Background: Henoch-Schönlein Purpura (HSP) is a systemic hypersensitivity disease of unknown cause that is characterized by a purpuric rash and systemic manifestations, such as colicky abdominal pain, polyarthralgia, and acute glomerulonephritis. Common complications of HSP that lead to surgical intervention include intussusception, perforation, necrosis, and massive gastrointestinal bleeding. Unusual clinical manifestations of HSP may include edema of the scrotum and eyes. Lumbar swelling is rarely seen as a complication of HSP. Case Report: A four-year-old boy was admitted to our emergency room with a 7 day history of increasing abdominal pain. Within 48 hours of admission, erythematous macules and palpable purpuric lesions developed on the lower extremities. On the third day of hospitalization, sudden onset of severe back pain, swelling on the lumbar region and refusal to walk were seen. On the fifth day, lumbosacral edema and pain resolved but facial edema developed. He was diagnosed clinically with HSP. Conclusion: To the best of our knowledge, only a few cases of HSP with lumbar edema have been reported so far. If the first clinical symptoms of HSP are atypical, clinical progress can be atypical, too.
To the best of our knowledge, no cases of CS have been reported following ocular fluorometholone use. Although eyedrops containing potent glucocorticoids may lead to CS, fluorometholone, a relatively less potent steroid, may also cause the syndrome, as in our case.
GLUT-1 deficiency syndrome is a rare, frequently unrecognized metabolic encephalopathy that is probably underdiagnosed. Although developmental delay, acquired microcephaly, spasticity, and impaired coordination were initially described as the classic findings, mild cases with no pronounced neuromotor compromise have since been included in the broad clinical spectrum with new mutations being identified more recently. We report a case of myoclonic seizures not responding to anti-epileptics since the age of one year in a 17-year-old patient with a normal phenotype and neuromotor development. Previously unreported p.Phe389Leu mutation was determined in the SLC2A1 gene in our patient. This case will be useful in clarifying the phenotype of GLUT-1 deficiency and reveals a new pathogenic mutation.
Recently, it has been reported that the mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) can be used as indicators of inflammation in various inflammatory diseases such as psoriasis, ankylosing spondylitis and ulcerative colitis. In this study, we aimed to assess MPV levels and NLR in children with chronic urticaria (CU) and to compare them with healthy controls. Materials and Methods: The cases of 46 children with CU [11 with inducible urticaria (IU) and 35 with chronic spontaneous urticaria (CSU)] admitted to our outpatient clinics, and 30 healthy children were evaluated retrospectively. Results: No statistically significant differences among the CU, CSU, and IU and the control groups were found in terms of NLR and MPV levels (p>0.05). The platelet counts in the CU, CSU, and IU and control groups were not statistically significantly different (p>0.05). Conclusion: We found that MPV levels and NLR were not different in children with CU, CSU, and IU and in healthy children. It seems that the MPV and NLR cannot be used as inflammatory markers of CU in children. We believe that further studies are required in this field.
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