Browsing by Subject "mucocutaneous lymph node syndrome"

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    Reno-vascular hypertension in childhood: A nationwide survey
    (2007) Bayazit A.K.; Yalcinkaya F.; Cakar N.; Duzova A.; Bircan Z.; Bakkaloglu A.; Canpolat N.; Kara N.; Sirin A.; Ekim M.; Oner A.; Akman S.; Mir S.; Baskin E.; Poyrazoglu H.M.; Noyan A.; Akil I.; Bakkaloglu S.; Soylu A.
    Renovascular disease accounts for 8-10% of all cases of paediatric hypertension, whereas, in adults, its incidence is approximately 1%. The Turkish Paediatric Hypertension Group aimed to create the first registry database for childhood renovascular hypertension in Turkey. Twenty of the 28 paediatric nephrology centres in Turkey responded to the survey and reported 45 patients (27 girls, 18 boys) with renovascular hypertension between 1990 and 2005. The age at presentation ranged from 20 days to 17 years. The mean blood pressure at the diagnosis was 169/ 110 mmHg. Chief complaints of symptomatic patients were headache (38%), seizure (18%), epistaxis (4%), growth retardation (4%), cognitive dysfunction (4%), polyuria (2%), palpitation (2%), and hemiplegia (2%). Renovascular hypertension was found incidentally in 11 children. The diagnosis of renovascular hypertension was established with conventional angiography in 39 patients, MR angiography in three, CT angiography in two, and captopril diethylene triamine penta-acetic acid (DTPA) scintigraphy in one patient. Twenty-one children had bilateral renal artery stenosis and 24 had unilateral renal artery stenosis. Of these, 14 (31%) had fibromuscular dysplasia; 12 (27%) Takayasu's arteritis; six (13%) neurofibromatosis; two (5%) Williams syndrome; one (2%) Kawasaki disease; one (2%) mid-aortic syndrome; one (2%) extrinsic compression to the renal artery, and eight (18%) unspecified bilateral renal artery stenosis. Hypertension was controlled with antihypertensive drugs in 17 patients. Percutaneous transluminal angioplasty (PTRA) or surgery had to be performed in 28 patients: PTRA in 16 patients, PTRA + surgery in one patient and surgery in 11 patients (four nephrectomies). The importance of vasculitic disease, especially Takayasu's arteritis, should not be underestimated in children with renovascular hypertension. © IPNA 2007.
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    Thrombolysis with Systemic Recombinant Tissue Plasminogen Activator in Children: A Multicenter Retrospective Study; [Çocuklarda Sistemik Rekombinant Doku Plazminojen Aktivatörü ile Tromboliz: Çok Merkezli Bir Retrospektif Çalışma]
    (Turkish Society of Hematology, 2021) Zengin E.; Sarper N.; Erdem A.Y.; Al I.O.; Evim M.S.; Yaralı N.; Belen B.; Akçay A.; Yıldırım A.T.; Karapınar T.H.; Güneş A.M.; Gelen S.A.; Ören H.; Olcay L.; Baytan B.; Gülen H.; Öztürk G.; Orhan M.F.; Oymak Y.; Akpınar S.; Tüfekçi Ö.; Albayrak M.; Güneş B.T.; Canpolat A.; Özbek N.
    Objective: This study aimed to evaluate systemic thrombolysis experiences with recombinant tissue plasminogen activator (rtPA). Materials and Methods: Retrospective data were collected from 13 Turkish pediatric hematology centers. The dose and duration of rtPA treatment, concomitant anticoagulant treatment, complete clot resolution (CCR), partial clot resolution (PCR), and bleeding complications were evaluated. Low-dose (LD) rtPA treatment was defined as 0.01-0.06 mg/kg/h and high-dose (HD) rtPA as 0.1-0.5 mg/kg/h. Results: Between 2005 and 2019, 55 thrombotic episodes of 54 pediatric patients with a median age of 5 years (range: 1 day to 17.75 years) were evaluated. These patients had intracardiac thrombosis (n=16), deep vein thrombosis (DVT) (n=15), non-stroke arterial thrombosis (n=14), pulmonary thromboembolism (PE) (n=6), and stroke (n=4). The duration from thrombus detection to rtPA initiation was a median of 12 h (range: 2-504 h) and it was significantly longer in cases of DVT and PE compared to stroke, non-stroke arterial thrombosis, and intracardiac thrombosis (p=0.024). In 63.6% of the episodes, heparin was initiated before rtPA treatment. LD and HD rtPA were administered in 22 and 33 of the episodes, respectively. Concomitant anticoagulation was used in 90% and 36% of the episodes with LD and HD rtPA, respectively (p=0.0001). Median total duration of LD and HD rtPA infusions was 30 h (range: 2-120 h) and 18 h (2-120 h), respectively (p=0.044). Non-fatal major and minor bleeding rates were 12.5% and 16.7% for LD and 3.2% and 25.8% for HD rtPA, respectively. At the end of the rtPA infusions, CCR and PCR were achieved in 32.7% and 49.0% of the episodes, respectively. The most successful site for thrombolysis was intracardiac thrombosis. HD versus LD rtPA administration was not correlated with CCR/PCR or bleeding (p>0.05). Conclusion: Systemic thrombolytic therapy may save lives and organs effectively if it is used at the right indications and the right times in children with high-risk thrombosis by experienced hematologists with close monitoring of recanalization and bleeding. © 2021, Turkish Society of Hematology. All rights reserved.
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    Evaluation of 601 children with multisystem inflammatory syndrome (Turk MISC study)
    (Springer Science and Business Media Deutschland GmbH, 2023) Yilmaz D.; Ekemen Keles Y.; Emiroglu M.; Duramaz B.B.; Ugur C.; Aldemir Kocabas B.; Celik T.; Ozdemir H.; Bayturan S.; Turel O.; Erdeniz E.H.; Cakici O.; Cakmak Taskin E.; Erbas İ.C.; Genceli M.; Sari E.E.; Caymaz C.; Kizil M.C.; Sutcu M.; Demirbuga A.; Alkan G.; Bagcı Z.; Timurtas Dayar G.; Ozkan E.A.; Tekin Yilmaz A.; Akca M.; Yesil E.; Kara S.S.; Akturk H.; Yasar B.; Umit Z.; Uygun H.; Erdem N.; Buyukcam A.; Karadag Oncel E.; Tuter Oz S.K.; Cetin H.S.; Anil A.B.; Yilmaz R.; Zengin N.; Uzuner S.; Albayrak H.; Borakay O.; Topal S.; Arslan G.; Yazar A.; Ozer A.; Kendirli T.; Kara E.M.; Demirkol D.; Battal F.; Kosker M.; Metin Akcan O.; Kihtir H.S.; Gul D.; Zararci K.; Alakaya M.; Kula N.; Celik E.; Petmezci E.; Evren G.; Kara Aksay A.; Konca C.; Sert A.; Arslan D.; Bornaun H.; Tekeli O.; Bal A.; Sahin I.O.; Demir S.; Sap F.; Akyol M.B.; Tanidir I.C.; Donmez Y.N.; Ucar T.; Coban S.; Arga G.; Hancerli Torun S.; Karpuz D.; Celik S.F.; Varan C.; Elmali F.; Oncel S.; Belet N.; Hatipoglu N.; Dalgic Karabulut N.; Turgut M.; Somer A.; Kuyucu N.; Dinleyici E.C.; Ciftci E.; Kara A.
    Purpose: Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU). Methods: This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented. Results: A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5–11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2% p = 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells × μL, platelet count 153 vs. 212 cells × 103/ μL, all for p< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 μg/L, ferritin 644 vs. 334 μg/L, all for p< 0.001). Being between ages 5–12 and older than 12 increased the likelihood of hospitalization in the ICU by four [95% confidence intervals (CI)1.971–8.627] and six times (95% CI 2.575–14.654), respectively, compared to being between the ages 0–5. A one-unit increase in log d-dimer (µg/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079–3.233) and 1.4 times (95% CI 1.133–1.789), respectively. Conclusion: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care. What is Known: • Lymphopenia and thrombocytopenia were an independent predictor factors in patients with MISC who needed to stay in intensive care unit. • The possibility of the need to stay in the intensive care unit in patients with MISC who had Kawasaki disease-like findings was controversial compared with those who did not. What is New: • A one-unit increase log D dimer and log troponin was demonstrated to require for intensive care unit by 1.8 and 1.4 times, respectively. • Serum procalcitonin levels had the best performance to predict stay in the intensive care unit stay. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.