Immunoglobulin A vasculitis (IgAV) is the most common systemic vasculitis in developmental age. The disease is most often characterized by a self-limiting course and good prognosis, but sometimes serious complications, like gastrointestinal bleeding or glomerulonephritis, may develop. The neutrophil to lymphocyte (NLR) and the platelet to lymphocyte (PLR) ratios are indicators related to clinical outcome in various inflammatory diseases. The mean platelet volume to platelet count ratio (MPR) has not been evaluated in patients with IgAV. The aim of this study was to analyze the values of the NLR, PLR and MPR in patients with an acute stage of IgAV compared to healthy children and to assess their suitability for predicting the severity of the disease. All children with IgAV hospitalized in our institution between 2012 and 2017 were reviewed retrospectively. The selected laboratory data were recorded before starting the treatment; these results allowed for NLR, PLR, and MPR calculation. The study involved 71 IgAV children. 57.7% of patients revealed signs of systemic involvement (including GT bleeding and/or glomerulonephritis) and 42.3% were nonsystemic (presenting skin and joint symptoms). 83% of patients were classified as mild and 17% as severe course of the disease. The NLR and the PLR were significantly higher in all IgAV children and in the systemic involvement group in comparison with non-systemic. The MPR was significantly lower in all IgAV group with the exception of children without systemic involvement. The NLR is a more valuable indicator than the PLR to identify patients at higher risk of systemic involvement in the course of IgAV. Clinical usefulness of the MPR requires further research.

Serum levels of selected cytokines [interleukin (IL)-17A, IL-18, IL-23] and chemokines (RANTES, IP10) in the acute phase of immunoglobulin A vasculitis in children

Adipose tissue is currently considered not only as an energy store but also as an organ of internal secretion. Numerous adipocytokines regulating a number of human body processes are important in many disease processes, including chronic kidney disease (CKD). Nowadays, the role of zinc a2-glycoprotein (ZAG) is being sought as a potential link between these two organs. ZAG, through its lipolytic effect, contributes to progressive malnutrition in patients undergoing dialysis, and this significantly increases their mortality. It seems that ZAG may be a new potential biomarker of kidney damage, and the specific pharmacotherapy will significantly reduce the progressive process of cachexia. (Endokrynol Pol 2019; 70 (2): 179-189)

Urticaria is a common pediatric dermatosis characterized by local swelling, pruritus, and skin redness. The primary lesions include wheals and/or angioedema. By definition, acute urticaria lasts up to 6 weeks and usually occurs as a single episode in life. Chronic urticaria lasts over 6 weeks and is uncommon. Urticaria is a heterogenous disease. The development of skin lesions depends on the action of mast cells and other cells of the immune system, and inflammation is common in all forms of urticaria. Autoimmune mechanisms and activation of coagulation and fibrinolysis also play an important role. The etiology usually remains unknown. Urticaria, especially its chronic form, contributes to a significant decrease in quality of life due to prolonged discomfort and the necessity of long-term and sometimes expensive treatment. This article presents an up-to-date review of the literature on the incidence, causes, diagnosis, treatment and prognosis of urticaria in children.

Introduction: Despite the current decline in the number of suicides, they are the second most common cause of death among children and adolescents. At the end of the 20th century, suicides represented about 10% of all causes of death of people up to 18 years old, but currently they reach up to 20%. Over the years, the number of suicide attempts (SA) has also increased. Aim of the study: The aim of the study was to analyse the cases of hospitalisation of children in the Department of Paediatrics of the Independent Public Clinical Hospital No. 1 in Zabrze (DP IPCH1) due to a suicide attempt. Material and methods: Medical records of 87 patients hospitalised due to SA in the years 2010-2016 in the DP IPCH1 were retrospectively analysed. Results: All children who were admitted to the hospital survived their suicide attempt. An almost 2.5-fold increase was observed in the numbers of hospitalisations in years 2010-2016. Up to 86.2% of the patients were girls. The average age in group was 15.2 ±1.4 years. In order to commit suicide, children most often used medications (97.7%). They regularly combined them with alcohol or self-harm. 3/4 of overdose incidents included prescription-only medicaments. Almost half of the patients previously showed self-destructive tendencies in the form of self-harm. For 78.2% of the responders it was the first suicide attempt. 40.7% of patients had pre-existing chronic diseases, and the next 20% were under the control of a psychologist or psychiatrist. After hospitalisation 11 children were transferred to a psychiatric ward for further treatment. Conclusions: The increase of hospitalisations due to suicide attempts is disturbing. In this context, special attention should be given to children from risk groups such as: previous suicide attempts, chronically ill, addicted to alcohol or drugs, with impaired parent-child relationship, or with self-harm history.