Neurologic impairment is common in OAD and UCD, whereas the involvement of other organs (heart, liver, kidneys, eyes) follows a disease-specific pattern. The identification of unexpected chronic renal failure in GA1 and ASL deficiency emphasizes the importance of a systematic follow-up in patients with rare diseases.

The initial presentation varies widely in OAD and UCD patients. This is a challenge for rapid diagnosis and early start of treatment. Patients with a sepsis-like neonatal crisis and those with late-onset of symptoms are both at risk of delayed or missed diagnosis.

Background Long‐COVID is a well‐documented multisystem disease in adults. Far less is known about long‐term sequelae of COVID in children. Here, we report on the occurrence of long‐COVID in Dutch children. Patients and Methods We conducted a national survey asking Dutch pediatricians to share their experiences on long‐COVID in children. We furthermore describe a case series of six children with long‐COVID to explore the clinical features in greater detail. Results With a response rate of 78% of Dutch pediatric departments, we identified 89 children, aged 2–18 years, suspected of long‐COVID with various complaints. Of these children, 36% experienced severe limitations in daily function. The most common complaints were fatigue, dyspnea, and concentration difficulties with 87%, 55%, and 45% respectively. Our case series emphasizes the nonspecific and broad clinical manifestations seen in post‐COVID complaints. Conclusion Our study shows that long‐COVID is also present in the pediatric population. The main symptoms resemble those previously described in adults. This novel condition demands a multidisciplinary approach with international awareness and consensus to aid early detection and effective management.

Background and aims Vitamin D plays an important role in bone homeostasis. Children with inflammatory bowel disease (IBD) are known to have several risk factors for hypovitaminosis D. We aimed to report the prevalence of hypovitaminosis D in this population and risk factors associated with low serum twenty five hydroxy-vitamin D (25OHD) concentration in children with IBD. Methods Serum 25OHD concentration of 448 patients with IBD 8 to 22 yrs measured between January 2006 and January 2009 at our Center was recorded via retrospective chart review. Data collected included diagnosis (ulcerative colitis (UC), Crohn disease (CD) and indeterminate colitis (IC)), demographics, serum albumin concentration, erythrocyte sedimentation rate, vitamin D intake, season of measurement and height, and weight. Factors related to serum 25OHD concentration were identified with regression analysis. Results Serum 25OHD concentration ≤20 ng/mL (insufficiency) was identified in 64 patients (14.3%) and serum concentration ≤15 ng/mL (deficiency) in 26 (5.8%). Factors associated with lower serum 25OHD concentration were: winter and spring season, dark skin complexion, higher body mass index Z-score, lack of vitamin D supplementation and higher erythrocyte sedimentation rate. Conclusion Hypovitaminosis D is prevalent among children and youth, including patients with IBD. Risk factors for deficiency of this vitamin are similar to those in healthy children, with the addition of higher erythrocyte sedimentation rate. Both patients with UC and CD are at risk for hypovitaminosis D.