Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder resulting from excessive activation and nonmalignant proliferation of T-lymphocytes and macrophages. Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Reports pertaining to the association between HLH and HUS are rarely published; however, we report on a 4-year-old boy who was diagnosed with both conditions and treated successfully with high-dose steroid and intravenous immunoglobulin. Differentiating HUS from HLH can be challenging because of their clinical similarities. Therefore, prompt diagnosis and immunosuppressive treatment are essential and life-saving to these patients.

Objective: The coronavirus disease pandemic is a major problem that the world has been facing since December 2019. It mainly affects the respiratory system; however, the disease can affect the kidneys to different degrees. This study aimed to determine the changes in tubular dysfunction and inflammation parameters in children with coronavirus disease using urine biomarkers. Materials and Methods: We included 36 children who tested positive for severe acute respiratory syndrome coronavirus 2 on real-time reverse transcriptase-polymerase chain reaction using respiratory specimens. Coronavirus disease-positive and -negative period parameters were evaluated. For measurement of interleukin-1β, interleukin-6, and urine β2 microglobulin levels, patients’ urine samples were collected at diagnosis and 1 month after discharge. Additionally, routine urine and hematological parameters were evaluated concurrently. Results: For all patients, the median urine β2 microglobulin, serum urea, and lactate dehydrogenase levels were significantly higher in the coronavirus disease-positive period than in the coronavirus disease-negative period (P < .05). Further, serum platelet count was significantly lower in the coronavirus disease-positive period than in the coronavirus disease-negative period (P < .05). However, there was no difference in serum creatinine, interleukin-6, or interleukin-1β levels between the 2 periods (P > .05). Conclusion: Our results suggest kidney involvement and tubular dysfunction in patients with asymptomatic, mild, and moderate infections. Furthermore, interleukin-1β and interleukin-6 levels were high in the urine, even in non-critically ill patients. We believe that these findings contribute to the accumulation of evidence on continued inflammation in the kidney. Cite this article as: Taş N, Uslu Gökçeoğlu A, Aykaç K, et al. Evaluation of tubular dysfunction using urine biomarkers in children with COVID-19. Turk Arch Pediatr. 2022;57(1):99-103.

Amaç: Üreteropelvik bileşke darlığı (UPD) olan hastalarda cerrahi tedavinin zamanı konusunda çelişkili sonuçlar bulunmaktadır. Bu nedenle UPD tanı ve tedavisinde ultrasonografi (USG) ve dinamik böbrek sintigrafisi parametrelerinin öngörücü gücünü karşılaştırmayı amaçladık.Gereç ve Yöntemler: 2015-2020 yılları arasında UPD tanısı alan hastalar geriye dönük olarak değerlendirildi, diğer konjenital üriner anomaliler dışlandı. Renal pelvis ön-arka çapı USG ile değerlendirildi ve Fetal Üroloji Derneği’nin derecelendirme sistemine göre evrelendi. Dinamik böbrek sintigrafisinde maksimum böbrek aktivitesine ulaşma süresi (Tmax), maksimum aktivitenin yarısının temizlenmesine kadar geçen süre (T1/2), diferansiyel böbrek fonksiyonu ve diüretik yanıtı kaydedildi.Bulgular: Çalışmaya 59 hasta dahil edildi. Elli dokuz hastanın 13’üne (%22) piyeloplasti yapıldı Piyeloplasti grubunda (%22) piyeloplasti yapılmayan gruba göre yüksek dereceli hidronefroz tesbit edildi ve bu grupta renal pelvis ön-arka çapı daha fazlaydı. Ayrıca piyeloplasti grubunda Tmax ve T1/2 değerleri piyeloplasti yapılmayan gruba göre anlamlı derecede daha uzundu (p

The authors aim to evaluate characteristics of children with fUTI and results of renal bladder ultrasonography (RBUS) and late dimercaptosuccinicacid (DMSA) scan. This study is designed as retrospective analysis of RBUS and DMSA reports of children with fUTI. Age, gender, number of fUTI, presence of constipation and vesicouretheral reflux (VUR) were recorded. The study included 160 children with fUTI with a median age of 7 years (6 months 18 years old). The majority of children in this study were girls (86.3 %), older than 60 months (73.1 %) and had one episode of fUTI. The recurrence rates of UTI were similar in both girls and boys. The total rate of constipation was 21.9 %. The rate of renal scarring on DMSA was 16.9 %. The rates of renal scarring were similar at three age groups and both genders. The rate of renal scarring was higher in children with recurrent UTI compared to those with one episode of fUTI (26.4 % and 12.5 %, respectively; p = 0.04). The rate of constipation in children with renal scarring and normal DMSA was similar (p = 0.07). The rate of trabeculation and thick bladder wall was higher in children with renal scarring at DMSA than children with no renal scarring (p = 0.03). The present study demonstrated that 16.9 % of children with fUTI had renal scarring. The rates of renal scarring were similar in both gender and age groups. Children with recurrent UTI and abnormal bladder results at RBUS had higher rates of renal scarring.

Objective: Vesicoureteral reflux (VUR) is a prevalent congenital anomaly in children, with a higher incidence in those with febrile urinary tract infections. Early detection and management of VUR are crucial to prevent reflux nephropathy and its associated complications. This retrospective observational study aimed to evaluate the accuracy and advantages of ultrasonography (USG) in diagnosing VUR grade compared to voiding cystourethrography (VCUG), the gold standard. Material and Methods: The study included 147 children aged 0-5 years who underwent VCUG for urinary tract infections, as well as antenatal and postnatal hydronephrosis. Patients were categorized into two age groups: 0-24 months (Group 1) and 25-60 months (Group 2). USG findings, including parenchymal thickness, renal pelvis anteroposterior diameter, renal parenchymal echogenicity, and distal ureteral dilatation, were compared between low-grade and high-grade VUR in both groups. Results: Binary logistic regression analysis revealed that renal pelvis anteroposterior diameter and distal ureteral dilatation were independently associated with high-grade VUR in Group 1. The optimal cut-off value of renal pelvis anteroposterior diameter for predicting high-grade VUR was 5 mm, with 78.0% sensitivity and 76.0% specificity. However, no USG findings were independently associated with high-grade VUR in Group 2. Conclusion: USG examinations performed by experienced radiologists can effectively decrease radiation exposure in children, especially those with high-grade VUR under two years of age, and may prevent unnecessary radiation exposure in some pediatric patients