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Öğe A case of May-Thurner syndrome with inconsistent radiological and surgical findings(Clinics Cardive Publ Pty Ltd, 2015) Akin, Fatih; Aygun, Serhat; Gormus, Niyazi; Kar, Yeter Duzenli; Susam, Hanife Tugce; Ozel, AhmetMay-Thurner syndrome is the result of compression of the left common iliac vein between the right common iliac artery and the overlying vertebrae. In this case report, we describe an 11-year-old boy presenting with swelling of the left lower extremity. An iliac MR venography showed compression of the left proximal iliac vein between the vertebra and the left iliac artery. In surgery, it was seen that the left common iliac vein was connected to the postero-inferior part of the inferior vena cava, and it was compressed between the right common iliac artery and the columna vertebralis, which was inconsistent with the radiological findings. An interposition of the great saphenous vein graft between the left common iliac vein and the inferior vena cava was made, with a successful outcome. Our case is interesting in that it showed inconsistent findings between the radiological images and surgery.Öğe Clinical and Laboratory Evaluations of Patients Diagnosed as Having Multisystem Inflammatory Syndrome Associated with Coronavirus Disease 2019 in Children: A Single Center Experience from Konya(Georg Thieme Verlag Kg, 2023) Genceli, Mustafa; Akcan, Ozge Metin; Erdogan, Kubra Nur; Kilic, Ahmet Osman; Yazar, Abdullah; Akin, Fatih; Gunes, MuhammedObjective Multisystem inflammatory syndrome in children (MIS-C), characterized by fever, inflammation, and multiorgan dysfunction, was newly defined after severe acute respiratory syndrome coronavirus 2 infection. The clinical spectrum of MIS-C can be classified as mild, moderate, and severe. We aimed to evaluate demographics, clinical presentations, laboratory findings, and treatment modalities of patients with MIS-C according to clinical severity.Methods We performed a retrospective study of patients who were diagnosed as having MIS-C between September 2020 and October 2021 in the Necmettin Erbakan University Meram Faculty of Medicine, Turkey.Results A total of 48 patients (24 females and 24 males) with a median age at diagnosis of 10.3 years (range: 42 months-17 years) were enrolled, the most common clinical severity of MIS-C was moderate. The common presentations of patients were fever (97%), nonpurulent conjunctivitis (89.6%), rashes (81.3%), fatigue (81.3%), strawberry tongue (79.2%), and myalgia (68.8%). The most common laboratory findings were lymphopenia (81.2%), thrombocytopenia (54.1%), elevated D-dimer levels (89.5%), C-reactive protein (CRP; 100%), procalcitonin (97%), erythrocyte sedimentation rate (87.5%), ferritin (95.8%), interleukin 6 (IL-6) (86.1%), and probrain natriuretic peptide (pro-BNP) (97%). High levels of CRP, procalcitonin, pro-BNP, and urea were associated with the severity of MIS-C ( p < 0.05). Fifteen of the patients were found to have pulmonary involvement. Ascites were the most common finding on abdominal ultrasonography (11 patients) and were not seen in a mild form of the disease. During the study period, two patients died.Conclusion It is important to make patient-based decisions and apply a stepwise approach in treating patients with MIS-C due to the increased risk of complications and mortality.Öğe Demographic and clinical characteristics of patients with serum sickness-like reaction(Springer London Ltd, 2018) Yorulmaz, Alaaddin; Akin, Fatih; Sert, Ahmet; Agir, Mehmet Akif; Yilmaz, Riza; Arslan, SukruIn this study, we aimed to review the demographic, clinical, and laboratory characteristics of patients who were followed up and treated with the diagnosis of serum sickness-like reactions (SSLR) in our pediatric rheumatology clinic retrospectively and emphasize the importance of early diagnosis and treatment. The files of 29 patients who were hospitalized in the pediatric rheumatology clinic between September 2016 and March 2017 with the diagnosis of type 3 hypersensitivity reaction were reviewed retrospectively. Patient records including C-reactive protein, erythrocyte sedimentation rate, serum electrolytes, blood glucose, urea, and liver function were recorded by using the computerized patient database. The gender, age, length of hospital stay, accompanying clinical findings, family history of atopy, preceding infection, and drug usage data were obtained from the files of the patients. Twenty-nine patients with the diagnosis of type 3 hypersensitivity reaction were evaluated. Fifteen (51.7%) of the patients were male and 14 (48.3%) were female. The male to female ratio was 1.07. The age distribution of patients ranged from 18 to 192 months (mean +/- SD 100.66 +/- 53.75 months). The hospitalization duration was 3-16 days (mean +/- SD 5.14 +/- 3.20 days). The use of many drugs, especially antibiotics, has increased even in the treatment of viral upper air way infections. As a result, side effects have also increased. The most important of these is SSLR. However, this disease is not well recognized by clinicians.Öğe Determining the Infectious Pathogens and Their Resistance to Antibiotics in a Pediatric Intensive Care Unit(Georg Thieme Verlag Kg, 2018) Akin, Fatih; Yazar, Abdullah; Dogan, MetinIntroduction Nosocomial infections are one of the main causes of morbidity and mortality. It is important to know the common infectious pathogens and their resistance profiles in intensive care units (ICUs) to determine appropriate treatment protocols. The aimof this study was to determine the epidemiological profile of microorganisms isolated in a pediatric ICU (PICU) and to determine antibiotic resistance in isolated strains. Materials and Methods This retrospective study was performed at the Meram Medical Faculty Hospital, Necmettin Erbakan University, Konya, Turkey. A total of 1,502 bacteria that were isolated from various specimens from children who were hospitalized in PICUs between January 2014 and December 2015 were included in this study to determine the isolated bacteria diversity and susceptibility to various antibiotics. Results Staphylococcus spp. was the most frequently isolated microorganism followed by Escherichia coli and Klebsiella spp., respectively. The sites where pathogens were isolated were as follows: 616 blood, (41%), 445 urine (29.6%), 60 sputum (4%), 44 cerebrospinal fluid (2.9%), 25 wound swab (1.6%), 20 tracheal aspirate (1.3%), and 26 others (1.7%). The carbapenem resistance rate was 40.8% among Pseudomonas aeruginosa isolates. Among 60 Acinetobacter baumannii isolates tested, 62% were resistant to carbapenems. Sensitivity rates of A. baumannii isolates to tigecycline and colistin were as high as 98 and 96%, respectively. Meropenem and colistin resistance rates to Klebsiella spp. were 16.2 and 15%, respectively. Conclusion In conclusion, it is essential to identify the infectious pathogens and their resistance to antibiotics especially in ICUs where infections with multidrug-resistant bacteria are frequent. Studies on this issue should be performed at appropriate time intervals.Öğe Early kidney injury in immunoglobulin A vasculitis: Role of renal biomarkers(Wiley, 2021) Ture, Esra; Yazar, Abdullah; Akin, Fatih; Topcu, Cemile; Aydin, Arif; Balasar, Mehmet; Atas, BulentBackground We aimed to determine whether urine kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) can be used as early noninvasive biomarkers of kidney injury in immunoglobulin A vasculitis. Methods Patients who were diagnosed with immunoglobulin A vasculitis were included in the study. Urine samples were collected for determination of urine KIM-1 and NGAL levels. The control group consisted of age-matched healthy children. Results Sixty-one patients who were diagnosed with immunoglobulin A vasculitis were included in the study; 37.7% of these patients were determined to have renal involvement. Median KIM-1 was found to be significantly higher in the patient group (69.59 pg/mL) than the control group (40.84 pg/mL) (P = 0.001). Median NGAL was determined to be statistically significantly higher in the patient group (59.87 ng/mL) compared with the control group (44.87 ng/mL) (P = 0.013). In 23.6% of the patients without renal involvement at admission renal involvement developed within the following 6 months. When median KIM-1 and NGAL at admission of these patients were compared with the control group, they were determined to be statistically significantly higher (P = 0.001, P = 0.003). Conclusions The fact that our patients with late-term nephropathy had no hematuria and / or proteinuria and that KIM-1 and NGAL levels were determined to be high indicates that these biomarkers might be potentially reliable, noninvasive and early determinants of kidney injury.Öğe The effect of attention deficit/hyperactivity disorder and other psychiatric disorders on the treatment of pediatric diabetes mellitus(Wiley-Hindawi, 2019) Yazar, Abdullah; Akin, Fatih; Akca, Omer F.; Eklioglu, Beray S.; Ture, Esra; Coskun, Fatma; Atabek, Mehmet E.Objective Psychiatric diagnoses of patients with type 1 diabetes mellitus (T1DM), the severity of attention deficit/hyperactivity disorder (ADHD) symptoms of the patients and their primary caregivers, and the effects of these factors on treatment were investigated. Methods Sixty-one patients with T1DM were included in the study along with their parents. Psychiatric diagnoses of the patients were determined using a semistructured psychiatric interview, and their depression and ADHD symptom severities were evaluated with self-report scales. The ADHD symptom severities of the parents were evaluated using self-report scales. The relationships among the psychiatric symptoms and the hemoglobin A1c (HbA1c), fasting blood glucose (FBG), and postprandial blood glucose (PBG) levels of the patients were investigated. Results HbA1c levels were found to correlate with the hyperactivity levels of children and the number of diagnoses they had. FBG and PBG values of patients diagnosed with ADHD were found to be higher than in those who did not have ADHD. HbA1c, FBG, and PBG values of the patients who had any disruptive behavior disorder were found to be higher than in those who did not. ADHD total scores, gender (being female), having diagnoses of ADHD or depression were found to be predictive of HbA1c levels according to the regression analyses. No relationship between the clinical findings of the children and their parents' ADHD levels was found. Conclusions The findings of this study implicate that children with T1DM should be evaluated in terms of ADHD which could have negative effects on the treatment.Öğe Is Asymmetric Dimethylarginine a Useful Biomarker in Children With Carbon Monoxide Poisoning?(Lippincott Williams & Wilkins, 2019) Yazar, Abdullah; Akin, Fatih; Sert, Ahmet; Ture, Esra; Topcu, Cemile; Yorulmaz, Alaaddin; Ercan, FatihObjective Carbon monoxide poisoning (COP) is the leading cause of mortality and morbidity due to poisoning worldwide. Because children are affected more quick and severely from COP, they may require a longer treatment period, even if carboxyhemoglobin (CO-Hb) and/or lactate levels return to normal. Therefore, a new marker that predicts the duration of treatment and the final outcomes of COP is needed. Methods This case control study was conducted on 32 carbon monoxide-poisoned patients younger than 18 years who had been admitted to pediatric emergency department. The control group included age- and sex-matched 30 healthy children. Blood samples were obtained for analysis of arterial blood gases, CO-Hb percent, methemoglobine, lactate, and asymmetric dimethylarginine (ADMA). Results Asymmetric dimethylarginine levels were significantly increased (P < 0.05) in patients with COP on admission and after the treatment when compared with controls (1.36 [0.89-6.94], 1.69 [0.76-7.81], 1.21 [0.73-3.18] nmol/L, respectively). There was no positive correlation between CO-Hb and ADMA levels on admission and at 6 hours (P = 0.903, r = 0.218, P = 0.231, r = 0.022, respectively). Positive correlation was found between lactate and CO-Hb levels on admission (P = 0.018, r = 0.423). Conclusions This study showed that ADMA levels were still high after 6 hours of 100% oxygen therapy in children with COP, even CO-Hb and/or lactate levels return to normal range. On the basis of these results, we consider that ADMA may be a useful biomarker in patient with COP.Öğe Management of acute mitochondriopathy and encephalopathy syndrome in pediatric intensive care unite: a new clinical entity(Springer Heidelberg, 2020) Arslan, Sukru; Yorulmaz, Alaaddin; Sert, Ahmet; Akin, FatihAcute mitochondriopathy and encephalopathy syndrome(AMES) is described differently by different authors in the literature. As a new clinical entity, we aimed to present the clinical signs and symptoms, diagnosis and treatment algorithm of our patients with AMES. 56 patients aged between 2 months and 18 years who were followed up in pediatric intensive care units of Konya Training and Research Hospital and Selcuk University Medical Faculty Hospital, between January 2010 and June 2017 were included. Patients' data were obtained retrospectively from the intensive care unit patient files. 34 (60.7%) of the patients were male and 22 (39.3%) were female. The median age of our patients was 10.0 months. At the time of admission, 42 (75%) of the patients had fever, 35 (62.5%) vomiting, 27 (48.2%) abnormal behaviour and agitation and 28 (50%) convulsion. The etiological classification of patients with AMES was divided into four groups as infection, metabolic disorder, toxic, and hypoxic-ischemic. 39 (69.6%) patients were found to have infection, 10 (17.9%) patients hypoxia, 7 (12.5%) patients metabolic disorders. AMES occurs rarely, but should be kept in mind in the differential diagnosis of patients with any encephalopathy of unknown origin especially in those with a history of ingestion of drugs, previous viral infection and vomiting. Early recognition and treatment is imperative to reduce morbidity and mortality in children with AMES.Öğe Mean Platelet Volume and Neutrophil-to-Lymphocyte Ratio May Be Used as Predictors in Febrile Seizures(Georg Thieme Verlag Kg, 2018) Yazar, Abdullah; Akin, Fatih; Ture, Esra; Caksen, Huseyin; Odabas, DursunFebrile seizure (FS) is the most frequent seizure disorder in childhood, associated with rapid onset of high fever. Our study aims are (1) to determine if the levels of mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) are risk factors for FS and to (2) assess the usefulness of these markers as predictors to distinguish the subgroups of FS. This prospective study includes children with FS, acute febrile illness (AFI) without seizure, and control group. Complete blood count was performed on all participants. The following data were obtained: white blood cell count (WBC), platelet count, MPV, hemoglobin (Hb), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), and NLR. MPV, WBC, ANC, and NLR were significantly increased in patients with AFI and FS compared with controls (p < 0.05). When patients with FS and AFI were compared, only WBC was increased significantly in patients with FS (p < 0.05). WBC, ANC, and NLR were significantly increased in patients with complex FS compared with simple (p < 0.05). Our findings showed that WBC, MPV, ANC, and NLR were higher in children with FS than in the control group. Additionally WBC, ANC, and NLR were found to be higher in children with CFS than in those with simple febrile seizure. Based on the study results, we suggest that only WBC may be used as predictors in children with FS.Öğe Mean platelet volume in children with hepatitis A(Biomed Central Ltd, 2016) Akin, Fatih; Sert, Ahmet; Arslan, SukruBackground: Mean platelet volume (MPV), which is commonly used as a measure of platelet size, indicates the rate of platelet production and platelet activation. We aimed to evaluate the mean platelet volume in children with hepatitis A. Methods: In this retrospective case-controlled study, the study population consisted of 62 children with hepatitis A and 62 healthy control subjects. Results: MPV values, aspartate transaminase (AST), and alanine transaminase (ALT) levels on admission were significantly increased in patients with hepatitis A when compared to controls whereas white blood cell (WBC) counts were significantly lower. Two weeks after admission, the MPV values showed a significant decrease from 9. 47 +/- 1.62 to 8.84 +/- 1.48 fL in patients with hepatitis A, but these values were still significantly higher than the controls. There was a significant difference in terms of MPV, WBC, AST, and ALT values between the controls and the patient group 2 weeks after admission. Conclusions: This study is the first to evaluate the MPV levels in children with hepatitis A. MPV values were found to be increased in children hospitalized with hepatitis A.Öğe Mean platelet volume in children with hepatitis A(Biomed Central Ltd, 2016) Akin, Fatih; Sert, Ahmet; Arslan, SukruBackground: Mean platelet volume (MPV), which is commonly used as a measure of platelet size, indicates the rate of platelet production and platelet activation. We aimed to evaluate the mean platelet volume in children with hepatitis A. Methods: In this retrospective case-controlled study, the study population consisted of 62 children with hepatitis A and 62 healthy control subjects. Results: MPV values, aspartate transaminase (AST), and alanine transaminase (ALT) levels on admission were significantly increased in patients with hepatitis A when compared to controls whereas white blood cell (WBC) counts were significantly lower. Two weeks after admission, the MPV values showed a significant decrease from 9. 47 +/- 1.62 to 8.84 +/- 1.48 fL in patients with hepatitis A, but these values were still significantly higher than the controls. There was a significant difference in terms of MPV, WBC, AST, and ALT values between the controls and the patient group 2 weeks after admission. Conclusions: This study is the first to evaluate the MPV levels in children with hepatitis A. MPV values were found to be increased in children hospitalized with hepatitis A.Öğe Outcomes of COVID-19 Infections in children: A single-center retrospective study(Wiley, 2022) Genceli, Mustafa; Akcan, Ozge Metin; Pekcan, Sevgi; Akin, Fatih; Ozdemir, Mehmet; Kilic, Ahmet Osman; Yazar, AbdullahThe COVID-19 pandemic is an important cause of morbidity and mortality, which has had a negative impact worldwide. Our aim was to describe clinical findings and outcomes of severe acute respiratory syndrome (SARS)-CoV-2 viral infection and COVID-19 cared for at a large pediatric tertiary care hospital during the first year of the pandemic. Patients aged 1 month to 18 years who were diagnosed as having COVID-19 between March 2020 and April 2021 were included. The files of patients diagnosed with COVID-19 were reviewed retrospectively. Results: Four hundred sixty seven children were included in the study. There were 34 (7.3%) patients under 1 year of age, 111 (23.8%) between 1 and 5 years, 98 (30.4%) between 5 and 10 years, 142 (30.4%) between 11 and 15 years, and 82 (17.6%) age over 15 years. Fever (88.2%), vomiting (32.4%), and diarrhea (29.4%) in patients aged under 1 year, sore throat (36.6%) in patients aged 11-15 years, and dysgeusia (11%), anosmia (14.6%), headache (18.3%), malaise (40.8%), myalgia (28%), and shortness of breath (17.1%) in those aged over 15 years were found to be significantly more common in comparison with the other age groups (p < 0.05). Thirty-five (7.5%) patients were asymptomatic, 365 (78.1%) had mild disease, 35 (7.5%) were moderate, 27 (5.8%) were severe, and five (1.07%) were critical. Leukocyte count, erythrocyte sedimentation rate, ferritin, and C-reactive protein values were significantly higher in hospitalized patients. Three patients died during the study period (0.64%). While SARS-CoV-2 infection may be asymptomatic and COVID-19 usually has a mild clinical course, some children have severe disease or mortality.Öğe Paediatric systemic lupus erythematosus: A single referral centre experience(Pakistan Medical Assoc, 2021) Atas, Bulent; Bulut, Mustafa; Sap, Fatih; Yazar, Abdullah; Akin, Fatih; Poyraz, Necdet; Tokgoz, HuseyinIn this study, the clinical and laboratory findings, management and follow-up of 32 children with paediatric systemic lupus erythematosus (pSLE) were evaluated to determine the prognostic factors in pSLE. Of the 32 patients, 25 (78.1%) were females. Age at onset of symptoms and diagnosis in the patients were 147.6 +/- 49 months and 154.3 +/- 48 months, respectively. The most common symptom on admission were joint problems, seen in 25 (78.1%) patients. Haematological alterations were seen in 25 (78.1%) cases during follow-up. Lupus nephritis was diagnosed in 10 (31.2%) patients. Malar rash was seen in a total of 12 (37.5%) patients during follow up, however it had been noted in five (15.6%) patients on admission. Antinuclear antibody and anti-dsDNA were positive in all patients and 31 (96.8%) patients, respectively. Decreased complement 3 and 4 levels were noted in 23 (71.8%) patients. Antiphospholipid antibody was studied in 27 patients and it was found to be positive in 13 (48.1%) patients. In conclusion, based on our findings, we would like to emphasize that pSLE has a large and remarkable clinical and laboratory findings.Öğe Pulmonary Hypertension in Children with Lower Respiratory Tract Infections in the Konya Province of Turkey(Georg Thieme Verlag Kg, 2020) Duzenli Kar, Yeter; Akin, Fatih; Sert, Ahmet; Arslan, SukruObjective Lower respiratory tract infections (LRTI) are one of the most important causes of morbidity and mortality in childhood. Hypoxemia, pulmonary hypertension (PH) due to pulmonary vasoconstriction, and heart failure due to various causes are the most important risk factors for mortality in LRTI. The aim of this study was to investigate characteristics of the patients with LRTI and the frequency of PH that developed secondary to LRTI. Materials and Methods The study included 70 patients who were diagnosed as having LRTI clinically and radiologically between January 2012 and March 2013 at Department of Pediatrics, Konya Training and Research Hospital. Age, sex, risk factors for LRTI, symptoms and physical examination findings, laboratory tests, and Doppler echocardiography findings of the patients were retrospectively reviewed. Results Of the patients, 44 (62.9%) were male and 26 (37.1%) were female. Thirty-seven (52.9%) patients were younger than 1 year, and the mean age was 2.5 +/- 3.11 years. The most common symptoms of the patients were cough and fever. Rhonchus, retraction, and crackles were found to be the most common findings in physical examinations. Heart failure was found in 10% of patients and PH was detected in 8.6% through Doppler echocardiography. Development of heart failure and the presence of bilateral patch infiltration on posteroanterior chest X-rays were significantly more frequent in patients with PH. Some 42.9% of patients had at least one viral agent in their nasopharyngeal swabs. The most common viral agents were respiratory syncytial virus and rhinoviruses. Conclusion PH may develop during the course of LRTI in children. Given that the development of PH can cause life-threatening complications such as heart failure, affected patients should be kept under close follow-up. It should be remembered that PH is more likely to develop in patients with bilateral patch infiltration on chest X-ray.Öğe A Rare Complication during Salmonella sp. Infection in a 4-Year-Old Child: Acute Pancreatitis(Georg Thieme Verlag Kg, 2021) Kilic, Ahmet O.; Akin, Fatih; Yazar, Abdullah; Cokbicer, Abdulkerim; Dogan, Metin; Energin, Vesile M.Objective We aimed to report a rare complication of acute pancreatitis which developed during Salmonella infection. Methods We report a 4-year-old girl with pancreatitis that occurred after salmonella gastroenteritis. Discussion Salmonella sp. infections cause serious mortality and morbidity worldwide. Salmonella transmission is mostly fecal oral from contaminated water and foods. Acute pancreatitis expresses the acute inflammatory process of the pancreas. Inflammation of the pancreas associated with bacterial, viral, and fungal agents can lead to acute pancreatitis. There are limited data regarding the frequency of infections leading to pancreatitis. Here, a pediatric case with pancreatitis that occurred after salmonella gastroenteritis is reported. Conclusion Acute pancreatitis due to S. sp. infection is very rare in children. Pancreatitis should be considered in patients with gastroenteritis with typical abdominal pain.Öğe Reply to the letter 'how can we better estimate the spontaneous passage of ?1 cm ureteral stones in children?'(W B Saunders Co-Elsevier Inc, 2021) Elmaci, A. Midhat; Donmez, M. Irfan; Akin, Fatih; Cetin, Bilal; Gunduz, Metin[Abstract Not Availabe]Öğe Simulation Based Endotracheal Intubation Education for Residents of Pediatrics(Emergency Medicine Physicians Assoc Turkey, 2021) Kilic, Ahmet Osman; Ture, Esra; Yazar, Abdullah; Akin, Fatih; Reisli, IsmailAim: Endotracheal intubation is an important element of cardiopulmonary resuscitation. Gaining adequate experience with endotracheal intubation during pediatric residency is important. Our clinic initiated a simulation-based endotracheal intubation training for pediatric residents. This study aimed to evaluate the success of our endotracheal intubation training. Materials and Methods: Residents received two programs of the simulation-based endotracheal intubation training at 1 year apart. Success rates were compared in terms of endotracheal intubation performance. Results: Intubation success rates after the first and second programs were 80% (28/35) and 100% (35/35), respectively, and the difference was significant (chi(2)=7.667, p=0.006). The mean durations of successful endotracheal intubation in both programs were 14.14 +/- 4.16 sec and 8.22 +/- 3.58 sec, respectively. Intubation durations in the second program were significantly lower than those of the first (p<0.01). Conclusion: In this study, the simulation based-endotracheal intubation training, which was performed 1 year apart using high-fidelity manikins, increased the success rate of endotracheal intubation attempts and shorten the intubation time.Öğe Zonulin and claudin-5 levels in multisystem inflammatory syndrome and SARS-CoV-2 infection in children(Wiley, 2022) Kilic, Ahmet O.; Akin, Fatih; Yazar, Abdullah; Akcan, Ozge Metin; Topcu, Cemile; Aydin, OrkunAim SARS-CoV-2 infection in children is generally asymptomatic or mild; however, it can lead to a life-threatening clinical condition, multisystem inflammatory syndrome in children (MIS-C), days or weeks after the infection. Increased intestinal permeability isa possible triggering factor at the onset of the hyperinflammation associated with MIS-C. Zonulin and claudin-5 are involved in intestinal permeability. In this study, we aimed to investigate serum zonulin and claudin-5 levels in SARS-CoV-2 infection and MIS-C disease. Methods The study group consisted of children diagnosed with MIS-C or SARS-CoV-2 infection who presented to a university hospital paediatric emergency or infectious diseases departments. The control group included well patients seen at the General Pediatrics units for routine follow-up. Serum zonulin and claudin-5 levels were measured at the time of diagnosis. Results Fifteen patients were included in the MIS-C group, 19 in the SARS-CoV-2 infection group and 21 in the control group. The mean zonulin level in the MIS-C group was significantly higher than in the control group (P < 0.001). Mean Claudin-5 levels were Psignificantly lower in the SARS-CoV-2 infection group than in the control group (P < 0.001). Conclusion These results indicate that increased intestinal permeability may be involved in the pathogenesis of SARS-CoV-2 infection and MIS-C disease. Larger clinical trials are needed to clarify the role of serum zonulin and claudin-5 on intestinal permeability in MIS-C and SARS-CoV-2 infection in children.
