1. High number of INS relapses in childhood is a risk factor for recurrences in adulthood. 2. INS relapses in childhood do not preclude active professional life in adulthood.

1. Children with IgAN have higher arterial stiffness compared to healthy peers. 2. In children with IgAN/HSN, proteinuria and hyperlipidemia are risk factors for elevated diastolic blood pressure, while obesity is a risk factor for increased blood pressure variability and pulse pressure. 3. Pediatric patients with IgAN/HSN require regular ABPM evaluation to allow for early detection of poor pharmacological control of hypertension.
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Urinary tract infections (UTIs) are one of childhood’s most common bacterial infections. The study aimed to determine the clinical symptoms, laboratory tests, risk factors, and etiology of different UTIs in children admitted to pediatric hospitals for three years. Methods: Patients with positive urine cultures diagnosed with acute pyelonephritis (APN) or cystitis (CYS) were analyzed for clinical symptoms, laboratory tests, risk factors, and etiology, depending on their age and sex. Results: We studied 948 children with UTIs (531 girls and 417 boys), with a median age of 12 (IQR 5–48 months). A total of 789 children had clinical symptoms; the main symptom was fever (63.4% of patients). Specific symptoms of UTIs were presented only in 16.3% of patients. Children with APN had shown significantly more frequent loss of appetite, vomiting, lethargy, seizures, and less frequent dysuria and haematuria than children with CYS. We found significantly higher median WBC, CRP, and leukocyturia in children with APN than with CYS. The risk factors of UTIs were presented in 46.6% of patients, of which 35.6% were children with APN and 61.7% with CYS. The main risk factor was CAKUT, more frequently diagnosed in children with CYS than APN, mainly in children < 2 years. The most commonly isolated bacteria were Escherichia coli (74%). There was a higher percentage of urine samples with E. coli in girls than in boys. Other bacteria found were Klebsiella species, Pseudomonas aeruginosa, Proteus mirabilis, and Enterococcus species. Conclusions: Patients with APN were younger and had higher inflammatory markers. Often, fever is the only symptom of UTI in children, and other clinical signs are usually non-specific. The most common UTI etiology is E. coli, regardless of the clinical presentation and risk factors.

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anemia of inflammation (ia), the second most common cause of childhood anemia, results from macrophage iron sequestration and impaired erythropoiesis. neutrophil gelatinase-associated lipocalin (nGaL) plays an important role in innate microbial immunity through its influence on intracellular iron homeostasis and inhibition of erythropoiesis. The predictive value of nGaL in ia was assessed in 74 children (age 6.30 ±3.64 ci): 1.128 (1.005-1.265), p = 0.040]. in stepwise multiple analysis age independently correlated with rBc (β = 0.051, p = 0.001), while crP independently correlated with HgB (β = -0.037, p = 0.027) and rBc (β = -0.022, p = 0.014). roc analysis demonstrated better diagnostic profiles for crP, procalcitonin (Pct) and fever duration for predicting the risk of ia than ngal (auc: 0.690, 0.669, 0.678 vs. 0.638, respectively). Despite the increase in HgB levels after 4-5 weeks from the onset of uti, HgB values were still significantly lower in the anemic than in non-anemic children. ngal was not useful for predicting ia in uti, since its diagnostic value was inferior to conventional inflammatory markers. months) with the first episode of urinary tract infection (uti). anemia of inflammation was found in 50% of children, including those with non-febrile uti, and delayed onset of anemia was observed in 20% of children. There were no differences in nGaL levels between the anemic and non-anemic children, and no correlations between ngal and hemoglobin (HgB) levels and red blood cell (rBc) count. in multivariate logistic regression analysis elevated c-reactive protein (crP) was only independently associated with the presence of anemia in children with uti [or (95%

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Wstęp: Zespół hemolityczno-mocznicowy (ZHM) to mikroangiopatia zakrzepowa, którą charakteryzuje triada objawów: anemia hemolityczna, małopłytkowość oraz ostre uszkodzenie nerek. Typowy ZHM (tZHM), wywołany przez bakterie produkujące werotoksynę, stanowi 88,1% przypadków. Cel pracy: Ocena przyczyn i przebiegu klinicznego ZHM u dzieci hospitalizowanych w 2016 r. w Katedrze i Klinice Pediatrii i Nefrologii WUM. Materiał i metody: Przeanalizowano historie chorób 15 dzieci z ZHM w wieku od 7 miesięcy do 15 lat. U wszystkich wykonano posiew kału, badania na obecność werotoksyn metodą PCR, przeciwciała przeciwko Escherichia coli, CH50, C3, C4, inhibitor i aktywność ADAMTS13 oraz parametry biochemiczne. Wyniki: W 2016 r. stwierdzono wzrost liczby przypadków ZHM. U 13 dzieci występowała biegunka, w tym u 1 z atypowym ZHM (aZHM). U 3 dzieci z kału wyhodowano E. coli, jednak u żadnego nie stwierdzono obecności werotoksyny. Badania serologiczne potwierdziły obecność przeciwciał przeciwko E. coli O26, O157, O145, odpowiednio u 6, 2 i 1 dziecka. U 13 dzieci rozpoznano tZHM, a u 2 z ciężkim przebiegiem klinicznym -aZHM. Rozpoznanie aZHM potwierdziły badania genetyczne wykazujące mutacje w obrębie alternatywnej drogi aktywacji dopełniacza. Dzieci z tZHM były leczone objawowo. Dializoterapii wymagało 11 dzieci (2 z aZHM i 9 z tZHM). U pacjentów z aZHM stosowano plazmaferezy i świeżo mrożone osocze, jednak nie osiągnięto poprawy funkcji nerek. Wnioski: Wzrost zachorowalności na ZHM w 2016 r. mógł być spowodowany zakażeniami E. coli O26. W przypadku ujemnych posiewów kału w potwierdzeniu typowej etiologii ZHM przydatne może być oznaczenie miana przeciwciał dla lipopolisacharydów E. coli. U pacjentów z tZHM zwykle następuje szybki powrót funkcji nerek.