The Journal of Pediatric Academy

Diagnosis, Treatment, and Management of Common Childhood Vasculitides

Büşra Başer Taşkın, Ayşenur Doğru, Nuray Aktay Ayaz — Fri, 20 Jun 2025 00:00:00 +0300

Childhood vasculitides, including immunoglobulin A vasculitis, Kawasaki disease, Behçet disease, and polyarteritis nodosa, are inflammatory disorders affecting varying-sized blood vessels. Their pathogenesis involves immune dysregulation, genetic predisposition, and environmental triggers. While treatment varies based on disease severity, immunosuppressive therapy is often required. Preventing complications depends mainly on early identification of the disease and initiating appropriate management. This review aims to guide clinicians in the early diagnosis and multidisciplinary management of childhood vasculitides by addressing their pathogenesis, clinical features, diagnostic approaches, and treatment strategies.

The Antibiotic Usage Patterns in Pediatric Patients with Lower Respiratory Tract Infections at Quang Tri General Hospital, Central Vietnam

Nguyen Thi Minh Thuan, Tran Dinh Binh — Mon, 23 Jun 2025 00:00:00 +0300

Lower respiratory tract infections (LRTI) are a significant cause of morbidity and mortality in children, especially in developing countries such as Vietnam. This study analyzed antibiotic use patterns in pediatric patients with LRTI at Quang Tri General Hospital in 2023. A cross-sectional design was used, examining 381 medical records of children aged 2 months to 5 years who received antibiotics for at least 3 days. Pneumonia was the most common diagnosis (82.4%), with severe illness observed in one-third of cases. The most commonly used antibiotic was cefotaxime (42.1%), mainly administered intravenously (62.3%). Antibiotic regimens varied, with an average of 1.55 drugs per patient. Most patients improved (99.0%) after treatment. The findings are consistent with existing literature on LRTI in children and provide insights into antimicrobial stewardship practices. This study highlights the importance of standardized protocols to optimize treatment and minimize inappropriate antibiotic use.

Evaluation of Psychiatric Consultations Requested from Pediatric Clinics During the COVID-19 Pandemic

Fatma Durak, Özlem Tezol, Gülen Güler Aksu, Gülçin Bozlu — Fri, 18 Apr 2025 00:00:00 +0300

We aimed to assess the characteristics of children and adolescents who presented to pediatric clinics and required psychiatric consultation during the Coronavirus disease 2019 (COVID-19) pandemic. This descriptive study employed data derived from a retrospective analysis of medical records for 264 patients under 18 years old who were referred to the Child and Adolescent Psychiatry Department upon their presentation to the Pediatric Emergency and General Pediatric Clinics of Mersin University Hospital between March 11, 2020, and May 5, 2023. The median age of the patients surveyed was 15 years (interquartile range: 12-16), with 168 (63.6%) identifying as female. Among the total, 48 patients (18.2%) were young children (under 10 years), whereas 216 patients (81.8%) were adolescents (10-18 years). The predominant cause for consultation among children was behavioral issues (52.1%), whereas for adolescents, it was suicide attempts (42.1%). Of the young child cases, 29.2% exhibited no significant psychopathology, whereas 70.8% were diagnosed with at least one psychiatric disorder. Attention-deficit/hyperactivity disorder was the most commonly diagnosed psychiatric disorder in young children (25%), followed by generalized anxiety disorder (8.3%) and tic disorder (8.3%). Among the adolescent cohort, 6% exhibited no major psychopathology, whereas 94% received a diagnosis of at least one psychiatric disorder. Major depressive disorder was the most prevalent psychiatric diagnosis in adolescents (39.8%), followed by somatic symptom disorder (8.3%). Anxious mood was observed in 43.7% of young children, whereas 26.8% of adolescents displayed depressive mood. A total of 71.2% of patients received prescriptions for psychotropic medication (39.6% of young children and 78.2% of adolescents). This study, conducted in the fifth year of the pandemic, reviews the impact of COVID-19 on young children's and adolescents’ mental health. It aims to enhance the awareness and knowledge of pediatricians, child and adolescent psychiatrists, and policymakers in our country regarding this issue.

Association of SNP (rs1360780) in FKBP5 Gene and Plasma Cortisol Levels in Children with Autism Spectrum Disorder

Hasan Bozkurt, Abdullah Haktan, Şeref Şimşek, Serkan Şahin, Salih Coşkun — Fri, 20 Jun 2025 00:00:00 +0300

The inconsistent results about cortisol levels in individuals with autism spectrum disorder (ASD) may be suggestive of other factors like gene polymorphisms rather than the disorder itself. We aimed to investigate the rs1360780 polymorphism in the FK506 binding protein 5 (FKBP5) gene and its relation to ASD and cortisol levels. Eighty-nine children with ASD ranging in age from two to fifteen years were selected for the study group, and eighty-six healthy children were selected for the control group. Blood samples were collected between 10 and 12 am in the morning. Enzyme linked immunosorbent assay and polymerase chain reaction were used to assay serum cortisol levels and genotyping, respectively. The mean cortisol levels for the study and the control groups were 8.5±3.6 μg/dL and 6.1±3.5 μg/dL, respectively. Cortisol levels were significantly higher in the study group compared to the control group (p<0.001). There was no statistically significant difference in terms of allele and genotype frequencies between the groups (p>0.05). Carrying the C allele was found possibly to increase the cortisol levels in the study group. This is the first clinical study to evaluate the association between rs1360780 polymorphism in the FKBP5 gene and serum cortisol levels in children with ASD compared to those of healthy participants. Since the prevalence of ASD is gradually increasing in recent years, possible endocrine and related genetic factors should be borne in mind while examining this population.

Clinical Indications and Diagnostic Yield of Transfontanelle Ultrasound in 346 Infants: A Retrospective Single-Center Study

Selcan Öztürk, Ümmügülsüm Özgül Gümüş — Mon, 23 Jun 2025 00:00:00 +0300

Transfontanelle ultrasonography (TFUSG) is a reliable and non-invasive imaging method used for early detection of cranial abnormalities during the neonatal and infant periods. This study aimed to evaluate the reasons for TFUSG requests, demographic features, and imaging findings in infants under one year of age. In this retrospective study, medical records of 346 infants who underwent TFUSG in the pediatric neurology outpatient clinic of a tertiary hospital between January 1, 2023, and December 31, 2024, were reviewed. Demographic data, TFUSG indications, and imaging findings were analyzed. The study included 346 infants, of whom 214 (61.8%) were male and 132 (38.2%) female, with a mean age of 3.06±2.4 months. A total of 60.1% of the infants were born prematurely. The most common indications for TFUSG were a history of prematurity and/or neonatal intensive care unit admission (56.6%), suspected seizures (20.8%), and clinical findings such as developmental delay, microcephaly, or macrocephaly (12.4%). TFUSG results revealed normal findings in 64.7% of cases, normal variants in 6.4%, and pathological findings in 28.9%. The most common pathologies included increased cerebrospinal fluid spaces (54%), germinal matrix hemorrhage (34%), and hydrocephalus (12%). Abnormal TFUSG findings were significantly more common in male infants, while no significant difference was found concerning gestational age. TFUSG is an effective imaging modality that contributes substantially to the diagnostic process in pediatric neurology outpatient settings. Further studies with larger cohorts are needed to standardize findings and improve diagnostic accuracy.

Plasma Amino Acid Levels in Obese Adolescents: A Case-Control Study and the Review of the Literature

Tue, 01 Jul 2025 00:00:00 +0300

Optimal balance among amino acids in the circulation is important for body homeostasis. This study aims to evaluate and define the amino acids associated with obesity and insulin resistance. Fifty obese and 42 healthy adolescents aged 10-18 years were included in this study. Fasting plasma glucose, liver enzymes, thyroid function tests, insulin, and lipid levels were studied as routine laboratory examinations, and 26 plasma amino acids were studied as specific laboratory examinations. Isoleucine, leucine, lysine, tryptophan, glutamate, tyrosine, phenylalanine, alanine, methionine, argininosuccinic acid, histidine and valine were significantly higher in patients with obesity. Asparagine and citrulline levels were lower in patients with insulin resistance. The metabolic pathways of various amino acids are significantly impaired in obesity. Plasma concentrations of essential, non-essential, branchedchain, and aromatic amino acids were elevated in this study.

The Radiological Findings in an Infant Suffering from Osteopetrosis Due to a Novel Variant in the CLCN7 Gene

Tue, 24 Jun 2025 00:00:00 +0300

Pancreaticopleural Fistula: A Rare Complication of Pancreatitis in Children - A Case Report

Mon, 14 Apr 2025 00:00:00 +0300

Pancreaticopleural fistula (PPF) is a rare complication of pancreatitis, which can present as massive pleural effusion. We herein report a six-year-old male, a follow-up case of acute pancreatitis, who later presented with bilateral pleural effusion due to PPF. Initially, tuberculosis was suspected as the cause of pleural effusion due to the patient’s maternal history of contact with tuberculosis and chronic history and chronic history. However, further investigations revealed a diagnosis of PPF. Management and outcome: He was managed conservatively for a prolonged period, following which there was a complete resolution of pleural effusion. This pediatric case highlights a rare complication of acute pancreatitis and the role of early initiation of management in these patients, thereby resulting in good outcomes even in a resource-limited setting.