scholarly journals COVID-19 and Digestive System in Children: A Retrospective Study

2020 ◽  
Vol 23 (11) ◽  
pp. 782-786
Author(s):  
Mohammadreza Esmaeili Dooki ◽  
Sanaz Mehrabani ◽  
Hadi Sorkhi ◽  
Maryam Nikpour ◽  
Mohamadreza Tabatabaie ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Retrospective Study ◽  
Digestive System ◽  
Liver Enzymes ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Liver Function Tests ◽  
Pulmonary Lesions ◽  
Respiratory Involvement ◽  
Gi Symptoms

Background: The aim of this study was to identify gastrointestinal (GI) and liver injury presentations in children admitted with COVID-19 infection. Methods: In this retrospective study, we studied all children with suspected symptoms of COVID-19, referred to Amirkola Children’s Hospital. Clinical manifestations of the digestive and respiratory systems and liver function tests were evaluated for all cases. Results: Eighteen children were studied. The most common clinical symptoms were fever, anorexia, weakness, nausea and vomiting, cough, diarrhea, and abdominal pain, respectively. Also, 5/18 (27.8%) and 7/18 (38.9%) of cases had abnormally high alanine aminotransferase (ALT), aspartate aminotransferase (AST), respectively. Additionally, in icteric cases, direct bilirubin was raised. There was no significant relationship between pulmonary lesions and abnormal excess in ALT (P = 0.59) and AST (P = 0.62). Conclusion: The findings showed that there were no severe clinical GI symptoms in children with COVID-19 infection. Besides, children with increased liver enzymes did not have more respiratory involvement than those without a rise in liver enzymes.

scholarly journals Non-Celiac Gluten Sensitivity: A Challenging Diagnosis in Children with Abdominal Pain

2018 ◽  
Vol 73 (Suppl. 4) ◽  
pp. 39-46 ◽  
Author(s):  
Frank M. Ruemmele
Keyword(s):  
Abdominal Pain ◽  
Celiac Disease ◽  
Clinical Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Clear Cut ◽  
Clinical Presentations ◽  
New Findings ◽  
Three Phase ◽  
Gi Symptoms

Several disorders related to the ingestion of gluten are well recognized despite overlapping clinical presentations: celiac disease, an autoimmune enteropathy triggered by gluten ingestions in susceptible individuals, allergy to wheat, and more recently non-celiac gluten sensitivity (NCGS). While celiac disease and wheat allergy are well-known disorders with a clear-cut diagnosis based on clinical tests and biological parameters, NCGS is a more difficult diagnosis, especially in children with functional gastrointestinal (GI) complaints. NCGS is considered a syndrome of intestinal but also extraintestinal symptoms occurring within hours, but sometimes even after several days of gluten ingestion. In children, the leading symptoms of NCGS are abdominal pain and diarrhea, while extraintestinal symptoms are rare, in contrast to adult patients. No precise diagnostic test nor specific biomarkers exist, except a rather cumbersome three-phase gluten-exposure, gluten-free diet, followed by a blinded placebo-controlled gluten challenge with crossover to provoke symptoms elicited by gluten in a reproducible manner that disappear on gluten-free alimentation. Recent data indicate that the peptide part of wheat proteins is not necessarily the sole trigger of clinical symptoms. Mono- or oligosaccharides, such as fructan and other constituents of wheat, were able to provoke GI symptoms in clinical trials. These new findings indicate that the term gluten sensitivity is probably too restrictive. The incidence of NCGS was reported in the range of 1–10% in the general population and to increase steadily; however, most data are based on patients’ self-reported gluten intolerance or avoidance without a medically confirmed diagnosis. Treatment consists of gluten avoidance for at least several weeks or months. Patients with NCGS require regular reassessment for gluten tolerance allowing with time the reintroduction of increasing amounts of gluten.

scholarly journals The Results of Giardiasis Treatment Using Giardicidal Drugs and their Combination with Probiotics in Children: A Retrospective Cohort Study

2018 ◽  
Vol 17 (4) ◽  
pp. 301-306
Author(s):  
Olga G. Kimirilova ◽  
Gennady A. Kharchenko
Keyword(s):  
Abdominal Pain ◽  
Combination Therapy ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Saccharomyces Boulardii ◽  
Lactase Deficiency ◽  
Intestinal Dysbiosis ◽  
Number Of Patients ◽  
Freeze Dried ◽  
Inpatient Settings

Background. Giardiasis in children remains an urgent problem, the significance of which is determined by the endemicity for many countries and regions, outbreaks of sporadic epidemics, polymorphism of clinical symptoms, and insufficient treatment efficacy. Objective. Our aim was to study the results of giardiasis treatment using giardicidal drugs or their combination with probiotics in children. Methods. We analyzed the frequency of Giardia lamblia elimination (the main outcome) as a result of giardiasis treatment (laboratory confirmed) in children aged from 3 months to 18 years who received giardicidal drugs (nifuratel, albendazole) or their combination with probiotics based on Saccharomyces boulardii (probiotic 1) and live freeze-dried lactic acid bacteria Lactobacillus acidophilus (L. gasseri), Bifidobacterium infantis, and Enterococcus faecium (probiotic 2) in outpatient or inpatient settings. Additionally, we registered the duration of the main symptoms of giardiasis (abdominal pain, diarrhea), the prevalence of intestinal dysbiosis and lactase deficiency. The considering period is from January 2015 to September 2017. Results. The results of giardiasis treatment were studied in 4 groups: monotherapy with nifuratel (n = 65) or albendazole (n = 64), a combination of nifuratel + probiotic 1 (n = 67) or albendazole + probiotic 2 (n = 64). The groups were comparable by sex, age, and clinical manifestations of the disease. The elimination of lamblia on the 14–16th day of monotherapy with giardicidal drugs was achieved in 56–60%, when combined with probiotics — in 84% of patients for each combination (df = 3, p < 0.001). Against the background of combination therapy, the disease symptoms (abdominal pain, diarrhea, vomiting) were reversed 1.5 times faster; the number of patients with lactase deficiency and intestinal dysbiosis decreased two and more times, under monotherapy with giardicidal drugs — 1.2 times (df = 3, p < 0.001). Conclusion. Giardiasis treatment in children using combination therapy, including giardicidal drugs and probiotics, is more effective than monotherapy with giardicidal drugs.

Lupus Enteritis, a Severe and Potentially Fatal Complication of Systemic Lupus Erythematosus

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S64-S64 ◽  
Author(s):  
Hany Meawad ◽  
Andrew Kobalka ◽  
Yaseen Alastal ◽  
Brooke Koltz
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Abdominal Pain ◽  
Lupus Erythematosus ◽  
Clinical Symptoms ◽  
Meckel’S Diverticulum ◽  
Severe Abdominal Pain ◽  
Meckel's Diverticulum ◽  
Systemic Lupus ◽  
Gi Symptoms ◽  
Lupus Enteritis

Abstract Objectives Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that can show wide manifestations in many organs. The gastrointestinal tract (GI) is commonly affected in SLE; symptoms are often related to the side effect of medications or to infections. One rare GI complication of SLE is lupus enteritis, a complex of manifestations including intestinal vasculitis and enteric ischemia, which presents with vague symptoms of severe abdominal pain, nausea, vomiting, and diarrhea. Methods We present the case of a 25-year-old female who was admitted to the hospital with complaints of abdominal pain, vomiting, diarrhea, and a history of SLE. Complicating the patient’s clinical picture and diagnosis was gastrointestinal bleeding requiring multiple blood product transfusions secondary to bleeding Meckel’s diverticulum, lupus flare, and positive stool culture for campylobacter antigen. Repeated upper and lower GI endoscopies with biopsy failed to identify the exact cause of bleeding and GI symptoms; the patient underwent exploratory laparotomy with right hemicolectomy to control bleeding. Microscopic examination revealed marked small vessel acute vasculitis consistent with lupus enteritis, ischemic enteritis, and Meckel’s diverticulum with gastric heterotopia. Results Our patient was subsequently aggressively treated; however, she developed further associated complications and died. Conclusion The pathologic diagnosis of lupus enteritis is challenging due to the nonspecific clinical symptoms and paucity of pathologic findings on most biopsy specimens. Lupus enteritis must be considered in the differential diagnosis of severe abdominal pain in lupus patients to aid in early diagnosis and treatment as this condition could be severe and potentially fatal.

scholarly journals Retrospective study of clinical profile and outcome of pediatric dengue cases in a teaching hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 226
Author(s):  
Alok Kumar M. K. ◽  
Timmangouda R. Patil ◽  
Santhosh Veerabadhraiah
Keyword(s):  
Retrospective Study ◽  
Respiratory Distress ◽  
Dengue Fever ◽  
Clinical Symptoms ◽  
Fluid Management ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Study Results ◽  
Wide Range

Background: Dengue fever is an acute febrile illness caused by 4 closely related viral serotypes of the genus Flavivirus. Dengue has a broad range of clinical manifestations and often with unpredictable clinical evaluation and outcome. So this study has been done to see the wide range of clinical presentation of dengue and its outcome.Methods: It is a retrospective study done in tertiary hospital during the period of 8 months. Study was done by collecting the previous records from hospital record section. There were 48 cases of serologically confirmed cases of dengue which satisfied the inclusion and exclusion criteria were included in the study. Results: In our study there were 52% of the cases of dengue fever, 16.6% of cases were dengue fever with warning signs and remaining 31.4% of patients were severe dengue. Common Clinical symptoms at admission were fever (100%), vomiting (77%), respiratory distress (56.25%), generalised weakness (54.1%) and pain abdomen (33.3%). Less common symptoms were loose stools (6.25%), periorbital puffiness (6.25%), altered sensorium (4.1%), oliguria (2%) and bleeding manifestations (2%). Out of these dengue children 70.8% of these children improved without complication, 20.8 % of children improved with complication, in the form of ARDS, acute liver failure, DSS, meningitis, 6.25 % of these children went DAMA and  2 % of children expired.Conclusions: In our study atypical presentations like respiratory distress, loose stools meningitis were commonly noted and bleeding manifestation at admission was rare in our study. Platelet transfusions have little role in management of dengue patients. Early diagnosis, careful monitoring and proper fluid management goes a long way in reducing the mortality due to dengue hemorrhagic fever and shock syndrome.  

Clinical and laboratory symptoms of changes in the pyelocaliceal system in pyelonephritis in children

1980 ◽  
Vol 61 (6) ◽  
pp. 24-25
Author(s):  
A. A. Protopopov
Keyword(s):  
Uric Acid ◽  
Abdominal Pain ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Lower Back ◽  
Calcium Phosphorus

It was found that the clinical symptoms of pyelonephritis in children are a reflection of changes in the calyx-pelvis system. Clinical manifestations such as asthenia, dysuric disorders, pain in the abdomen and lower back, with bilateral changes in the calyx-pelvic system, occur 2-4 times more often than with unilateral ones. The degree of impairment of the outflow of urine from the kidneys also clearly affects the frequency of asthenia, abdominal pain, dysuric and dyspeptic disorders. With pyelonephritis, the excretion of ammonia decreases and the release of oxalates, uric acid, calcium, phosphorus increases in proportion to the severity of changes in the pyelocaliceal system.

scholarly journals Cholestatic syndrome in patients with systemic erythematous lupus: Differential diagnostic aspects

2008 ◽  
Vol 61 (5-6) ◽  
pp. 291-294 ◽  
Author(s):  
Ratko Tomasevic ◽  
Gradimir Golubovic ◽  
Miroslav Kiurski ◽  
Aleksandar Pavlovic
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Liver Disease ◽  
Lupus Erythematosus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Previous Treatment ◽  
Liver Function Tests ◽  
Systemic Lupus ◽  
Elevated Bilirubin ◽  
Cholestatic Syndrome

Systemic lupus erythematosus is a multisystemic inflammatory disease with diverse clinical manifestations. Hepatic lesion is a rarely seen complication of systemic lupus erythematosus. We report a case of complication of lupus presented as cholestatic syndrome in a 41-year old woman with lupus in her medical history for the past seven years. A general examination showed jaundice and hepatomegaly, with elevated bilirubin and aminotransferase levels in the liver function tests. The liver biopsy was performed and the microscopic examination revealed cholestasis with bile plugs without any signs of inflammation and liver tissue necrosis. After the three months steroid therapy the clinical symptoms resolved and the laboratory values normalized. The various factors are considered to be involved in the ethiopathogenesis of liver damage. Previous treatment with potentially hepatotoxic drugs (imuran in this case) or viral hepatitis have usually been implicated as the main cause of liver disease in lupus patients. On the other hand, even after careful exclusion of these ethiologies, the problem remains whether to classify the patient as having a primary liver disease with associated autoimmune and laboratory features resembling lupus, or as having a liver disease as a manifaestaion of lupus.

scholarly journals Fecal calprotectin as a prognostic factor for gastrointestinal involvement in pediatric Henoch-Schölein purpura patients: a retrospective analysis

2020 ◽  
Author(s):  
Eun Young Paek ◽  
Dae Yong Yi ◽  
Ben Kang ◽  
Byung-Ho Choe
Keyword(s):  
Abdominal Pain ◽  
Prognostic Factor ◽  
Clinical Symptoms ◽  
Systemic Vasculitis ◽  
Clinical Score ◽  
Fecal Calprotectin ◽  
Gi Tract ◽  
Early Screening ◽  
Gi Symptoms ◽  
Pain Duration

Abstract Background Henochchönlein purpura (HSP) is a systemic vasculitis occurring in children. HSP prognosis is usually good, but its recurrence is relatively common, and if the intestines get affected, severe complications could arise, including intussusception or intestinal perforation. Here, we investigated the value of fecal calprotectin (FC) in early screening of HSP and the usefulness of FC as a prognostic factor for GI manifestations. Methods We retrospectively reviewed the medical records of pediatric patients who were diagnosed with HSP and had undergone FC testing during the acute phase. Subjects were categorized into gastrointestinal (GI) involvement and non-GI involvement groups based on their clinical symptoms. Moreover, GI involvement levels were divided as follows: upper GI tract up to the duodenum and lower GI tract from the ileocolic Results Sixty-nine patients were diagnosed with HSP and underwent FC testing. Among them, 40 patients (58.0%) showed signs of GI involvement. The GI involvement group showed higher FC levels (379.9 짹 399.8 vs. 77.4 짹 97.6 mg/kg, P = 0.000). There were no significant differences in the relapse of HSP symptoms or GI symptoms. The cut-off value according to GI involvement was 69.10 mg/kg (P < 0.01). Patients with FC levels of >50 mg/kg more frequently showed GI involvement (77.8% vs. 20.8%, P = 0.000) and a more severe prognosis. Significant correlations were observed for abdominal pain duration, HSP clinical score, and abdominal pain severity (P = 0.002, P = 0.000, and P = 0.000, respectively). Additionally, FC levels were significantly higher in patients with lower GI tract involvement (214.67 짹 150.5 vs. 581.8 짹 510.1 mg/kg, P = 0.008), and the cut-off value was 277.5 mg/kg (P < 0.01). Conclusion FC testing is useful for predicting the involvement of GI, location of involvement, and course of prognosis in pediatric HSP patients.

scholarly journals CYTOMEGALOVIRUS-INDUCED GASTROINTESTINAL BLEEDING AND PANCREATITIS COMPLICATING SEVERE COVID-19 PNEUMONIA: A PARADIGMATIC CASE.

2020 ◽  
Vol 12 (1) ◽  
pp. e2020060 ◽  
Author(s):  
Giacomo Marchi ◽  
Alice Vianello ◽  
Ernesto Crisafulli ◽  
Alessio Maroccia ◽  
Stefano Francesco Crinò ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Bleeding ◽  
Respiratory Symptoms ◽  
Clinical Manifestations ◽  
Immune Dysregulation ◽  
Multiple Infections ◽  
Key Points ◽  
Gi Symptoms ◽  
Clinical Description ◽  
High Level

Key points: COVID-19 is a novel pandemic disease whose pathophysiology and clinical description are still not completely defined. Besides respiratory symptoms, gastrointestinal (GI) symptoms (especially including anorexia, diarrhea, and abdominal pain) represent the commonest clinical manifestations. Emerging data point out that severe SARS-CoV-2 infection causes an immune dysregulation, which in turn may favor other infections. Here we describe a patient with severe COVID-19 pneumonia who developed in the resolving phase abdominal pain associated to cytomegalovirus (CMV)-induced duodenitis with bleeding, and pancreatitis. A high level of suspicion toward multiple infections, including CMV, should be maintained in COVID-19 patients with heterogeneous clinical manifestations.

scholarly journals A human case of Dioctophyma renale (giant kidney worm) accompanied by renal cancer and a retrospective study of dioctophymiasis

Parasite ◽  
2019 ◽  
Vol 26 ◽  
pp. 22 ◽  
Author(s):  
Fengkun Yang ◽  
Weizhe Zhang ◽  
Baiyan Gong ◽  
Lan Yao ◽  
Aiqin Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Renal Cancer ◽  
Clinical Symptoms ◽  
Subcutaneous Tissue ◽  
Clinical Manifestations ◽  
Morphological Characteristics ◽  
Human Case ◽  
Tissue Sections ◽  
History Of ◽  
Loin Pain

Due to the rarity of human cases and the nonspecific clinical symptoms of dioctophymiasis, Dioctophyma renale infection is not well recognized and is easily neglected or misdiagnosed. Recently, we diagnosed a human case of dioctophymiasis accompanied by renal cancer. To enhance the understanding of human dioctophymiasis, this case is presented here, and a retrospective study of this disease was conducted based on relevant papers screened from PubMed and three Chinese databases. In the end, 32 papers describing 37 human cases of dioctophymiasis were assessed. These cases were distributed in ten countries of Asia, Europe, North America and Oceania, with the highest number in China (n = 22). The majority of the cases occurred in adults (91.9%, 34/37) and involved the kidneys (83.8%, 31/37). Ectopic parasitism mainly occurred in subcutaneous tissue (83.3%, 5/6). A proportion of 45.9% (17/37) of individuals had a history of eating raw or undercooked fish or frogs. The main clinical manifestations of human dioctophymiasis were loin pain (59.5%) and hematuria (59.5%). All the cases were diagnosed based on the morphological characteristics of eggs or adults in urine or tissue sections. Currently, there is no strictly defined therapeutic approach. This is the first retrospective analysis of human cases of dioctophymiasis. These review data will deepen our understanding of dioctophymiasis and help avoid misdiagnosis in clinical practice.

scholarly journals Simple Acupoints Prescription Flow Chart Based on Meridian Theory: A Retrospective Study in 102 Dogs

2013 ◽  
Vol 2013 ◽  
pp. 1-13
Author(s):  
Jong-Ho Jeong ◽  
Joo-Young Song ◽  
Hyo-Gwon Jo ◽  
Ji-Min Kim ◽  
Samuel-S. Yoon ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Retrospective Study ◽  
Intervertebral Disc ◽  
Recovery Time ◽  
Acupuncture Treatment ◽  
Clinical Symptoms ◽  
Flow Chart ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Simple Flow

To help the clinicians prescribe acupoints easily and effectively, we developed one simple flow chart to select acupoints. This study aimed to evaluate the usefulness of flow chart to select acupoints in dogs. Total 102 dogs showing intervertebral disc disease (IVDD) (n=12), vomiting (n=11), diarrhea (n=2), abdominal pain (n=5), cough (n=66), or epilepsy (n=6) received acupuncture treatment according to the chart, and its outcomes were evaluated as regards clinical symptoms, duration, treatment numbers, and recovery time. Dogs (8/8) with IVDD from grades I to III recovered over periods of 5 days to 6 weeks after 1–12 treatments, while 1/4 dogs with grade IV recovered over 7 weeks after 15 treatments. Vomiting dogs with acute/subacute (n=8) and chronic symptoms (n=3) required about 1 and 7 treatments to recover fully, respectively. All dogs (n=5) with abdominal pain showed fast relief within 24 hours after acupuncture. Two diarrhea cases recovered over 2–9 days after 1-2 treatments. Fifty-four of 66 coughing dogs were recovered by 1-2 treatments. And 5 of 6 epilepsy dogs under a regular acupuncture treatment had no epileptic episode during followup of 12 months. These results suggest that this flow chart can help the clinicians prescribe acupoints effectively.

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