Idiopathic hemosiderosis of the lung tissue

Idiopathic hemosiderosis of lung tissue is a rare disease with lung damage caused by massive hemorrhage into the lung tissue, with iron-containing hemosiderin deposition. Mainly it occurs in childhood. The article describes the clinical case of idiopathic hemosiderosis of lung tissue in a 3 years 11 months old child. The girl was observed for anemia of unclear etiology, she was repeatedly treated at a hospital and received erythrocyte transfusions. In the future, respiratory syndrome joined the anemic syndrome. It should be noted that a correctly collected anamnesis, timely diagnosis of the disease and the appointment of immunosuppressive therapy make it possible to prevent the rapid progression of the process and the development of complications, including pneumosclerosis.

Food protein-induced enteropathy and its complications

Currently, in pediatric practice, a special place is occupied by patients with severe allergic lesions of the gastrointestinal tract, which often manifest immediately after the birth of a child. Food protein-induced enteropathy reduces the quality of life of the child and family; it is difficult to diagnose and to treat. We present a clinical case of a patient with food protein-induced enteropathy, complicated by severe B12-deficiency anemia and edema syndrome. In the tactics of patient management, attention is paid to the late diagnosis of the underlying disease and complications, the complexity of prescribing diet therapy and the lack of alertness regarding the diagnosis of malabsorption associated with food intolerance.

Clinical characteristics and cellular immunity in children with rotavirus infection

Objective. To determine clinical course and state of cellular immunity in young children with rotavirus infection.Children characteristics and research methods. The scientists examined children without infectious pathology and with rotavirus infection (20 patients in each group) using general clinical methods. Rotavirus infection was diagnosed by polymerase chain reaction and immunochromatography. Cellular immunity parameters were determined by flow cytometry.Results. All the children under observation had a moderate form of the disease with symptoms of exsicosis of the II degree. Changes in the immune status were mainly of a regulatory, adaptive nature, which contributed to the favorable course of rotavirus infection in children, however, the dynamics of the number of cells expressing Toll-like receptors indicates the immunosuppressive properties of rotavirus.Conclusion. Currently, rotavirus infection in young children is typical with watery diarrhea as the most pronounced and long-lasting clinical symptom. Shifts in immunogram indices in general indicate a deficiency of the cellular link of immunity and a violation of its regulation with simultaneous activation of the immune system in an effort to achieve the eradication of the rotavirus with immunosuppressive properties.

Clinical manifestations of new coronavirus infection (COVID-19) in children admitted to hospital

Objective. To describe clinical and laboratory features of COVID-19 in children admitted to the hospital.Children characteristics and research methods. The authors carried out a retrospective observational study, which included 204 children admitted to the Kazan hospital with a diagnosis of “new coronavirus infection” in the period from May 1 to October 30, 2020.Results. It was revealed that all hospitalized children had RNA of the SARS-CoV-2 virus (100%) in a smear from the nasopharynx and oropharynx detected by PCR and only 50% of patients were diagnosed with lung tissue lesions by computed tomography. The clinical picture of COVID-19 in children most often corresponds to the classic manifestations of a respiratory viral infection. Risk factors for the development of severe forms, described in adults, were recorded only in isolated cases in our study.Conclusion. The clinical picture of COVID-19 in children most often corresponds to the classic manifestations of a respiratory viral infection. Risk factors for the development of severe forms, described in adults, were recorded in isolated cases in our study.

Possibilities of the ultrasonography in the diagnosis of craniosynostosis in children of the first year of life

Craniosynostosis is a premature closure of the skull sutures, manifested by deformation of the head requiring surgical treatment. An instrumental examination of the state of the cranial sutures is necessary for the differential diagnosis of craniosynostosis and benign positional deformities of the skull in infants. Traditionally, radiation methods, such as X-ray and computed tomography with three-dimensional reconstruction, are used for this purpose. Over the past two decades, we have accumulated a large amount of data on the high information content of the ultrasound method in assessing the state of the cranial sutures in children. Ultrasound examination is widely available, easy to perform, reproducible; it does not require sedation of the patient and does not carry radiation exposure, which is especially important when examining young children. A negative result of the study makes it possible to exclude the diagnosis of craniosynostosis, while the detection of suture fusion serves as an indication for referring the child to visit a surgeon and further examination. The ultrasound method should be more widely used as a screening method for detecting head deformity and suspicion of craniosynostosis in children of the first year of life.

Clinical and immunological features of the combined course of pertussis and rhinovirus infection in children

The association of pertussis with various respiratory infections in children is the leading factor determining the complicated course and unfavorable outcome of the disease.Objective. To analyze clinical and immunological features of the combined course of pertussis and rhinovirus infection.Children characteristics and research methods. The authors observed 20 patients: 10 (50%) children were under the age of 1 year, 5 (25%) children of 1–3 years old, 3 (15%) children of 4–6 years, 2 (10%) children of 7 -14 years old.Results. The rhinovirus infection developed mainly at 1-2 weeks of illness in 18 (90%) children. Bronchitis developed in 11 (55%) children, pneumonia – in 4 (20%). Special attention was drawn to the low content of NK cells in 82.4% of patients when assessing the subpopulation composition of lymphocytes. The cytokine profile was characterized by a low level of interferon-gamma and interferon-alpha production – in 94.4 and 61.1% of patients, respectively.Conclusion. The combination of pertussis and rhinovirus infection in children contributes to the uneven course of the disease, the frequent development of bronchopulmonary complications.

Diffuse B-cell lymphoma in a child with HIV infection

Objective. To describe the case of diffuse B-cell lymphoma in a child with HIV infection.Results. A 16-year-old child with HIV infection and generalized lymphadenopathy was diagnosed with diffuse large B-cell lymphoma, stage III, negative central nervous system. The patient was diagnosed on the basis of the results of immunohistochemical study of biopaths of the tissue of the lymph nodes of the submandibular and right axillary region. The study in order to identify markers of active infection caused by the Epstein-Barr virus, cytomegalovirus and human herpesvirus type 6, made it possible to exclude the active phase of diseases that are the main infectious causes of lymphoproliferative syndrome. At the time of hospitalization, the patient was treated with antiretroviral therapy of the combined drug Eviplera. There was no HIV RNA in the blood, the level of CD4 lymphocytes was 0.4·109/l. The BFM chemotherapy regimen was used, which was accompanied by positive dynamics in the form of normalization of body temperature, reduction in the size of lymph nodes.Conclusion. This case shows that immunohistochemical examination of tissue biopsies of enlarged lymph nodes is of decisive importance in the diagnosis of lymphoma, the main non-infectious cause of lymphoproliferative syndrome in patients with HIV infection.

The treatment of patients with posthemorrhagic hydrocephalus

The article discusses the possible causes of polycystic posthemorrhagic ventriculomegaly in infants, as well as predictors of this pathological process. When choosing a treatment method the doctor shall take into account not only the etiology of the disease, but also age parameters, concomitant pathology. An important aspect in the approach to the treatment of polycystic posthemorrhagic multilevel hydrocephalus includes the determination of the biomechanical properties of the craniospinal system, especially the compliance of the brain and resorption of cerebrospinal fluid. Particular attention is paid to the timely correction of complications, including the analysis of inflammatory changes markers in the craniospinal system, which serve as predictors of the outcome of cerebrospinal fluid resorption. The authors also noted that the violation of the cerebrospinal fluid outflow from the cranial cavity in children may depend on a large number of «extracerebral» factors. They consider the stages of neurosurgical care to patients in this group on a clinical example. This example and literature data demonstrate that children with age develop changes not only in the craniospinal segment, which is responsible for the transformation of free fluid, but also in the extracranial cavities. Thus, we are able to recommend an integrated approach for the management of newborns with intracranial hemorrhage, complicated by posthemorrhagic hyporesorbent and occlusive hydrocephalus, with the justification of the optimal neurosurgical tactics for managing drainage-dependent patients, the course of the disease in which is accompanied by a multicomponent inflammatory syndrome.

Clinical and diagnostic significance of endothelial dysfunction and serotonin levels in children with hemolytic-uremic syndrome

Hemolytic-uremic syndrome is a serious problem in pediatrics and pediatric nephrology. Hemolytic-uremic syndrome is one of the leading causes of acute kidney injury with potential transformation into terminal chronic kidney disease. Currently, the endothelial dysfunction is strongly associated with changes in the serotonergic system in the pathogenesis of hemolytic-uremic syndrome. There are few studies that have revealed an increase in the blood plasma serotonin concentration in children with hemolytic-uremic syndrome, but its role in the pathogenesis of chronic kidney disease has been insufficiently studied. The progressive course of hemolytic-uremic syndrome, up to the terminal stage of renal failure, requires the search for markers of renal tissue damage as prognostically significant factors for the development of nephrosclerosis, which is of particular importance for optimizing the management of such children.

Features of cognitive development in children of early and preschool age using gadgets

The article describes the impact of technological devices – gadgets – on the early cognitive and speech development in children. In early childhood, object-activity communication is the leading form of activity; its influence on the speech development is determined by the interaction of the child with the adult (object-oriented actions, the understanding of the purpose of objects, the use of verbal communication). The play activity of preschoolers helps to enhance communication and interaction with peers. Long and uncontrolled interaction with gadgets is connected with insufficient attention of parents and caregivers, which disrupts the process of communication and cognition, in particular, slows down the process of speech development. Foreign pediatric associations recommend eliminating the use of mobile devices in children aged 0–2 years and limiting their use to one hour per day for children aged 3–5 years. Most researchers identify a connection between the long-term use of gadgets by preschoolers, delayed development of endogenus attention, social interaction, distortion of cognitive development, delayed speech development and such positive effects as a high level of exogenus attention development, quick response to external stimuli.