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    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, Sukru
    In 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.
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    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, Fatih
    Acute 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.
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    Mean platelet volume in children with hepatitis A
    (Biomed Central Ltd, 2016) Akin, Fatih; Sert, Ahmet; Arslan, Sukru
    Background: 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.
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    Mean platelet volume in children with hepatitis A
    (Biomed Central Ltd, 2016) Akin, Fatih; Sert, Ahmet; Arslan, Sukru
    Background: 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.
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    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, Sukru
    Objective 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.