Pediatric Sciences Journal最新文献

{"title":"Automated Auditory Brainstem Response in Neonates with Exchange Transfusion Indirect Hyperbilirubinemia Levels","authors":"Salma Elhouchi, Hussein Sherif Hamdy, Fatma Alzhraa Hegazy, Islam Ezzat Abd Elkader, E. Elmazzahy","doi":"10.21608/cupsj.2024.291699.1129","DOIUrl":"https://doi.org/10.21608/cupsj.2024.291699.1129","url":null,"abstract":": Background: Neonatal hyperbilirubinemia maybe complicated by severe neurologic disability including hearing impairment (HI). There is no agreement on the precise bilirubin level that may cause auditory affection. Aim of the work: to study the frequency of HI in neonates with indirect hyperbilirubinemia threshold for exchange transfusion (","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"84 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Assessment in children with Congenital Heart Diseases after Cardiac Surgeries","authors":"Amir Fawzy Kamal, Fatma Al Zahraa Mostafa, Walaa Fakher, Ahmed Soltan, Mohammed Mohammed Abdelraouf","doi":"10.21608/cupsj.2024.291837.1130","DOIUrl":"https://doi.org/10.21608/cupsj.2024.291837.1130","url":null,"abstract":": Background: Children with congenital heart defects (CHD) now live longer due to advances in surgical and catheter techniques. Their neurodevelopment, including intellectual functioning, has become a major area of concern, attracting both clinical and research interest . Objectives: To assess the cognitive functions in children with CHD after cardiac surgeries and to compare between cyanotic and acyanotic heart disease regarding cognitive functions . Patients and methods: This cross-sectional study included sixty patients with CHD, 30 patients with cyanotic heart disease and 30 patients with acyanotic heart disease, who underwent cardiac surgeries and were examined by Stanford Binet IQ test 5th edition. They were recruited from the post cardiac intervention clinic at Pediatric Hospitals of Cairo University. Results : The mean ± SD age of the children with cyanotic and acyanotic heart diseases was 5±2 and 4 ±1 years respectively (p= 0.345). The IQ was higher among the children with cyanotic compared to those acyanotic heart diseases with mean ± SD (range) of 85.4 ± 12 and 99.9 ± 13 respectively (p= 0.0001). IQ was not influenced by age at operation (p= 0. 171), type of operation (p= 0. 381), sex (p= 0.323), or oxygen saturation (p= 0.308). Mean ±SD IQ of those with cyanotic CHD who underwent closed and open heart surgeries was 88±11 and 84±13 respectively (p= 0.381), and in acyanotic group was 104±14 and 98±13 respectively (p= 0.323). Conclusion: Children with congenital heart defects may have cognitive dysfunction. Children with cyanotic CHD have significantly lower IQ values than those with acyanotic CHD. No significant differences in IQ were found between patients who underwent closed and open heart surgery.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silent Restrictive Lung Disease is Common Among Children with ß-thalassemia: A Single Center Study","authors":"Mona Hassan Eltagui, C. W. S. Basanti, M. Kotb, Toka Emaad Eldin Saad, Mai Mohamed Abd El Salam","doi":"10.21608/cupsj.2024.283002.1125","DOIUrl":"https://doi.org/10.21608/cupsj.2024.283002.1125","url":null,"abstract":": Background: β -thalassemia syndromes are a group of hereditary blood diseases characterized by reduced or absent β -globin chain synthesis, resulting in reduced hemoglobin in red blood cells. Pulmonary dysfunction ranging from restrictive to obstructive was reported among those with β - thalassemia. Aim of the work: to evaluate the pulmonary functions in patients with β -thalassemia. Patients and Methods: We conducted a cross-sectional study that included 60 ß-thalassemia patients following up at the Hematology Outpatient Clinic of Cairo University Children’s Hospital. They all underwent assessment of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximal expiratory flow (MEF) and peak expiratory flow (PEF) using spirometry and assessment of resistance (R) and reactance (Z) to different frequencies by impulse oscillometry (IOS). Results: The mean ± SD age of the studied group was 10.63 ± 3.53 years. Of them, 32 (53.3%) were females and 28 (46.7%) were males. 39 (65%) were transfusion dependent, 23 (38.3%) were compliant to chelation therapy and only 8 (13.3%) did not need chelation therapy. 30 (50%) patients showed restrictive pattern in spirometry (FVC<80%, FEV1<80% and FEV1/FVC >80%”) and 15 (50%) of them also showed abnormal high impulse IOS to 5 and 20HZ (readings above 150%). The non-compliant patients had airway obstructive pattern by spirometry MEF50 (p=0.075), and higher IOS resistance pattern to R5Hz (p= 0.007), R20Hz (p=0.007) and X5Hz (p= 0.003). Higher airway resistance on IOS (0.0001) was associated with transfusion dependency, and need for chelation therapy (p=0.039). Poor compliance to chelation therapy correlated with spirometry restrictive pattern (p=0.0006). Conclusion: Restrictive lung disease is a common pulmonary dysfunction among children with ß-thalassemia. Compliance to adequate chelation therapy decreases the incidence of pulmonary dysfunction.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"49 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Presenting Central Pontine Myelinolysis Post-tonsillectomy in a Child: Case Report","authors":"M. Kotb, Menna t-allah Mahmoud El zabet, Walaa El Naggar","doi":"10.21608/cupsj.2024.296772.1134","DOIUrl":"https://doi.org/10.21608/cupsj.2024.296772.1134","url":null,"abstract":": Central pontine myelinolysis (CPM) is a notorious grave complication of rapid correction of hyponatremia. CPM is a noninflammatory demyelination. It presents clinically with variable degrees of loss of coordination, unconsciousness, blurred vision, cranial nerve affection, progressive spasticity, quadriparesis, pseudo bulbar palsy up to locked in syndrome, coma and death. We report a 4.5-year-old who presented to emergency room (ER) with generalized tonic-clonic seizures, and sepsis. His parents reported that he underwent un-eventful tonsillectomy 3 days earlier. Two days post-tonsillectomy he developed fever. On third day post-tonsillectomy he developed an attack of convulsions at home, 3 hours prior to presenting to ER. He presented to the ER by another attack of seizures. His seizures were controlled on IV midazolam and levetiracetam loading dose. His conscious level was clouded beyond the postictal 30 minutes. His Glasgow Coma scale was 12 which necessitated Pediatric Intensive Care Unit (PICU) admission. His condition was complicated by acute liver and kidney injury that improved within 48 hours. Upon admission his sodium level was 141 mmol/L, and did not drop below 140 mmol/L all through the hospital stay. By the 7 th day after admission the child developed left sided convergent squint (6 th cranial nerve palsy) and progressive spasticity. Magnetic resonance imaging revealed CPM. The isolated CPM in this child developed irrespective of hemodynamic stability, lack of hyponatremia and its rapid correction. CPM in our studied child might be an isolated presentation of sepsis associated encephalopathy, or a late complication post-tonsillectomy.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"141 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Sclerosis First Presentation in a Child: Diffuse Motor Demyelinating Polyradiculopathy: Case Report","authors":"W. Elnaggar, M. Kotb","doi":"10.21608/cupsj.2024.295970.1132","DOIUrl":"https://doi.org/10.21608/cupsj.2024.295970.1132","url":null,"abstract":": Multiple sclerosis is a mostly debilitating chronic demyelinating immune disease of the central nervous system that compromises quality of life within 10-15 years of onset. The clinical picture spectrum varies widely depending on the underlying pathogenesis of demyelination; the macrophage induced demyelination, antibody mediated against myelin proteins, T cell-mediated small vessel vasculitis and subsequent ischemia or cytokine mediated oligodendrocyte death. Axonal injury is limited to 5% of cases. Peripheral nerve demyelination is an exceptionally rare association of multiple sclerosis. We report a 9-year-old who developed bilateral lower limb weakness and loss of truncal support. Electromyography revealed demyelinating diffuse motor polyradiculopathy. He was diagnosed as Guillain-Barré syndrome and received intravenous immunoglobulins with no response. Magnetic resonance imaging of the brain and cervical spine revealed multiple cerebral and cerebellar foci of abnormal signal representing demyelination. He was diagnosed as multiple sclerosis and had a full recovery within 3 weeks from start of management by methylprednisolone. Peripheral demyelinating neuropathy may be the initial presentation of multiple sclerosis in a child.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The C-Reactive Protein/Albumin Ratio As An Early Diagnostic Marker Of Neonatal Sepsis In Preterm Neonates: A Case-Control Study","authors":"Dina K Khedr, Samar Nabil, Asmaa Abdelnaby, Abdulrahman A Abdulrazek, Sohilla Lotfy","doi":"10.21608/cupsj.2024.297476.1135","DOIUrl":"https://doi.org/10.21608/cupsj.2024.297476.1135","url":null,"abstract":": Background: Neonatal sepsis is a serious systemic infection that might be fatal. Early diagnosis is challenging. The c-reactive protein (CRP)/albumin ratio is a promising biomarker that may help with early diagnosis and timely management of sepsis. Aim of the work: to study the sensitivity and specificity of the CRP/albumin ratio as a diagnostic marker of neonatal sepsis in preterm newborns. Patients and Methods: in this case-control study CRP/albumin ratio was estimated in 154 preterm newborns admitted to Neonatal Intensive Care Units (NICUs) of Cairo University Children's Hospitals. They were divided into 2 groups. Group (I), the sepsis group “based on positive blood culture” (n=54), and group (II), a control group, with no clinical signs or laboratory evidence of sepsis (n=100). Results: The mean age of newborns in the sepsis group was 3 ± 2.5 days vs 4.5 ± 2.5 days for the control group. The sepsis group had a mean ± SD CRP/albumin ratio higher than that of the control group (18.5 ± 20 vs 0.6± 0.7, p= 0.00). 30 (55%) of those in the sepsis group died; they had a mean ± SD CRP/albumin ratio of 20± 21, vs 15 ± 17 for those who survived (p value=0.3). Neonatal Sepsis was best diagnosed by the CRP/albumin ratio above the cutoff value of 1.5 with 100 % sensitivity, 95% specificity, 91.5 % positive predictive value (PPV), 100 % negative predictive value (NPV), (area under the curve (AUC)= 0.99, and 95 % confidence interval (CI) 0.983 - 1), which was not different than that of CRP alone (p=0.800). CRP above the cutoff point of 4.3 showed 96.3 % sensitivity, 96% specificity, 92.9 % PPV, 98 % NPV, (AUC= 0.99 , 95 % CI 0.983 - 1). The I/T ratio (shift to the left) above the cutoff point of 0.2 showed 64.8% sensitivity, 100 % specificity, 100% PPV and 84% NPV (AUC= 0.94 , 95% CI 0.891 - 0.973). Conclusion: CRP/albumin ratio is a highly sensitive and specific early diagnostic biomarker for neonatal sepsis in premature newborns that has marginal superiority to the CRP in the diagnosis of neonatal bacterial sepsis. More studies are needed to validate the sensitivity and specificity of a score that combines both the CRP/ albumin ratio above 1.2 and the I/T ratio above 0.2 in predication of true positive cases and exclusion of the true negative cases.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"122 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Lockdown aggravated the Health-Related Quality of Life in Children with Transfusion-Dependent-Thalassemia","authors":"Ilham Youssry, Hend Fawzy, Noha Asem, Dalia Abd Elaziz","doi":"10.21608/cupsj.2023.239453.1107","DOIUrl":"https://doi.org/10.21608/cupsj.2023.239453.1107","url":null,"abstract":": Background: Thalassemia is the most prevalent cause of chronic hemolytic anemia and associated with high rates of morbidity and mortality. Its management is demanding, timely and multidisciplinary creating a strain on the patients, their families, and society. Aim of the work: To study the effect of the corona virus disease of 2019 ( COVID-19) pandemic lockdown on the health-related quality of life (HRQoL) of the children with transfusion-dependent thalassemia. Subjects and Methods: The HRQoL (child self-report) and (parent proxy-report for those children) questionnaires of the Pediatric Quality of Life Inventory (PedsQL) Measurement Model were used to study the same group of 131 children with transfusion-dependent-thalassemia before and during the-COVID-19 era lockdown and compared them to 200 matched children with their parents as a control group. Results : 67 (51.1%) males and 64 (48.9%) females, transfusion-dependent thalassemia patients were included in our study. The mean age was 8.28 ± SD3.81 (range 5-18) and 8.94 ±SD 3.78 years at initial assessment and during the lockdown respectively (p=0.0001). in the pre-COVID-19 the score of patients in all the aspects of PedsQL questionnaire was 60.4±22.8 while that of the control group was 97.3±3 (p <0.001). The mean ± SD of total PedsQL score in the patients before COVID-19 was 60.24 ± 22.8 SD and during the lockdown was 55.96±18.3 (p <0.001). The parent proxy-report for those children was lower than that of the patients (p <0.001). Before COVID-19 the least PedsQL 25.22±4.5 and 25.43±7.2 were reported by those on IV deferoxamine , and by older patients (13-18 years) compared to the control group of 97.3±3 (p <0.001 and p <0.00) respectively. During the lockdown the values dropped significantly as reported by the children and their parents (p<0.001). Conclusion : Transfusion-dependent thalassemia has an alarming negative impact on all aspects of the quality of life of the affected children and their families. This straining negative aspect was accentuated by the COVID-19 lock-down. Multidisciplinary task force to address the emotional, social, and physical perception of children with transfusion-dependent thalassemia and their parents is imperative.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"161 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138982848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P53 Mutation at Codon 249 is Uncommon in Neonatal Kotb Disease Biliary Atresia","authors":"M. Kotb, Ayda Kelany, Sherif Shehata, Gamal H. El Tagy, S. Kaddah, Haytham Esmat, Nahla Sabry, Ahmed Elhaddad, Radwa A. Shamma","doi":"10.21608/cupsj.2023.231747.1102","DOIUrl":"https://doi.org/10.21608/cupsj.2023.231747.1102","url":null,"abstract":": Background: Hepatocellular carcinoma (HCC) is known to result from aflatoxin B1 that induces p53 mutation at codon 249. Aflatoxins are also known to cause The Kotb disease Biliary atresia (BA) variant which is characterized by congenital aflatoxicosis B1 in neonates with null glutathione S transferase M1. Aim of the Work: We aimed to search for the aflatoxin B1 induced HCC 249 codon p53 mutation among neonates with Kotb disease BA variant and their mothers. Patients and Methods: This study included 13 neonates and infants with confirmed BA who presented to Hepatology Clinic, New Children Hospital, Cairo University, Egypt during January-May 2019. All subjects and their mothers underwent detection of aflatoxins from peripheral blood. BA cases underwent detection of mutation from liver biopsy tissue as well. Results: The studied cohort with confirmed BA comprised 9 (69.2%) girls and 4 (30.8%) boys, with mean ages ± standard deviation (SD) at onset, presentation, diagnosis and portoenterostomy of 8.1±5.7 days, 44.8±11 days, 57±14.53 and 64.5±21.34 days respectively. All 13 and their mothers were found to have elevated blood levels of aflatoxin B1 with a mean of 8.56 ± 4.2ng/ml and 14.75±16.78ng/ml respectively. The mean ± SD duration of follow up was 259.1±141 days. None of the mothers had abnormal levels of bilirubin or liver aminotransferases. All samples tested negative for p53 mutation at codon 249 except for one infant who tested negative for the mutation in his whole blood and had heterozygous mutation in DNA from his liver tissue. None of the studied cohort or their mothers had HCC. Cholestasis resolved in 2 children, 7 had progressive course and 4 died. There was no correlation between outcome and neonate/maternal aflatoxin B1 level (p=0.299; p=0.443), age at portoenterostomy (p=0.93), hepatic fibrosis degree (p=0.56), or other lab or liver biopsy findings. Conclusion: p53 mutation at codon 249 is uncommon in infants with Kotb disease BA variant, despite the aflatoxicosis they suffer from. The cause remains to be studied. Screening for p53 mutation at codon 249 cannot be used as a diagnostic test for Kotb disease.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139020927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of Myocardial Dysfunction in Neonatal Sepsis: A Single Center Experience","authors":"Sara AboElnour, Al Kassem Al Gameel, Noha Hammad","doi":"10.21608/cupsj.2023.211603.1093","DOIUrl":"https://doi.org/10.21608/cupsj.2023.211603.1093","url":null,"abstract":": Background : Myocardial dysfunction is an association of neonatal sepsis that might occur without underlying cardiac structural defect (CSD). Aims of the work: To study frequency of myocardial dysfunction (MD) in sepsis in full term neonates without CSD. Subjects and Methods: All the full term neonates with neonatal sepsis admitted to Neonatal Intensive Care Unit, Fayoum University between December 2019 and December 2020 without underlying CSD were included in the study. They underwent conventional echocardiography and tissue Doppler studies. Results: 103 neonates with neonatal sepsis were included in the study. Of them 30 patients (29.12%) were found to have myocardial dysfunction. Global myocardial dysfunction was encountered in 16 (53.3%), isolated right ventricle dysfunction in 8 (26.6%) cases, isolated left ventricle dysfunction among 6 (20%). The dysfunction was both systolic and diastolic in 2 (6.6%) cases, isolated systolic in 6 (20%), and isolated diastolic in 22 (73.3 %). No noted risk factors were associated with myocardial dysfunction as age (p=0.193), weight (p=0.100), sex (p=0.130) or type of bacterial infection (p=0.125). The outcome among those with myocardial dysfunction and those without was complete resolution in 13 (43.3%) and 43 (59%) patients (p=0.149), cardiogenic shock and death in 17 cases (56.7%) and 30 (41%) (p=0.149) respectively while no cases developed progressive cardiomyopathy. Conclusions: Full terms with neonatal sepsis can experience significant cardiovascular dysfunction that is either global or limited to right or left ventricle. The dysfunction might be systolic or diastolic or both. Myocardial dysfunction among neonates with sepsis might be self-limiting or culminates increasing the risk of mortality.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"67 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139016502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shear Wave Elastography in Children with Portal Vein Thrombosis is not a Sensitive Predictor of Upper Gastrointestinal Bleeding: a Pilot Study","authors":"M. Kotb, Marwa Onsy, Bothainah Abduljalil, Mona Kamel, Rania Hashem","doi":"10.21608/cupsj.2023.232465.1103","DOIUrl":"https://doi.org/10.21608/cupsj.2023.232465.1103","url":null,"abstract":": Background: Extrahepatic portal vein thrombosis (EHPVT) is a cause of portal hypertension in children. It is complicated by upper gastrointestinal variceal bleeding. Aim of the work: to study shear wave elastography (SWE) assessed liver and spleen stiffness among children with EHPVT as a predictor of esophageal varices, its grade and/or upper gastrointestinal (GIT) bleeding. Methods: This case-control study included 18 children with EHPVT who were not secondary to liver disease and 18 healthy children as a control group who underwent ultrasonography and SWE of the liver and spleen. The patient group underwent upper GIT endoscopy as well. Results: The mean ± SD age of the children with EPVT was 9.11 ± 5.26 years, and 5 (27.7%) were females. Three (16.7%) had thrombophilia, 11 (61.1%) had undergone neonatal placement of umbilical catheter, both neonatal intensive care unit admission and thrombophilia in 2 (11.1%) and omphalitis in one (5.5%). All had clinically evident splenomegaly and sonographic evidence of portal vein cavernoma, 2 had recanalized portal vein. SWE stiffness of the right lobe was 7.39 ± 0.86 kPa, the left lobe was 7.64± 0.99 kPa and splenic stiffness was (mean± SD was 68.1 ± 22.8 kPa and range 28-121 kPa) among those with EHPVT, compared to the control group which was 6.83 ± 0.37 kPa, 7.39 ± 0.85 kPa, and (mean± SD was 19.61 ± 2.7 kPa and range 17.2-24.2 kPa), (p = 0.018), (p=0.036) and (p=0.00001) respectively. Esophageal varices bleeding and grade did not correlate with the modified caudate to right lobe diameter ratio (p=0.621), and (p= 0.53), stiffness of the right lobe (p=0.64) and (p= 0.684), left lobe (p=0.297) and (p= 0.223), or spleen stiffness (p=0.499) and (p= 0.196) respectively. Eleven (61.1%) had patent lienorenal collaterals, they were older (mean age 10± 5.3years) compared to those who did not develop (6.7 ± 3.6 years) lienorenal collaterals (p=0.06).","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}