Introduction. Idiopathic hypercalciuria (IH) is one of the most common metabolic disorders in children and is one of the leading causes of calcium urolithiasis and osteoporosis. The strategic goal of treatment for IH is to reduce urinary calcium excretion. Materials and methods. The study included 93 IH children aged from 3 to 14 years with identified IH. At the first stage, IH children have been prescribed low sodium and high potassium diet with increased fluid intake for three months without additional drug therapy. For children with persistent IH at the second stage, the diet was supplemented daily with 1000-1500 mg of fish oil for children for 3 months. At the third stage of treatment, persistent IH patients were prescribed hydrochlorothiazide at a dose of 1 mg/kg for 3 months. After each stage of treatment, we analyzed IH’s manifestations in dynamics and monitored urinary calcium excretion by calcium/creatinine ratio (CCR). Results. Evaluation of clinical and laboratory manifestations of IH after the first stage of treatment showed the effectiveness of the diet in 59.1% of patients. Among 38 patients included in the second stage of therapy, the normalization of urinary calcium excretion was noted in 52.6% of cases. The third stage of therapy was performed in 18 patients (19% of the initial group of IH children patients). The normalization of CCR was achieved in 16 (88.9%) children. Conclusion. For the correction of IH in children, a step-by-step approach should be recommended, starting with recommendations on the drinking regimen and nutrition, then prescribing fish oil preparations and resorting to thiazide diuretics in the lack of an effect from the first stages of treatment.
Introduction. Gastroesophageal reflux disease (GERD) is a common disease characterized by the ingestion of stomach contents into the esophagus, causing symptoms and/or complications. According to various authors, the prevalence of signs of erosive esophagitis in GERD children patients, is 10-50%. Further study of the prevalence and clinical manifestations of erosive esophagitis in children is an urgent task. Purpose: to study the prevalence of erosive esophagitis in schoolchildren with clinical manifestations of dyspepsia. Materials and methods. We examined five hundred ninety six children patients who underwent primary gastroenterological examination for persistent signs of dyspepsia. The comparison group consisted of 30 children aged to 18 years. All children underwent endoscopic examination using a GIF XP-20 apparatus from Olympus (Japan). Esophagitis was diagnosed according to the Los Angeles classification. Results. The prevalence of erosive changes in the esophagus in the examined patients was 17.4%. Erosive lesions of the esophagus occurred with equal prevalence in patients of primary and secondary school age. Boys predominate among patients with erosive esophagitis. Erosive esophagitis at the stage A was detected more often - 90.4%, less often at stages B - 7.7% and C - 1.9%, esophagitis in stage D was not detected in any of the cases. Conclusion. The main clinical manifestations of erosive esophagitis are abdominal pain, heartburn, belching, and nausea. The features of the clinical course depending on the stage of esophagitis were established.
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