Pediatric health, medicine and therapeutics最新文献

{"title":"Surge in Mycoplasma Pneumoniae infection and Respiratory Viruses Co-infection in Children With Community-Acquired Pneumonia in the Post-Pandemic.","authors":"Jie Chi, Heng Tang, Fang Wang, Yuxuan Wang, Zhifeng Chen","doi":"10.2147/PHMT.S473669","DOIUrl":"https://doi.org/10.2147/PHMT.S473669","url":null,"abstract":"<p><strong>Purpose: </strong>During the COVID-19 pandemic, multifaceted non-pharmaceutical interventions have not only reduced the transmission of SARS-CoV2 but also affected the prevalence of other respiratory pathogens. With the lifting of many restrictions, a surge in cases of pneumonia in children has been reported in many hospitals in China. The study assessed the changes in pathogen and symptoms of children with community-acquired pneumonia (CAP) before and after the adjustments of prevention and control measures of epidemic and provided recommendations for CAP in children.</p><p><strong>Patients and methods: </strong>Children diagnosed with CAP were enrolled in the study from 2022 to 2023. A cross-sectional retrospective study was conducted in a general hospital. We analyzed the data about demographic data, clinical symptoms, pathogens, and medical treatments. The Chi-square and Mann-Whitney <i>U</i>-test were used to assess the statistical significance of groups.</p><p><strong>Results: </strong>We studied 1103 children, 339 in 2022 and 764 in 2023. Compared with children in 2022, more children were diagnosed with CAP in 2023 and these children had a higher body temperature and levels of CRP and PCT, which indicated these children got severe inflammation. The positive rate of the pathogen was also higher in 2023, especially the detective rate of <i>Mycoplasma pneumoniae</i>. The number of children infected with more than two pathogens was higher in 2023, especially those co-infected with the virus and <i>M. Pneumoniae</i>. Concerning the medicine therapy, the usage of β-lactam antibiotics, Macrolide antibiotics, and antiviral drugs kept rapid growth.</p><p><strong>Conclusion: </strong>After the adjustment of epidemic prevention and control policies in 2023, more children got CAP with severe clinical symptoms, and more antibiotics and antiviral drugs were used. Further study is needed to explore the reasons for the increase in children with CAP and to explore the rationality of treatment.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"279-288"},"PeriodicalIF":1.7,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficient Method for Rapid Diagnosis of Streptococcal Pneumoniae in the Context of Co-Infection in Children-Case Report.","authors":"Loredana Stavar-Matei, Oana-Mariana Mihailov, Alexandra-Mihaela Crestez, Anamaria Madalina Alexandru, Cristina-Mihaela Popescu, Aurel Nechita","doi":"10.2147/PHMT.S467351","DOIUrl":"10.2147/PHMT.S467351","url":null,"abstract":"<p><strong>Background: </strong>Bacterial pneumonia caused by <i>Streptococcus pneumoniae</i> continues to be one of the most common medical conditions in the pediatric population under 5 years of age, sometimes requiring prolonged hospitalizations and high costs. The time period (3 to 7 days) from the collection of biological samples (ie nasal exudate, pharyngeal exudate, sputum, blood culture and various secretions) to the arrival of the results has been a much discussed issue. Thus, the use of a rapid diagnostic test for <i>Streptococcus pneumoniae</i> urinary antigen, which is easy to use, may lead after the result is known to a targeted therapeutic management and thus to a favorable prognosis of the disease for the patient.</p><p><strong>Methods: </strong>This case report presents the case of a 4 years and 5 months old patient diagnosed with invasive pneumococcal-associated pneumococcal infection in the context of SARS-COV2 infection.</p><p><strong>Results: </strong>The clinical course was slowly favorable with complications that required a long hospitalization.</p><p><strong>Conclusion: </strong>In conclusion, some rapid diagnostic techniques, clinician judgment and some prevention methods, such as vaccination, can improve a patient's quality of life. One prospect for the future would be the development of new vaccines covering other aggressive <i>Streptococcus pneumoniae</i> serotypes.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"273-278"},"PeriodicalIF":1.7,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth Status of Full-Term Infants with Different Sizes for Gestational Age During the First Year of Life.","authors":"Zhuo-Ren Zhou, Yong Guo","doi":"10.2147/PHMT.S468778","DOIUrl":"10.2147/PHMT.S468778","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the growth of full-term infants with different sizes at birth and examine catch-up and catch-down growth in their first year.</p><p><strong>Methods: </strong>This retrospective population-based cohort study was based on the Guangdong Provincial Women and Children Health Information System. 194797 full-term singleton live births were extracted. Measurements for weight and length were taken at birth, 6 months, and 12 months. The size-for-gestational age was categorized as small (SGA, <10th centile), appropriate (AGA, 10th-90th centiles), or large (LGA, >90th centile) based on the international newborn size for gestational age and sex INTERGROWTH-21st standards. Catch-up and catch- down growth were defined as a change in standard deviation in z-score greater than 0.67 in the growth curves.</p><p><strong>Results: </strong>Of the 194797 full-term singletons, the average gestational age was 39.28 ± 1.03 weeks, and the average weight of the newborns was 3205 ± 383 grams. 15632 infants were identified as SGA (8.0%) and 12756 were LGA (6.5%). At 1 year of age, catch-up growth in weight was observed in 63.0% of SGA infants, 29.5% of AGA infants, and 5.4% of LGA infants. Conversely, catch-down growth occurred in 3.3% of SGA infants, 17.8% of AGA infants, and 54.7% of LGA infants. The proportions of catch-up growth in length for SGA, AGA, and LGA infants within the first year were 31.4%, 22.5%, and 17.1%, respectively. Catch-up or catch-down growth predominantly occurred before 6 months of age. However, from 6 to 12 months, there was no significant variation in WAZ among children with different birth sizes.</p><p><strong>Conclusion: </strong>In their first year of life, full-term singleton live births tend towards regression to the mean in their postnatal weight and length. The average delay in the growth of LGA is compensated by an increase in it of the SGA. Early monitoring and intervention are crucial for optimizing growth in infants with different birth sizes.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"265-272"},"PeriodicalIF":1.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Toxicology of OTC Cough and Cold Pediatric Medications: A Narrative Review.","authors":"Ajeng Diantini, Mohammed Alfaqeeh, Lanny Indah Permatasari, Mirna Nurfitriani, Lela Durotulailah, Wening Wulandari, Truly Deti Rose Sitorus, Gofarana Wilar, Jutti Levita","doi":"10.2147/PHMT.S468314","DOIUrl":"10.2147/PHMT.S468314","url":null,"abstract":"<p><p>Cough and cold symptoms (CCS) are common pediatric conditions often treated with over-the-counter (OTC) medications. However, the available knowledge regarding the safety and toxicity of these medications in children is inadequate. Therefore, understanding their clinical toxicology is crucial for safeguarding children's well-being. This narrative review highlights the importance of clinical toxicology in evaluating the safety and toxicity profile of OTC medications for treating CCS in pediatric patients. The pharmacology, clinical features, and adverse effects of various drug classes commonly found in cough and cold medications are briefly discussed. Pharmacokinetic and pharmacodynamic parameters are also examined to understand the interactions between these drugs and the body. OTC cough and cold medications often contain active ingredients such as antihistamines, decongestants, antitussives, expectorants, and analgesics-antipyretics. The combination of multiple ingredients in these products significantly increases the risk of adverse effects and unintentional overdoses. Several case studies have reported significant toxicity and even fatalities associated with the use of these medications in children. This review underscores the critical importance of clinical toxicology in evaluating the safety and toxicity profile of OTC medications employed for treating CCS in pediatric patients. The findings highlight the significance of informed clinical practice and public health policies to ensure the well-being of children using OTC cough and cold medications.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"243-255"},"PeriodicalIF":1.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Computer Tomography Findings in Pediatric Accidental Head Trauma-Review.","authors":"Cristina-Mihaela Popescu, Virginia Marina, Anisoara Munteanu, Floriana Popescu","doi":"10.2147/PHMT.S461121","DOIUrl":"10.2147/PHMT.S461121","url":null,"abstract":"<p><p>Head trauma in paediatric patients is a worldwide and constant issue. It is the number one cause for childhood mortality and morbidity. Children of all ages are susceptible to sustaining head trauma and the anatomical characteristics of the region put them in a high-risk category for developing severe traumatic brain injuries. Boys are more frequently victims of accidental head traumas, and their injuries are more severe than those encountered in girls. The mechanisms of the trauma are a determining factor for the types of lesions we find. The traumatic injuries fall into two categories, primary and secondary. Primary traumatic injuries can be severe and life threatening, and their presence needs to be documented in order to set the correct therapeutic conduct. Due to their importance, this pictorial review focuses on them and the images used herein are selected from the database of our hospital. It is important to distinguish each of the different injuries that can be encountered. At the same time, radiologists are advised to remember that for children up to five years of age, some non-accidental imaging findings may appear to coincide with those found in accidental head trauma.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"231-241"},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Shock: The Magnitude, Its Determinants and Short-Term Outcome on Patients. A Cross-Sectional Hospital-Based Study.","authors":"Mebrahtu Gebreslassie Kidanu, Engdaeshet Tazebe, Alemseged Berhane Tesfa, Marta Yemane Hadush, Mebrihit M Kahsay, Mebrahtu G Tedla","doi":"10.2147/PHMT.S458438","DOIUrl":"10.2147/PHMT.S458438","url":null,"abstract":"<p><strong>Background: </strong>Pediatric shock is a potentially fatal illness which develops after a systemic circulatory system failure in children. It appears to be a common emergency in children and produces substantial morbidity and mortality particularly if there is no early identification and therapy. The extent and causes of shock-induced death among children in Ethiopia have not been sufficiently studied.</p><p><strong>Objective: </strong>This study was conducted to evaluate the magnitude, determinants and short-term outcome of shock in pediatric patients who visited Ayder Comprehensive Specialized Hospital in Tigray, Northern Ethiopia.</p><p><strong>Methods: </strong>From October 1, 2020, to July 30, 2022, an observational cross-sectional study was carried out at Ayder Comprehensive Specialized Hospital. The study included 132 children from the age of 1 month to 18 years. According to pediatric advanced life support guidelines, shock was diagnosed among patients. To gather information, a pretested questionnaire was employed. To examine the relationship between the independent variables and shock outcome, bivariate logistic regression was performed, and statistical significance was defined as a P-value of 0.05 or lower.</p><p><strong>Results: </strong>The prevalence of shock was 2.2%. This study revealed 70.5% decompensated stage of shock. Mortality rate of shock was 45.5% (95% CI: 37.1-53.8). A delayed presentation by more than one week with an adjusted odd ratio (AOR) of 16.9 (95% CI: 2.3-123), type of shock other than hypovolemic shock with AOR of 8.3 (95% CI: 1.4-48), stage of shock with AOR of 27.8 (95% CI: 2.8-157), requirement of mechanical ventilation with AOR of 11 (95% CI: 2.6-53) and length of hospital stay less than three days with AOR of 9 (95% CI: 1.7-48) were identified as a predictor of mortality by shock in children.</p><p><strong>Conclusion: </strong>According to this study, shock causes a high rate of child mortality. Independent predictors of mortality included delayed presentation, shock type, stage of shock, the need for mechanical ventilation, and brief hospital stay (less than three days).</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"213-221"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Microvascular Complication of Type 1 Diabetes Mellitus and Its Predictors Among Children with Type 1 Diabetes Mellitus in Ethiopia; A Single Center Experience: Ambi Directional Cohort Study.","authors":"Konjit Eshetu, Lemma Demissie Regassa, Merga Dehresa, Desta Genete","doi":"10.2147/PHMT.S456541","DOIUrl":"10.2147/PHMT.S456541","url":null,"abstract":"<p><strong>Introduction: </strong>Type 1 diabetes mellitus is the most common pediatric endocrine disorder. Poor glycemic control in diabetes mellitus can result in microvascular complications (retinopathy, neuropathy, and nephropathy). There is no study done in our setting either about prevalence of pediatric type 1 diabetes mellitus or chronic microvascular complication among these patients, which gap this study is expected to fill.</p><p><strong>Objective: </strong>This study aimed to assess the risk and predictors of chronic microvascular complication of type 1 diabetes mellitus among children with diabetes at Haramaya University Hiwot Fana Compressive Specialized Hospital from September 10, 2021 to January 30, 2023.</p><p><strong>Methods: </strong>A hospital-based Ambi directional cohort study was conducted. Survival data are described by follow-up time and Kaplan-Meier graph. To determine predictors associated with chronic microvascular complication we used a Poisson regression optimal model selected using the information criterion. All associations are tested at the 95% confidence level and a reported IRR <i>P</i>-value less than 0.05 is declared as a significant association between variables.</p><p><strong>Results: </strong>A total of 124 children with type 1 diabetes mellitus were followed with total 407.5 years risk time. The overall incidence rate of chronic microvascular complication was 83 per 1000 population per year (95% CI: 59-116). The median time for detection of microvascular complication was 7 years after diagnosis. Being male with IRR 1.71 (95% CI: 0. 0.81-3.56), being at pubertal age IRR 1.91 (95% CI: 1.05-3.48), longer diabetes mellitus duration IRR 1.13 (95% CI: 1.07-1.28), and poor glycemic control IRR 1.50 (95% CI: 0.46-4.97) were found to be at higher risk for chronic microvascular complication.</p><p><strong>Conclusion: </strong>There was high incidence of chronic microvascular complication of diabetes mellitus. Being pubertal age group and more than 3 years duration after diagnosis had statistically significant association with complication.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"201-212"},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11130991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life in Sudanese Children with Nephrotic Syndrome: A Comparative Cross-Sectional Study.","authors":"Fatima S Naim, Yassir M Bakhiet, Mohmmed A Mohmmedahmed, Bashir A Yousef","doi":"10.2147/PHMT.S437364","DOIUrl":"10.2147/PHMT.S437364","url":null,"abstract":"<p><strong>Background: </strong>Nephrotic syndrome (NS) is an essential chronic disease in children that has a major impact on a child's health-related quality of life (HRQoL). This study aimed to evaluate the HRQoL of Sudanese children with NS and clinical parameters that can influence their HRQoL.</p><p><strong>Methods: </strong>This study was a descriptive cross-sectional of children with NS conducted in Khartoum state hospitals. A standardized PedsQLTM 4.0 Scale Score evaluated the HRQoL of the participants. Patients' socio-demographics, clinical data, and disease complications were collected using a data collection sheet. This study assessed the HRQoL of children with NS and compared it with apparent age and sex-matched to three groups (healthy children, children with chronic diseases, and kidney-transplanted children).</p><p><strong>Results: </strong>80 children with NS were recruited from April to August 2021. Children over eight years old represented (63.8%) of the study subjects. The total mean HRQoL scores of nephrotic children were significantly lower than those of healthy children (78.46 ± 24.01) (p = 0.001) and those with other chronic diseases (78.45 ± 24.01) (p= 0.006); however, it was not significantly different from those with kidney transplantation. Socio-demographics did not significantly affect the total mean HRQoL scores of children with NS. Clinical parameters such as the duration of illness, \"less than one year\" (p= 0.006), and the minimum change nephropathy histopathology (p= 0.035) significantly lowered the total mean HRQoL scores of NS children. Regression analysis further confirmed that edema, proteinuria, and hospital admission had a high impact on the total mean HRQoL.</p><p><strong>Conclusion: </strong>The total mean HRQoL scores of children with NS were low and significantly lower than healthy children. Parameters such as the patient's socio-demographics and phenotype of NS had no significant effect on the total mean HRQoL scores of children with NS. However, other clinical parameters significantly lowered their total mean HRQoL scores.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"133-144"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potocki-Lupski Syndrome in Ethiopian Child: A Case Report.","authors":"Endayen Deginet, Deme Abdissa, Tadele Hailu","doi":"10.2147/PHMT.S451161","DOIUrl":"10.2147/PHMT.S451161","url":null,"abstract":"<p><strong>Background: </strong>Potocki-Lupski syndrome (PTLS) is a rare developmental disorder resulting from the partial duplication of the short arm of chromosome 17. Affected children may have hypotonia, facial dysmorphism, or neurological abnormalities.</p><p><strong>Case presentation: </strong>We present the case of a 5-year-old female patient from Ethiopia diagnosed with Potocki-Lupski syndrome (PTLS)(17p11.2 microduplication) through multiplex ligation-dependent probe amplification (MLPA) testing. This technique identified the duplication of regions of the 17p11.2 chromosome (<i>RAI1, DRC3, USP22, COPS3 and LLGL1</i>). The patient exhibited neurological manifestations including speech delay and mild intellectual disability, along with craniofacial dysmorphism characterized by a triangular face, wide forehead, dental malocclusion, and micrognathia.</p><p><strong>Conclusion: </strong>A multidisciplinary team approach is imperative for managing patients with PTLS. Parental counseling and genetic advice are crucial for families with children affected by PTLS.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"129-131"},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10981369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HLH Syndrome in a Community Hospital: The Challenge of an Early Diagnosis.","authors":"Yuval Wagner, Dganit Adam, Galit Pomeranz Engelberg, Avishalom Pomeranz, Yoav H Messinger","doi":"10.2147/PHMT.S446681","DOIUrl":"10.2147/PHMT.S446681","url":null,"abstract":"<p><strong>Introduction: </strong>Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal hyperinflammatory cytokine storm. It can be secondary to infections, malignancies, autoimmune diseases, or the manifestation of genetic disorders, including primary immune deficiency. HLH requires a high index of suspicion and is challenging for community hospitals.</p><p><strong>Methods: </strong>Medical records of children with HLH admitted to the Meir Medical Center in Israel between 2014 and 2017 were reviewed.</p><p><strong>Results: </strong>Nine children met ≥5/8 HLH-2004 criteria. The median age was 1.1 year, and 78% of the patients were aged <2 years. All patients had prolonged fever, cytopenia, and elevated soluble interleukin-2 receptor, and 89% had elevated ferritin levels. Of three children who underwent gene panel evaluation, one had heterozygote genetic variants of <i>UNC13D</i> and <i>STXBP2</i> of unclear significance, whereas the other two had no variants. Infection was identified in 8 of 9 patients: adenovirus, HHV6, EBV, and Streptococcus Group A. Only 2 patients received HLH-2004 therapy (dexamethasone, etoposide, cyclosporin-A) and the others received dexamethasone and/or intravenous gamma globulins (IVIG), with rapid resolution of fever (median 2 days). One patient (11%) died of Pseudomonas septicemia and multiorgan failure. At a median follow-up of 7 years (range 2.6-8.1 years), all others (8/9) are long-term survivors with no recurrent HLH, but 2 patients developed adenovirus-related bronchiolitis obliterans.</p><p><strong>Conclusion: </strong>Children presenting with prolonged fever and abnormal blood counts should be evaluated with ferritin, triglycerides, and fibrinogen levels which indicate possible HLH. Early intervention with corticosteroids and/or IVIG may prevent deterioration, spare them from chemotherapy and provide time for more elaborate testing to identify true HLH. Unfortunately, mortality remains a significant risk for these children.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 ","pages":"111-120"},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10926863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}