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Iulia Carmen Straticiuc Ciongradi

Latest posts by Iulia Carmen Straticiuc Ciongradi (see all)

  • SEMNIFICATIA SINDROMULUI DE CITOLIZA LA COPIL – STUDIU CAZUISTIC - 21/07/2015
  • THE SIGNIFICANCE OF CYTOLYSIS SYNDROME IN CHILDREN - 21/07/2015

Articole semnate de acelasi autor in Revista Romana de Pediatrie:

SEMNIFICATIA SINDROMULUI DE CITOLIZA LA COPIL – STUDIU CAZUISTIC

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 4, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIGHLIGHTS

ICMJE- Recommendations

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Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

SEMNIFICATIA SINDROMULUI DE CITOLIZA LA COPIL – STUDIU CAZUISTIC

Laura Mihaela Trandafir, Georgeta Diaconu, Iulia Carmen Straticiuc Ciongradi, Eugen Cirdeiu and Dana Teodora Anton Păduraru

REZUMAT

Determinarea valorilor transaminazelor face parte din protocolul de investigaţii biochimice de rutină care se efectuează la copil, indiferent de simptomatologia clinică. Transaminazele (TGP, TGO) sunt markeri ai leziunilor tisulare care se modifică atât în afecţiuni hepatice, cât şi extrahepatice. Scopul acestui studiu a fost de a stabili etiologia şi semnificaţia clinică a sindromului de citoliză hepatică fără colestază la copiii internaţi pentru diverse afecţiuni pediatrice. Lotul de studiu a cuprins 394 de copiii (cu vârsta cuprinsă între 1,5 luni şi 16 ani) la care au fost decelate valori crescute ale transaminazelor. Protocolul de investigaţii a cuprins anamneza, examenul fizic, investigaţiile biologice complete, markerii virali şi ecografia hepatică.În funcţie de valoarea transaminazelor faţă de valoarea normală (VN), pacienţii au fost incluşi în trei loturi de studiu: 222 pacienţi cu creşteri uşoare ale TGP, TGO (< 2xVN) (lotul I), 164 pacienţi cu TGP, TGO între 2-3xVN (lotul II) şi 8 pacienţi cu TGP, TGO > 3xVN (lotul III). Valoarea transaminazelor a fost determinată lunar în primele 3 luni, iar ulterior, la interval de 2 până la 6 luni din momentul identificării hepatocitolizei. În toate loturile etiologia sindromului de citoliză a fost dominate de afecţiunile acute bacteriene (respiratorii, urinare, digestive) şi virale (infecţia cu virus Epstein Barr, Cito megalovirus). Alte cauze ale sindromului de citoliză au fost bolile nutriţionale şi de metabolism (obezitatea, diabetul zaharat, fenilcetonuria, fibroza chistică, hipotiroidismul congenital). În 20,31% dintre cazuri etiologia nu a fost elucidată, dar valoarea transaminazelor la 6 luni s-a normalizat ca urmare a dietei şi hepatoprotectoarelor. Creşterile uşoare ale valorii TGP, TGO nu necesită învestigaţii laborioase, ele normalizându-se în primele trei luni. Creşterile medii şi severe, persistente după trei luni de tratament, impun continuarea investigaţiilor pentru stabilirea etiologiei (infecţii virale, boli autoimune, nutriţionale şi de metabolism).

Cuvinte cheie: transaminaze, sindrom de citoliză, copil

Full text | PDF

Laura Mihaela Trandafir

THE SIGNIFICANCE OF CYTOLYSIS SYNDROME IN CHILDREN

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 4, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
NLM Catalog
Ebsco Host - Medline
Google Academic
Semantic Scholar

HIGHLIGHTS

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

THE SIGNIFICANCE OF CYTOLYSIS SYNDROME IN CHILDREN

Laura Mihaela Trandafir, Georgeta Diaconu, Iulia Carmen Straticiuc Ciongradi, Eugen Cirdeiu and Dana Teodora Anton Păduraru

ABSTRACT

The measurement of aminotransferases levels has become part of the routine biochemical tests done in children regardless of their clinical symptoms. Aminotransferases (ALT, AST) are tissue necrosis markers which change in both hepatic and extra-hepatic conditions. The aim of this study was to establish the etiology and clinical significance of the cytolysis syndrome without cholestasis in children hospitalized for various pediatric conditions. The study group consisted of 394 children (aged between 1.5 months and 16 years)with elevated values of ALT, AST. The investigation protocol applied included history, full physical examination, complete biological investigations, viral markers and liver ultrasounds.Depending on the aminotransferases values as compared to the normal value (NV), the patients were included in 3 study subgroups: 222 patients with slightlyelevated transaminases values (< 2xNV) (subgroup I), 164 patients with ALT and AST values between 2-3xNV (subgroup II) and 8 patients with TGP, TGO values > 3 x NV (subgroup III). The ALT and AST values were determined monthly during the first 3 months, and then every 2 to 6 months. In all groups the etiology was dominated by acute bacterial (respiratory, urinary, digestive) and viral (Epstein Barr, Citomegalovirus infection) conditions. Other causes of cytolysis syndrome were nutritional and metabolic diseases (obesity, mellitus diabetes, phenylketonuria, cystic fibrosis, congenital hypotiroidism). The etiology remained unclear in 20.31% of the cases, yet the transaminase values returned to normal after 6 months with diet and hepatoprotective therapy. Slightly elevated ALT andASTvalues do not require thorough investigations, as they usually return to normal within the first three months. On the other hand, mildly and severe increases, which persist after three months therapy require further investigation to determine the etiology (viral infections, autoimmune, nutritional and metabolic diseases).

Key words: aminotransferases, cytolysis syndrome, child

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Laura Mihaela Trandafir


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