Down syndrome is a genetic disorder associated with various congenital anomalies and hematologic abnormalities. Various hematologic disorders such as transient leukemia-like proliferative disorders, increased incidence of leukemia, isolated thrombocytopenia and thrombocytosis were observed in Down syndrome. The etiology of thrombocytopenia in Down syndrome is not exactly kwnown and there are limited data about this subject. In this review, we aimed to to evaluate the impact of the clinics of Down syndrome  on thrombocytopenia and other hematologic parameters so as to emphasize necessary information related to the approach to Down syndrome and thrombocytopenia.

Key words: Down syndrome, thrombocytopenia

Resul Yılmaz *, Yusuf Ziya Aral **, Yıldız Dallar ***

Sibel Çelik *, Nurullah Çelik *, Asım Gültekin *, Fadime Okur YÜKSEL *, Semra Kara *, Füsun Dilara İçağasıoğlu *, Ömer Cevit *
Sivas İl Merkezinde Dokuz-On Altı Yaş Grubu Çocuklarda Kızamık, Kızamıkçık ve Kabakulak Seroprevalansının Araştırılması

Berkant Öztürk *, Burçin Nalbantoğlu **, Eda ÇELİK Güzel ***, Sami Hatipoğlu ****, Ayşin Nalbantoğlu *****

Çocuk Acil Ünitesine Febril Konvülziyon Tanısıyla Başvuran Beş Ay-Beş Yaş Arasındaki Çocukların Retrospektif Olarak İncelenmesi

Objective: The purpose of this study was to determine the demographic characteristics of patients admitted to emergency unit with febrile convulsions, and the mistakes during diagnosis so as to evaluate various treatment modalities.

Methods: The study was conducted with 326 patients (aged 5 months to 5 years) admitted to emergency unit because of febrile convulsions. Patients with congenital anomalies, history of head trauma and mental retardation were excluded from the study. Patients were evaluated as for age, gender, temperature, sodium and calcium levels, C-reactive protein, leucocyte count, serum glucose, family history, treatment and hospitalization. SPSS for Windows 13.0 software programme was used for statistical analysis. This study was approved by the ethics committee of the Bakırköy Dr. Sadi Konuk Hospital.

Results: Mean age of the cases was 25.0±15.3 months, while 147 (45.1 %) of them were female and 179 (54.9 %) of them were male, and 29 (8.9 %) patients had familial history of febrile convulsions. Body temperature levels changed between 36.8 Co  and 41°C and mean temperature was 38.49±0.64. Upper respiratory tract infections were found to be the most common causes of the febrile convulsions with a rate of 75.8 %. Paracetamol use was significantly higher in simple convulsions, however midazolam use was significantly higher in complicated convulsions (p<0.01). Hospitalization rate was found to be significantly higher in complicated convulsions than the simple ones (p<0.01).

Conclusion: Febrile convulsions have good prognosis, but follow up is important because of high recurrence rate and higher epilepsy risk than normal population.

Key words: Fever, convulsion, children

Burak Tatlı *, Barış Ekici *

İhsan Esen *, Ümmü Aydoğmuş *, Tuncer Gürler *, Fatma Demirel *, Can Naci Kocabaş *

Herpetic whitlow is a herpes simplex virus type 1 or 2 infection of the fingers. This rare form of herpes virus infection is characterized by painful and non-purulent vesicles in children and adolescents. Misdiagnosis of herpetic whitlow usually leads to inappropriate interventions. Pediatricians should be aware of this entity for correct initial diagnosis and accurate management. In addition, pediatricians everyday come into close contact with oral secretions of many children who might be infected with herpes simplex type 1 virus. Herpetic whitlow should be remembered as an occupational hazard. In this paper we reported a case of herpetic whitlow in a 9-month-old girl.

Key words: Herpetic whitlow, herpes simplex virus, child

Yasemin KENDİR DEMİRKOL *, Nihal OLGAÇ DÜNDAR **, Metehan ÖZEN ***

Brucellosis is widespread throughout the world. Cases of neurobrucellosis may present with many different clinical findings based on the involvement  of the central and peripheric nervous systems. The patient can rarely present with signs of increased intracranial hypertension. It is known that infectious and postinfectious cases can cause pseudotumor cerebri. A 16-year-old boy was admitted with the complaint of headache and diplopia persisting for ten days. His family reported intake of unpasteurized milk in the past. Limited lateral gaze palsy in the right eye was observed. He was diagnosed as pseudotumor cerebri and given acetazolamide. The aim of this report is to present a patient with increased intracranial pressure presumably  caused by postinfectious state rather than active Brucella infection, and mistreated accordingly.

Key words: Brucellosis, pseudotumor cerebri, central nervous system

Methylmalonic aciduria (MMA) is an inherited autosomal recessive disease characterized by interruption of conversion of methylmalonil-CoA to succinyl-CoA and subsequent hydrolization to methylmalonic acid leading to increased methylmalonic acid levels in blood, cerebrospinal fluid and urine. Three days old female newborn admitted to Emergency Department with complaints of severe vomiting, lethargy and respiratory distress. In physical examination 12.3 % weight loss was remarkable. Laboratory tests revealed pancytopenia, metabolic acidosis and hyperammonemia. Increased blood amonium levels, urine organic acid and acyl carnitine profile suggested methylmalonic aciduria. Plain abdominal radiograms did not reveal any air passage to distal of the stomach. In laparotomy prepyloric web was found. Although vomiting may be observed as the initial symptom in inborn errors of metabolism, in cases with severe vomiting in differential diagnosis, mechanical obstruction should be kept in mind.

Key words: Methylmalonic aciduria, prepyloric web, newborn

Although infective endocarditis  is an uncommon disease during childhood, it has high rates of morbidity and mortality. Congenital heart diseases and rheumatic valve damages are the most important predisposing factors for infective endocarditis and the risk is increased by heart surgery and interventional treatments. The most significant complications of infective endocarditis are congestive heart failure and embolic events. We report a four-year-old boy presented with acute ischemic stroke two months following balloon angioplasty for aortic coarctation diagnosed as infective endocarditis. During follow-up, parotid and intramuscular abscess formation because of septic embolism were observed as complications of infective endocarditis.

Key words: Infective endocarditis, stroke, children

Lymphangioma is one of the most common congenital cystic malformation of the head and neck region in the neonatal period. In situations where  neurovascular structures are  infiltrated, the excision of the lesion is difficult and recurrence rate is high. In that case, the most common alternative treatment is intralesional injection of sclerosing agents. In this case report, the effectiveness of a single dose intralesional bleomycin for therapy of the congenital cervical lymphangioma which recurred after surgical excision has been discussed together with the relevant literature.

Key words: Newborn, lymphangioma, bleomycin

The Child September 2005