IntroductionAtopic dermatitis (AD) is a frequent chronic skin disease in infants. It creates great difficulties, both diagnostic and therapeutic.AimTo assess the prevalence of atopic dermatitis in infants during the first 6 months of life.Material and methodsThe analysis comprised 2256 children at the age of not more than 6 months, treated at the 2nd Department of Paediatrics and Allergology of the Polish Mother's Memorial Hospital in Lodz, Poland, during seven years. Out of all the patients, children with cutaneous changes were isolated, and the location, type and aetiology of changes were assessed.ResultsDermal changes were diagnosed in 471 children, including 391 (17.3% of all the patients) with atopic dermatitis. Out of the children with AD, IgE-dependent allergy was identified in 39.9%. Cow's milk protein was the most frequent sensitising allergen. In 71.6% of the infants, cutaneous changes were disseminated and involved at least two areas of the body. All of them were strongly itching. An applied elimination diet, together with anti-allergic medications in some of the children, provided a clear clinical improvement.ConclusionsPerformed studies demonstrated the prevalence of atopic dermatitis in 17.3% of examined children. The changes in children with AD were disseminated, what was confirmed already at the infantile age. The obtained clinical improvement after the applied therapy indicates a relationship between the observed symptoms and allergic disease.
IntroductionWe aimed to characterize biochemical and cardiovascular predictors of paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) risk based on the data from the LATE-COVID-Kids study.Material and methods148 consecutive COVID-19 convalescents hospitalized for the clinical evaluation after the acute phase of COVID-19 were classified into two groups related to symptoms: 33 children finally diagnosed with PIMS-TS and 115 children without PIMS-TS (control group).ResultsPIMS-TS children were significantly younger (6.79 ±4.57 vs. 9.10 ±4.94 years). After adjustment, in comparison to those without, PIMS-TS children had a higher level of antithrombin III (111 ±9.30 vs. 105 ±11.4), higher heart rate (HR)/min (100 (89.0–111) vs. 90 (79.7–100)) and sinus rhythm (p = 0.03) but lower PQ interval (p = 0.02) on admission to hospital. The lymphocytes (absolute count and percentage) were significantly higher in children with PIMS-TS, and the opposite results were obtained for IgA and neutrophils. Furthermore, children with PIMS-TS had a higher level of thyroid stimulating hormone (2.76 (2.16–4.18) vs. 2.36 (1.73–2.83)) and red cell distribution width (p < 0.005) compared to those without.ConclusionsIt is the first data on the possible predictors of PIMS-TS risk in the Long-COVID period. These results need to be further validated to next create the PIMS SCORE algorithm, which might enable the effective prediction of children with the risk of PIMS-TS occurrence after COVID-19 recovery.
Introduction: Gastroesophageal reflux (GER) and food allergy are conditions occurring most often in young children. Many authors emphasize the relationship between them. Aim: To evaluate 24-h oesophageal pH monitoring in children with food allergy. Material and methods: The retrospective analysis included 84 children with food allergy aged from 4 months to 24 months. The control group consisted of 15 children at the same age diagnosed with GER but without features of allergy. All children underwent 24-h oesophageal pH monitoring. Results: Gastroesophageal reflux was diagnosed among children with allergy in 29 patients (34.5%). A gradual increase of the number and duration of reflux episodes in the period between meals compared to the postprandial period in both groups with GER was observed. The number of reflux episodes was higher in children with coexistent allergy. Analysis of graphic record of oesophageal pH monitoring revealed a primary reflux in 12 children with GER and allergy as well as in 9 children from the control group. In the remaining children from both groups the record showed features of secondary reflux, but the phases were not fully presented. The incidence of GER with features of secondary reflux was similar in both groups. Conclusions: Twenty-four-hour oesophageal pH monitoring is helpful, but it cannot be the sole diagnostic criterion in the diagnosis of GER dependent on food allergy. Such a diagnosis should be based on the results of oesophageal pH monitoring as well as allergological and immunological tests.
Background: Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is a novel entity. The inflammatory process involves the circulatory, digestive, respiratory, and central nervous systems, as well as the skin. Making a diagnosis requires extensive differential diagnoses, including lung imaging. The aim of our study was to retrospectively assess the pathologies found in lung ultrasound (LUS) in children diagnosed with PIMS-TS and to evaluate the usefulness of the examination in diagnostics and monitoring. Methods: The study group consisted of 43 children diagnosed with PIMS-TS, in whom LUS was performed at least three times, including on admission to hospital, on discharge, and 3 months after disease onset. Results: Pneumonia (mild to severe) was diagnosed in 91% of the patients based on the ultrasound image; the same number had at least one pathology, including consolidations, atelectasis, pleural effusion, and interstitial or interstitial-alveolar syndrome. By the time of discharge, the inflammatory changes had completely regressed in 19% of the children and partially in 81%. After 3 months, no pathologies were detected in the entire study group. Conclusion: LUS is a useful tool for diagnosing and monitoring children with PIMS-TS. Inflammatory lesions of the lungs resolve completely when the generalized inflammatory process subsides.
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