Turkish Journal of Pediatric Disease

Objective: Ambulatory blood pressure monitoring (ABPM) is the preferred method for diagnosis of hypertension(HT) in children. Here, we aimed to demonstrate the reasons for ABPM application and incidence of HT, white coat and masked HT in our cohort besides the evaluation of dipping status, biochemical and radiological parameters between the patients with normotension, elevated blood pressure(EBP) and HT. Material and Methods: Twenty-four hour ABPM results of children followed at department of pediatric nephrology and whose office blood pressure measurements revealed HT or EBP and ABPM records of normotensive patients having chronic kidney disease or renal anomalies were evaluated retrospectively. Twenty-four hour ABPM SD score ≥1.96 defined HT while the value between 1.64 and 1.95 indicated EBP. In addition to assessment of blood pressure loads and nocturnal dipping; age, gender, body mass index(BMI), proteinuria, kidney function tests and ultrasound of urinary system were also assessed. Results: Although ABPM was applied to total of 244 patients, 189 of them were included in the study. High casual blood pressure measurements in 108 (57.1%) asymptomatic patients constituted the major group for ABPM application. Total of 57 patients (30.2%) were normotensive, 18 (9.5%) with EBP and 114 (60.3%) were hypertensive. No difference was found in regards of BMI, proteinuria, serum creatinine levels and sonographic results between the groups. Patients with HT and EBP had significantly lower nocturnal dip than normotensive group (p&amp;lt;0.001). However there was no difference in number of patients with inadequate nocturnal fall in all three groups. Conclusion: ABPM should be preferred for definitive diagnosis of HT in childhood. Patients with inadequate nocturnal fall should be evaluated carefully and followed-up regularly as it had been implicated in the development of cardiovascular disease.

Mehmet Baha Aytac

Kenan Doğan

Şule Ayas Ergül

Neslihan Dinçer Malkoç

Kenan Bek

Ambulatory Blood Pressure Monitoring in Children: Single Center Experience

儿童动态血压监测：单中心经验

Objective: Acute poststreptococcal glomerulonephritis (APSGN) is the leading cause of acute glomerulonephritis in children. APSGN often develops after pharyngitis due to the activation of antibodies and complement proteins to streptococcal antigens by an immune complex-mediated mechanism. In this study, we aimed to analyze APSGN patients diagnosed before and after the pandemic, with their demographic characteristics , clinical and laboratory findings. Material and Methods: In this study, patients diagnosed with APSGN in a tertiary children’s hospital between October 2022 and March 2023 were retrospectively analyzed. The patients were compared with a large cohort followed up with the same diagnosis between 2010-2022. The patients were divided into two groups: group I (n=153, pre-pandemic) and group II (n=28, post-pandemic). Clinical, radiologic, and laboratory findings were compared between the two groups. Results: The mean age at diagnosis in the group I (2010-2022) was 7.36±2.92 years, and in the group II 8.69±2.51 years. More than three-fourths of the cases [group I/group II; 106 (69.3%) / 21 (71.4%)] were male in both studies. As macroscopic hematuria was the most common finding in the group I, hypertension was the most common finding in group II. Complement 3 (C3) levels were significantly lower in the group I and C3 recovery time was significantly shorter in the group II. Five (19.4%) of patients in group I and only one patient in group II progressed to RPGN. Conclusion: The incidence of APSGN increased rapidly after the Covid-19 pandemic when the use of face masks was discontinued. Although the patients presented with a serious clinic, their prognosis was better.

Bahriye Uzun Kenan

Evrim Kargın Çakıcı

Tülin Güngör

Deniz Karakaya

Evra Çelikkaya

Aysun Çaltık Yılmaz

Changing Face of Pediatric Acute Poststreptococcal Glomerulonephritis in the Pre and Post Pandemic Period: A Comparison Study

大流行前后儿童急性链球菌后肾小球肾炎的变化：一项比较研究

Objective: The aim of our study was to determine concerns and fears of parents of children with asthma towards the use of ICS, and its’ impact on asthma management. Material and Methods: This prospective study was conducted between 01.04.2023 and 01.06.2024, at the Dr.Burhan Nalbantoğlu Hospital, The Pediatric Immunology and Allergy Clinic, and patients who had been followed up with asthma diagnosis, were included. Results: There was 100 patients in our study. Out of 100 patients, 67 (67 %) were male. The median age of the children was 84.5 months (IQR,73.2-119.5). The median age of asthma diagnosis was 65.5 months (IQR, 24-76.75). All of the patients were using asthma maintenance therapy, and 87 (87%) patients were using it regularly. Out of 100 parents, 78 (78 %) had fear and concern of potential adverse effects of using inhaled corticosteroid treatment long time in their children. The most common fears and concerns were described as causing weight gain in 34 (34%) parents, dependance to drug in 33 (33%) parents, and causing growth retardation in 27 (27 %) parents. Patients having fear of corticosteroid tended to have difficulties in medicine use (p=0.001). Patients not knowing the treatment of asthma, and not knowing the role of corticosteroid in asthma tended not to have fear of corticosteroid treatment (p=0.046, and 0.001 respectively). Conclusion: In our study, 78% of the parents had fear and concern of potential adverse effects of inhaled corticosteroid treatment. The most common fear and concerns were about weight gain, dependance to drug, and growth retardation.

Azize Pınar Metbulut

Evaluation of Parents’ Opinions About the Fear of Inhaler Corticosteroid Treatment in Child Patients Diagnosed with Asthma

评估哮喘患儿父母对吸入性皮质类固醇治疗恐惧的意见

Objective: The aim of the this study was to evaluate immunoglobulin A vasculitis (IgAV) patients on colchicine therapy and determine the causative factors leading to the initiation and maintenance of colchicine. Material and Methods: This retrospective study was conducted receiving IgAV patients on colchicine at our clinic between January 2013 and June 2023. Demographic, clinical, and laboratory data of IgAV patients were obtained from their electronic medical records. Results: A total of 33 IgAV patients receiving colchicine, 20 (60.6%) males and 13 (39.4%) females, were included in the study. The mean age at diagnosis of IgAV was 111.6±45.5 months. Colchicine was initiated in 13 (39.4%) patients with persistent rash, 8 (24.2%) with severe gastrointestinal tract involvement, seven (21.2%) with generalized/severe rash, and five (15.2%) with recurrent IgAV. The median elapsed time to colchicine initiation was 30 (10.5-60) days. The median duration of colchicine usage was ten (IQR, 6-54) months. Colchicine treatment was discontinued in 14 patients after a median 6.5 (IQR, 3-11.2) months. At the last visit, 13 (39.4%) patients were receiving colchicine for familial Mediterranean fever (FMF), four (12.1%) for recurrent IgAV, and two (6.1%) for persistent rash. Conclusion: Colchicine should be kept in mind especially in the presence of severe, persistent or recurrent rash. Early initiation of colchicine treatment should be considered in IgAV patients with severe GI tract disease, especially in countries where FMF is common.

Merve Cansu Polat

Mehveş Işıklar Ekici

Melike Mehveş Kaplan

Elif Çelikel

Zahide Ekici Tekin

Vildan Güngörer

Cüneyt Karagöl

Nimet Öner

Didem Öztürk

Emine Özçelik

Yasemin Uğur Es

Sultan Nilay Yoğun

Banu Acar

A Familiar Face in the Treatment of Immunoglobulin A Vasculitis: Colchicine

秋水仙碱在免疫球蛋白A血管炎治疗中的熟悉面孔

Objective: Phenylketonuria is a metabolic disorder resulting from mutations in the PAH gene, causing elevated blood phenylalanine (Phe) levels which can lead to severe neurological damage if untreated. The primary treatment is a lifelong low-protein diet with amino acid substitutes and micronutrient supplements. During the COVID-19 pandemic, classical phenylketonuria (PKU) patients faced significant challenges, including restricted access to routine care like clinical visits and metabolic control monitoring. The aim of the this study was to examine the disruptions in outpatient visits, the variances in pre- and post-pandemic Phe levels, and clinical severity among patients who contracted COVID-19. Material and Methods: Starting from the pandemic date of March 11, 2020, demographic data, laboratory characteristics, and details about COVID-19 infection were retrospectively reviewed for classical PKU patients with accessible electronic records from March 2018 to March 2022. Results: When the median blood Phe levels before and after the pandemic were compared, a significant difference was found. We observed that adult patients diagnosed with classical PKU often defaulted on their follow-up appointments. Conclusion: The COVID-19 pandemic significantly disrupted the follow-up and management of classical PKU patients. However, no severe COVID-19 cases were reported among this population, suggesting they did not face an increased risk from the infection. This study emphasizes the critical need to develop robust strategies for patient engagement and follow-up, especially for adult classical PKU patients who are at risk of discontinuing routine care.

Ayca Burcu Kahraman

Yılmaz Yıldız

Neslihan Nisa Geçici

Kısmet Çıkı

İzzet Erdal

Halil Tuna Akar

Ali Dursun

Ayşegül Tokatli

Serap Sivri

Impact of the COVID-19 Era on Phenylalanine Levels and Classical Phenylketonuria Patients Follow-Up: A Retrospective Analysis

COVID-19时代对苯丙氨酸水平及经典型苯丙酮尿症患者随访的影响：回顾性分析

Objective: This study aimed to investigate the relationship between maternal and child nutritional status, considering the importance of children’s nutrition at an early age. Material and Methods: Mother-child pairs who attended a social pediatrics outpatient clinic participated in the study. A survey form was used to collect data, including questions regarding general information, breastfeeding, complementary feeding, and dietary records. The 24-hour dietary recall method was used as a dietary assessment method. Height and body weight were taken using measurement techniques by researchers. Data of pairs were collected from mothers, and they assisted in taking anthropometric measurements of the children. The recorded data were used to calculate the percentage of daily energy and nutrient requirements met by each participant. Pearson correlation analysis was performed to detect the coefficients of the relationship in SPSS statistic package program. Results: The study included 104 mother-child pairs. The mean age of the mother and children was 30.7±5.7 years and 41.7±17.3 months, respectively. While 13.5% of the mothers were obese, 16.3% of the children were obese. A significant relationship was found between mothers’ and children’s daily main and snack numbers. The percentage of meeting their energy and protein requirements did not vary according to breastfeeding and complementary feeding parameters. Statistical analysis results showed significant relationships between percentages of meeting their macro and micronutrient requirements of mother-child pairs, except for energy and magnesium. Conclusion: The study’s results indicate that there is a relationship between the nutritional status of mothers and their children. There is a need for further research investigating the nutritional status of both mothers and children and emphasizing the interdependency of nutrition within the family.

Aylin Bayındır Gümüş

Seda Nur Köktürk

Hülya Yardımcı

Aysun Kara Uzun

Nevra Koç

The Association Between Maternal and Child Nutritional Status: Evidence From a Social Pediatrics Outpatient Clinic

母婴营养状况的关联性：来自社会儿科门诊的证据

Objective: Moyamoya disease is a rare progressive cerebrovascular disorder. It is characterized by progressive stenosis in the terminal branches of the internal carotid arteries, leading to the formation of an abnormal vascular network. The aim of this study was to present the clinical findings and outcomes of pediatric patients diagnosed with Moyamoya disease by analyzing our cohort to identify the common clinical presentations, diagnostic challenges, and treatment outcomes associated with this rare cerebrovascular disorder. Material and Methods: Nine pediatric cases of Moyamoya disease admitted over a 10-year period were retrospectively reviewed. Clinical presentations, associated diseases, radiological findings, treatments, and outcomes were analyzed. Results: The median age at diagnosis was 48 months (3-87). Presenting symptoms included hemiparesis in five patients, seizures in six patients, headache in one patient, and choreathetosis with headache in one patient. Three patients experienced symptoms triggered by fever, and one patient by exposure to hot water. Seven patients presented with ischemic symptoms, while two presented with non-ischemic symptoms. Neurofibromatosis type-1 (NF-1) was associated with the disease in four patients. Recurrent attacks occurred in two patients. Interictal electroencephalograms (EEGs) showed hemispheric/focal slowing in five cases. Cranial magnetic resonance imaging (MRI) revealed infarctions in seven patients, and MR angiography showed bilateral findings in six patients. Two patients experienced no long-term sequelae. Conclusion: Moyamoya disease manifests with both ischemic and non-ischemic symptoms. Recognition of non-ischemic presentations requires a high index of suspicion for accurate diagnosis.

Betül Diler Durgut

Beril Dilber

Tulay Kamasak

Ahmet Sarı

Ali Cansu

Clinical Findings and Outcome of Moyamoya Disease/Syndrome

烟雾病/综合征的临床表现与预后

Turkish Journal of Pediatrics 1st Ankara Bilkent City Hospital, Pediatrics Congress 17-19 October 2024, Presentation Abstracts

Orkun Tolunay

Meeting Abstract 2024

会议摘要 2024

Vaccination is the cheapest, safest, and most successful public health approach to protect children's health and prevent infectious diseases. High vaccination rates ensure community immunity and prevent epidemics. A drop in immunization rates below 95% can lead to outbreaks of vaccine-preventable diseases, particularly measles, as well as increased morbidity and mortality. With the recent emergence of vaccine hesitancy (VH) and vaccine refusal (VR) concepts, especially in developed countries, the number of unvaccinated children is increasing both in our country and around the world. Vaccine hesitancy stems from many personal and environmental reasons, as well as sociocultural, environmental, economic, and political reasons. Lack of information about vaccines, fear of side effects, concerns about vaccine efficacy and safety, the idea that vaccines are harmful, anti-vaccine publications on the internet and social media, belief in natural immunity, and religious reasons are seen as the most common reasons for VH and VR in different studies. Raising awareness in society about the importance and necessity of vaccination, identifying the factors that lead to VH, and producing solutions are among the primary measures to be taken. Healthcare personnel play a very important role in the fight against vaccine hesitancy. It is important to establish good, effective, and trusting communication with vaccine-hesitant parents. Recently, in addition to vaccine refusal cases, the number of families refusing vitamin K and heel blood sampling has been increasing. Vaccine refusal, and refusal of health care services will increase neonatal and childhood morbidity and mortality. Legal measures should be taken to protect the best interests of the child. Valid and reliable scales that evaluate parents' vaccine acceptance and hesitancy will be a source of information in the fight against vaccine hesitancy.

Ayça Kömürlüoğlu Tan

S. Songül Yalçın

Childhood Vaccination and Vaccine Hesitancy: A Comparison Between Türkiye and the signifificance of vaccination

儿童疫苗接种与疫苗犹豫：土耳其与疫苗接种重要性的比较

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Share Submission Experience

Ambulatory Blood Pressure Monitoring in Children: Single Center Experience

Changing Face of Pediatric Acute Poststreptococcal Glomerulonephritis in the Pre and Post Pandemic Period: A Comparison Study

Evaluation of Parents’ Opinions About the Fear of Inhaler Corticosteroid Treatment in Child Patients Diagnosed with Asthma

A Familiar Face in the Treatment of Immunoglobulin A Vasculitis: Colchicine

Impact of the COVID-19 Era on Phenylalanine Levels and Classical Phenylketonuria Patients Follow-Up: A Retrospective Analysis

The Association Between Maternal and Child Nutritional Status: Evidence From a Social Pediatrics Outpatient Clinic

Clinical Findings and Outcome of Moyamoya Disease/Syndrome

Meeting Abstract 2024

Childhood Vaccination and Vaccine Hesitancy: A Comparison Between Türkiye and the signifificance of vaccination

Impact of the COVID-19 Era on Phenylalanine Levels and Classical Phenylketonuria Patients Follow-Up: A Retrospective Analysis