.
Assuntos
Anemia Ferropriva , Anemia , Lactente , Criança , Humanos , Anemia Ferropriva/complicações , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/prevenção & controle , Estudos Retrospectivos , Ferro/uso terapêutico , Anemia/complicações , Anemia/tratamento farmacológico , Hemoglobinas/análise , Hemoglobinas/uso terapêutico , Vitamina D/uso terapêuticoRESUMO
OBJECTIVES: To determine vitamin D supplementation frequency among children aged 1-24 months, factors that influence adherence, and reasons for discontinuation of initiated vitamin D. METHODS: This cross-sectional study was conducted using a questionnaire administered to the mothers via face-to-face interview of 560 children aged from 1 to 24 months admitted to outpatient clinics from June to December 2017. RESULTS: A total of 351 children were administered vitamin D, and the rate of supplementation in the first year of life was 83%, while it was only 28% between 13 and 24 months. The rate of vitamin D supplementation was higher among exclusively formula-fed children (p < .05). When the data were analyzed using logistic regression analysis, only visit family physicians were statistically significant independent variable in increasing supplementation (p < .05). Compared with family refusal, the rate of discontinuation of vitamin D by the healthcare providers was higher after the first year of life (p < .05). The rate of vitamin D discontinuation by healthcare providers, especially by nurses who considered the duration of supplementation adequate, was statistically significantly higher when compared with the fontanel closure and other independent variables (p < .05). CONCLUSION: The rate of vitamin D supplementation was higher among families who visited family physicians, which suggests the importance of well-baby visits. Since vitamin D supplementation was less common among exclusively breastfed children, mothers should be educated. Healthcare professionals need further education about the importance of vitamin D supplementation and indications for discontinuation.
Assuntos
Deficiência de Vitamina D , Vitamina D , Aleitamento Materno , Criança , Pré-Escolar , Estudos Transversais , Suplementos Nutricionais , Feminino , Humanos , LactenteRESUMO
INTRODUCTION: Arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome is a rare multisystem disorder first described in 1979 and recently ascribed to mutation in VPS33B whose product acts in intracellular trafficking. It exhibits wide clinical variability. Arthrogryposis, spillage of various substances in the urine, and conjugated hyperbilirubinemia define an ARC core phenotype, in some patients associated with ichthyosis, central nervous system malformation, deafness, and platelet abnormalities. Many patients with different associations of cholestasis, renal tubular acidosis, and dysmorphic morphology may be underdiagnosed. CASE REPORT: We report the third patient of ARC syndrome from Turkey with an incomplete form with renal tubular dysfunction and cholestasis in the absence of arthrogryposis but exhibiting other rare features. CONCLUSION: Our case highlights that the variability of involvement of different systems in ARC syndrome is well described; however, the renal glomerulocystic appearance has not been reported previously. Knowledge of this rare condition can benefit the practitioner as well as the patient.
Assuntos
Anormalidades Múltiplas , Artrogripose , Luxação Congênita de Quadril , Doenças Renais Císticas , Erros Inatos do Transporte Tubular Renal , Evolução Fatal , Feminino , Fraturas Espontâneas/congênito , Humanos , Hiperbilirrubinemia Neonatal , Recém-Nascido , Doenças Renais Císticas/patologia , Erros Inatos do Transporte Tubular Renal/patologia , Síndrome , TurquiaRESUMO
A 10-year-old boy with unilateral ophthalmoplegia, ptosis, and proptosis underwent diagnostic examination. Symptoms of headache, nausea, dyspnea, fatigue, weakness, and loss of appetite began 14 days after the onset of ocular manifestations and 7 days before he was examined. Complete blood count showed an increased white blood cell count with 64% blast cells, anemia, and thrombocytopenia. The patient was transferred to a pediatric hematology unit, where he underwent bone marrow aspiration biopsy. Bilateral ocular inflammatory findings and left-sided mild proptosis became evident. He was diagnosed as having B-cell non-Hodgkin lymphoma infiltrating the bilateral cavernous and sphenoid sinuses.
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Seio Cavernoso/patologia , Exoftalmia/etiologia , Linfoma de Células B/diagnóstico , Oftalmoplegia/etiologia , Biópsia por Agulha Fina , Medula Óssea/patologia , Criança , Diagnóstico Diferencial , Exoftalmia/diagnóstico , Citometria de Fluxo , Humanos , Linfoma de Células B/complicações , Imageamento por Ressonância Magnética , Masculino , Oftalmoplegia/diagnóstico , SíndromeRESUMO
The aim of this study was to elucidate the pathologic sequence changes and associated clinical phenotypes in 9 new patients showing homozygosity for perforin gene among a total of 37 (24%) Turkish FHL families studied by linkage analysis. These 9 unrelated patients (5M/4F) were coming from consanguineous families and their presentation ages of systemic symptoms were ranged from birth to 15 years. Direct sequencing of coding exons of the perforin gene led to the identification of five different homozygous alterations. The nonsense W374X mutation was identified in three patients while four different missense mutations namely G149S, V50M, A91V and novel A523D were detected in the rest six patients.
Assuntos
Códon sem Sentido/genética , Predisposição Genética para Doença , Linfo-Histiocitose Hemofagocítica/genética , Mutação de Sentido Incorreto/genética , Perforina/genética , Adolescente , Criança , Pré-Escolar , Consanguinidade , Feminino , Ligação Genética , Homozigoto , Humanos , Lactente , Recém-Nascido , Linfo-Histiocitose Hemofagocítica/epidemiologia , Masculino , Turquia/epidemiologiaRESUMO
Brucellosis is a disease transmitted to humans by consumption of unpasteurized animal milk, or through direct contact with infected animals. The aim of this study was to evaluate clinical, laboratory findings of pediatric patients with brucellosis. Data of 97 patients diagnosed with brucellosis between January 2000 and December 2010 were evaluated retrospectively.
Assuntos
Brucelose/patologia , Adolescente , Animais , Criança , Pré-Escolar , Técnicas de Laboratório Clínico , Feminino , Humanos , Masculino , Estudos Retrospectivos , TurquiaRESUMO
INTRODUCTION: Hepatitis A is the most common form of acute viral hepatitis worldwide, especially in children. The clinical severity of the hepatitis A virus (HAV) infection varies from an asymptomatic infection to a fulminant disease. In this study, we aimed to evaluate characteristics of pediatric patients diagnosed with HAV infection. METHODOLOGY: Patients younger than 18 years of age admitted between January 1, 2006 and January 1, 2011 to our hospital, an important reference center located in the middle part of Turkey, diagnosed as having hepatitis A were evaluated. RESULTS: Of 427 patients, 49.4% were female and 50.6% were male. Hospitalization rate of the patients was 28.3%. The reason for hospitalization was vomitting in 58.7% of the patients and abdominal pain in 28%. The mean time of hospitalization was 5.2 ± 4.5 (1-40) days. There was no significant difference in hospitalization time by age. Vomiting and abdominal pain were significantly more common, and PT and aPTT levels were significantly elevated in patients with elevated AST and ALT levels over 1000 IU/L (p < 0.001). PT elevation was present in 15.2% of the patients, aPTT elevation in 11.9%, leukopenia in 16.6%, and thrombocytopenia in 2.6%. In terms of atypical course, four patients (0.9%) had cholestatic hepatitis, one had recurrent hepatitis, and one had fulminant hepatitis, yet no mortality was observed. CONCLUSIONS: Atypical courses of hepatitis A were more scarce in pediatric patients, but careful follow-up of patients with AST and ALT levels > 1000 IU/L is necessary.
Assuntos
Vírus da Hepatite A/isolamento & purificação , Hepatite A/patologia , Adolescente , Análise Química do Sangue , Criança , Pré-Escolar , Feminino , Hepatite A/diagnóstico , Hepatite A/virologia , Humanos , Lactente , Masculino , Estudos Retrospectivos , TurquiaRESUMO
OBJECTIVE: Pseudotumor cerebri (PTC) is diagnosed at increasing rates probably due to the increase in obesity prevalence all over the world and awareness about the disease. Our aim in this study was to evaluate the PTC clinical picture and etiological factors in children at the present time. METHOD: The records of 53 patients with 32 females, who were diagnosed with PTC in a child neurology department between the years of 2005 and 2012 were retrospectively analyzed. RESULTS: The mean age at presentation was 10.9 years (3-17 years) and approximately half of patients were aged of 11 years or less. While more than half of prepubertal patients were male, girls rate reaches 74% at puberty. An etiological factor such as venous sinus thrombosis, infections, anemia, steroid discontinuation, drugs, slit ventricle syndrome and minor head injury causing the PTC was identified in 43% of the patients. The mean duration of treatment was 6.4 months (3-24 months) and the mean follow-up duration 16.5 months (3-52 months). Visual field constriction was moderate in only two pubertal and obese female patients and mild in four patients. CONCLUSIONS: PTC is seen in prepubertal children as often as in puberty. An etiological factor causing PTC is present in about half the patients in childhood. The main etiological factors of the disease currently consist of cranial venous thrombosis, infections, anemia and drugs. Malnutrition, renutrition and related vitamin deficiencies or excesses commonly seen previously have become less important in PTC etiology. PTC is a disease that requires long-term treatment and follow-up but the prognosis is good in patients who are diagnosed early, receive appropriate treatment and show good compliance with the treatment.
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Pseudotumor Cerebral/diagnóstico , Pseudotumor Cerebral/epidemiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Papiledema/epidemiologia , Prognóstico , Pseudotumor Cerebral/etiologia , Estudos Retrospectivos , Centros de Atenção Terciária , Campos VisuaisRESUMO
The aim of this study was to evaluate the causes of thrombocytosis, which was defined as a platelet count greater than 500 x 10(9)/L, and to compare the groups with mild and severe thrombocytosis. A total of 484 patients were evaluated for the etiology of thrombocytosis. Patients with a platelet count between 500-800 x 10(9)/L were considered to have mild thrombocytosis, while those with a count of ≥800 x 10(9)/L were considered as having severe thrombocytosis. Of 484 patients included, 63% had thrombocytosis due to an infectious disease, 11.4% had a chronic inflammatory condition, 8.5% had anemia, and 5.2% had tissue injury. The frequency of chronic inflammation was higher in the severe thrombocytosis group compared to the mild thrombocytosis group (p=0.006). In conclusion, severe infections and chronic inflammatory conditions should be considered in the differential diagnosis of a patient with severe thrombocytosis.
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Infecções/complicações , Inflamação/complicações , Trombocitose/etiologia , Adolescente , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Recém-Nascido , Masculino , Contagem de Plaquetas , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Trombocitose/sangue , Trombocitose/diagnósticoRESUMO
BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) virus causes a severe disease in humans with a mortality up to 30%. In Turkey there has been an increase in the number of cases during years since 2002. Humans of all ages living in endemic areas,especially those who are working as shepherds and toddlers, have high risk of acquiring CCHF. OBJECTIVES: The epidemiological, clinical, and laboratory characteristics of the children, who were diagnosed as Crimean-Congo hemorrhagic fever (CCHF) were described. STUDY DESIGN: The children infected with CCHF virus between April 2008 and October 2009, and hospitalised in Ankara Diskapi Children's and Research Hospital were included. RESULTS: Laboratory diagnosis was set by detection of CCHF IgM antibodies and/or genetic detection of CCHF virus. Thirtyone cases included to the study, and all were from the northeastern Anatolia and the southern parts of Black sea region. The mean age was 9.45+/-4.9 years, the proportion of females was 38.7%. The majority (87%) of the cases had the history of tick bite. There was no fatal case. All the patients had the history of fever. Malaise,tonsillopharyngitis, nausea-vomiting, headache, diarrhea, myalgia and rash were the most common symptoms. The mean AST and ALT levels on the admission were 116 (range 25-389) and 61 (range 8-180)U/L respectively. The mean platelet count on admission was 125,000/mm3, and the lowest was 23,000/mm3. The mean of the lowest white blood cell count was 2353/mm3 and the mean of the highest lactate dehydrogenase was 861IU/L. CONCLUSIONS: The clinical course of CCHF among children seems to be milder than in adults. Tonsillopharyngitis is a common symptom among children with CCHF.
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Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Febre Hemorrágica da Crimeia/epidemiologia , Febre Hemorrágica da Crimeia/patologia , Adolescente , Anticorpos Antivirais/sangue , Criança , Pré-Escolar , Feminino , Vírus da Febre Hemorrágica da Crimeia-Congo/genética , Vírus da Febre Hemorrágica da Crimeia-Congo/imunologia , Febre Hemorrágica da Crimeia/diagnóstico , Hospitalização , Humanos , Imunoglobulina M/sangue , Lactente , Masculino , Faringite/virologia , RNA Viral/sangue , Tonsilite/virologia , Turquia/epidemiologiaRESUMO
Valproic acid is one of the most frequently prescribed antiepileptic drugs for the therapy of generalized and focal epilepsies. Valproate induces a variety of hemostatic disorders such as thrombocytopenia, abnormal platelet function, hypofibrinogenemia, and decreased concentrations of von Willebrand factor, and it rarely causes serious bleeding complications. It may also lead to atherosclerosis and thrombosis. However, there is still lack of knowledge about the incidence and occurrence of these particular side effects. In this prospective systematic study, we assessed the early effects of sodium valproate on both pro- and anticoagulatory factors, homocysteine, and lipoprotein (a) in 24 newly diagnosed epileptic children treated with valproate. Valproate causes decreased factor VII levels, platelet count, factor VIII, Protein C, fibrinogen, and increased lipoprotein (a) levels. To the best of our knowledge, our report is the first in the medical literature, which describes that valproate significantly reduces factor VII levels even during short-term therapy.
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Anticonvulsivantes/efeitos adversos , Transtornos da Coagulação Sanguínea/induzido quimicamente , Fatores de Coagulação Sanguínea/efeitos dos fármacos , Transtornos das Proteínas Sanguíneas/induzido quimicamente , Ácido Valproico/efeitos adversos , Adolescente , Anticonvulsivantes/administração & dosagem , Biomarcadores/análise , Biomarcadores/sangue , Transtornos da Coagulação Sanguínea/metabolismo , Transtornos da Coagulação Sanguínea/fisiopatologia , Fatores de Coagulação Sanguínea/metabolismo , Transtornos das Proteínas Sanguíneas/metabolismo , Transtornos das Proteínas Sanguíneas/fisiopatologia , Criança , Pré-Escolar , Regulação para Baixo/efeitos dos fármacos , Regulação para Baixo/fisiologia , Esquema de Medicação , Epilepsia/tratamento farmacológico , Fator VII/efeitos dos fármacos , Fator VII/metabolismo , Fator VIII/efeitos dos fármacos , Fator VIII/metabolismo , Feminino , Fibrinogênio/efeitos dos fármacos , Fibrinogênio/metabolismo , Homocisteína/efeitos dos fármacos , Homocisteína/metabolismo , Humanos , Lipoproteína(a)/efeitos dos fármacos , Lipoproteína(a)/metabolismo , Masculino , Contagem de Plaquetas , Estudos Prospectivos , Proteína C/efeitos dos fármacos , Proteína C/metabolismo , Ácido Valproico/administração & dosagemRESUMO
Primary subacute haematogenous osteomyelitis is one of the causes of limp. It usually involves tubular bones. Flat and small bones are affected less commonly. Diagnosis is difficult and usually takes weeks together for completion. Salmonella spp. can be isolated as a cause of primary subacute haematogenous osteomyelitis, if a usually underlying disorder, such as sickle cell anemia is associated. In this study, we present a child with normal immunity diagnosed as Salmonella primary subacute haematogenous osteomyelitis of the navicular bone, which is a rare condition. Primary subacute haematogenous osteomyelitis must be considered as a cause of limp for timely diagnosis and treatment.