Objective: Eosinophilic esophagitis is a clincopathologic entity characterized by esophageal symptoms in association with a dense eosinophilic infiltrate, the aim of this study is to describe the clinical presentation, laboratory, endoscopic and histopathologic results in children diagnosed with eosinophilic esophagitis. Methods: This is a retrospective review of the medical records for 38 children with histologic diagnosis of eosinophilic esophagitis performed at King Hussein Medical Center, during the period between January 2001 to February 2011, with the cut off biopsy diagnosis ≥20/HPF eosinophilic infiltrate. Patients were excluded if gastric or duodenal biopsies showed prominent eosinophilic infiltrate. Patients medical records were reviewed regarding age at presentation, gender, clinical presentation, associated disease. Laboratory, endoscopic and histologic results were also reviewed. Results: A total 38 patients with histological diagnosis of eosinophilic esophagitis were included in this study. Thirty-one (82%) were males and 7 (18%) were females. Their ages ranged between 2-14 years. Mean age 8 years. The most commonly clinical presentation of eosinophilic esophagitis was vomiting which occurred among 26 children (68%), however, rash was presented in only one child (2%). Peripheral eosinophilia >(0.5×10/L) was found in 45%. High serum IgE level (>100 IU/ml) was found in 39%. Positive radio allergo sorbent testing in 39%. The most frequent endoscopic findings were loss of normal vascularity found in 19 (50%) children, however, white exudates were found in 2(5%) children. Mean eosinophil count was 70 (20-120), eosinophilic degranulation, and bazal zone hyperplasia reported in 18 children (47%). Conclusion: Eosinophilic esophagitis in Jordan displays similar clinical, endoscopic and pathologic features to those described in other countries. Endoscopic and histologic feature remain the gold standard for diagnosis of eosinophilic esophagitis
Nephrocalcinosis (NC) is defined as deposition of calcium crystals in the renal parenchyma and tubules. This is a retrospective review of all the data of 63 children presented to Pediatric Nephrology Clinic at King Hussein Medical Center (KHMC) over a 15-year period with bilateral NC. We determine their causes, clinical presentation and evaluate their growth and renal function during their follow-up. Thirty-five (55.5%) cases were males and 28 (44.5%) were females. The median (range) age at presentation was four (2-192) months. The most common leading cause to NC was hereditary tubulopathy in 48% followed by hyperoxaluria in 35%. The cause of NC remained unknown in 3% and Vitamin D excess accounts for 5% of the cases. The most presenting symptom was a failure to thrive (68%) and the second most common symptom was abdominal pain and recurrent urinary tract infection was found in 40%, polyuria and polydipsia were found in 32% of cases, and 16% of cases were diagnosed incidentally. At a median follow-up of 38 (14-200) months, estimated glomerular filtration rate had decreased from 84.0 (42-110) mL/min per 1.73 m2 body surface area to 68.2 (10-110) mL/min/1.73 m2 body surface (P = 0.001). This study illustrated the need for a national registry of rare renal diseases to help understand the causes of these conditions in our populations and provide support to affected patients and their families.
The aim of the present study is to share the experience of chronic peritoneal dialysis (PD) at King Hussein Medical Center, Amman, Jordan, and to highlight the complications of this procedure. This is a retrospective chart review study for all the children from day 1 of life to 14 years, who underwent chronic PD for end-stage renal disease (ESRD) during the period of 10 years extending from 2009 to 2019. The following data were collected: mode of dialysis, type of peritoneal dialysis, age of starting peritoneal dialysis, gender, aetiology of ESRD, duration on PD, complications and outcome. A total number of 269 children were included: 229 patients received haemodialysis and 40 children (22 boys and 18 girls) received PD. Of those, two children were on automated PD and 38 children were on continuous ambulatory peritoneal dialysis. The mean age at the start of PD was 62 ± 38 months. The mean duration of PD was 43 months. The mean catheter duration was 34 months. Six patients were shifted to haemodialysis permanently and four patients received a kidney transplant. Eleven patients died. The most common complications were peritonitis (52.5%), exit-site infection (30%) and malfunctioning catheter (12.5%). The rate of peritonitis was one episode per 22 patient-months. Peritoneal dialysis is a promising mode of dialysis for children in Jordan. Peritonitis is the most common complication associated with PD. Kidney transplantation is the best modality of renal replacement therapy in terms of longterm survival and quality of life and should be encouraged on national level.
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