Background This case series aims to evaluate the presenting symptoms, laboratory data, systemic findings, and response to early treatment in patients who were followed up with the diagnosis of multisystemic inflammatory syndrome associated with novel coronavirus disease 2019 (COVID‐19). Methods The presentation, laboratory findings, and responses to treatment of patients hospitalized and diagnosed with multisystemic inflammatory syndrome were evaluated retrospectively. Results A total of 32 patients were included in the study. The median age was 90 (1.5–204) months and 62.5% of the patients were male; 59.4% of the cases were non‐specific disease, 31.2% typical (complete) Kawasaki, and 9.4% had phenotypic characteristics of atypical (incomplete) Kawasaki. Most of the patients were found to have low albumin and elevated C‐reactive protein, sedimentation rate, and d‐dimer, and all patients had elevated N‐terminal pro‐B‐type natriuretic peptide, and procalcitonin. Lymphopenia was detected in 25 patients (78.1%) and serum ferritin levels were elevated in 25 patients (78.1%). Eleven (34.4%) patients responded well only to intravenous immunoglobulin treatment. Twenty patients (62.5%) received intravenous immunoglobulin and steroid therapy (second‐line therapy). Only one patient (3.1%) received third‐line therapy (intravenous immunoglobulin + steroid +anakinra + plasmapheresis). None of the patients died. Conclusions Most patients had mild clinical symptoms and responded well to intravenous immunoglobulin and / or steroid therapies as first‐ and second‐line therapies. Only one of our patients was clinically stabilized after third‐line treatment because he did not respond to intravenous immunoglobulin and steroid therapy. We think that all of our patients diagnosed with multisystem inflammatory syndrome in children recovered because we had recommended quickly medical intervention. Treatment should therefore be started immediately in patients diagnosed with multisystem inflammatory syndrome in children. If there is no response after 24 h to the initial treatment, the next treatment protocol should be started.
Background Cystic fibrosis (CF) is an autosomal recessively inherited disease. Clinical findings vary by age of the patient, the organ systems involved, and the severity of the CFTR gene mutation. Pancreatic and liver involvement is prominent and exocrine pancreatic insufficiency is observed in the majority of patients. Point shear wave elastography (pSWE) is a non‐invasive method that can quantitatively determine tissue elasticity and stiffness. In this study, the morphological evaluation of the pancreas was performed using the pSWE technique in pediatric patients diagnosed with CF. The effectiveness of this method for the early detection of pancreatic insufficiency was investigated. Methods Fifty‐five patients with CF (24 girls, 31 boys) and 60 healthy children (29 girls, 31 boys) without any chronic diseases and who were suitable for the pSWE examination were included in the study. Results The mean value of pSWE was 1.12 ± 0.16 in the healthy group and 0.97 ± 0.16 in the patients with cystic fibrosis. There was a statistically significant difference between the two groups (P < 0.001). Significant negative correlations were found between pSWE and age (r = −0.319; P = 0.018), height (r = −0.293; P = 0.03), serum glucose (r = −0.346; P = 0.01), HbA1C (r = −0.592; P = 0.02), and duration of the disease (r = −0.806; P < 0.001). Conclusions Investigating pancreatic elasticity and detecting pancreatic insufficiency using pSWE (a simple, inexpensive, and non‐invasive method) in the early period before overt laboratory and clinical symptoms of EPI appear can contribute positively to long‐term results in young patients with CF.
Introduction Excess iron accumulation occurs mainly in organs such as reticuloendothelial cells, the pituitary gland, and the pancreas in beta-thalassemia because of blood transfusions. In the present study, it was aimed to investigate the relationship between T2* values on magnetic resonance imaging (MRI) and clinically diagnosed pituitary endocrinological disorders in children with thalassemia major. Methods This study enrolled patients diagnosed with beta-thalassemia at pediatric hematology outpatient clinics. In the study, in addition to the medical history of the patients, routinely performed tests, including hemoglobin electrophoresis, routine biochemical tests, and tests for pubertal development (follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, etc.), as well as iron deposition measured by hepatic MRI T2* (STAR) sequence, were retrospectively assessed. A total of 29 patients were enrolled. Results Hypothyroidism was detected in 34.6% (9/26) of patients, short stature in 37% (10/27), and pubertal retardation in 50% (14/28) of the patients. There was no significant correlation between hypothyroidism and pituitary MRI T2* values. No significant correlation was found between laboratory parameters and pituitary MRI examination. Although the sensitivity of T2* levels could rise above 80%, their specificity remained low. This is one of the major limitations of the pituitary MR T2* study for the prediction of short stature. The best lower cut-off level of MR T2* to predict short stature was found 14.6 ms. Conclusion The diagnostic specificity pituitary MR examination levels for short stature were detected as low. Thus, the clinical standardization and validation of pituitary MR T2* values examination are needed before clinical follow-up and multifaceted studies are needed.
ÖZKlasik olarak ilaçlara bağlı erken tip hipersensitivite reaksiyonlarında uygulanmasına rağmen geç tip reaksiyon nedeniyle yapılan hızlı desensitizasyon olgu bildirimlerinin sayısı da artmaktadır. Temozolamid malign glioma tedavisinde kemoterapi amaçlı kullanı-lan bir ilaçtır. Temozolamid kullanımı sonrası geç erüpsiyon gelişen olguda hızlı desensitizasyon tedavisi başarılı şekilde uygulanmıştır. Bu olgu, hızlı desensitizasyon protokolünün gecikmiş tip ilaç reaksiyonu gelişen hastalarda alternatif güvenli ve etkili tedavi seçeneği olabileceğini göstermektedir. ABSTRACTDespite rapid desensitization protocols classically applied to immediate hypersensitivity reactions, the number of case reports of rapid desensitization in delayed hypersensitivity is gradually increasing. Temozolamide is a chemotherapeutic agent used in the treatment of malignant glioma. The rapid desensitization protocol was performed successfully in a case with delayed skin eruptions after temozolamide treatment. This case shows that the rapid desensitization protocol can be an alternative safe and effective choice of treatment for delayed hypersensitivity reactions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.