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IgA vasculitis is the most common vasculitis in childhood, and its main feature is leukocytoclastic vasculitis, in which the capillaries are affected by the deposit of IgA immune complexes. Skin rash is the principal clinical manifestation, along with arthralgia or arthritis, digestive and renal tract involvement, and is often self-limiting. Although it occurs at any age, it prefers children between 3 and 12 years. It is common to identify a trigger, the most frequently associated with infection, with reports of up to 31% along respiratory tract infections, followed by gastrointestinal infections at 5%. Dermatological manifestations are the characteristic element of the disease; 100% of patients have purpura at some point; however, renal involvement determines the prognosis of these patients. The diagnosis is clinical, supported by laboratory and cabinet assistants and classification criteria; however, since the prognosis is mainly conditioned by renal involvement, having simple and safe alternatives, adequate follow-up, evaluation of the efficacy of the treatment, and the prognosis of the disease are some of the main objectives of biomarkers. Initial treatment consists of general measures, but in the case of gastrointestinal, renal, or other target organ involvement, such as testicles, therapy with corticosteroids and immunosuppressants is necessary. Since the end of the last century, it has been recognized that not all patients with IgA vasculitis had a benign outcome; however, recent data supports a deleterious outcome both in patients with nephritis and in pregnancy. Keywords: IgA vasculitis; Lueukocytoclastic vasculitis; AgA immune complexes; Rash; Biomarkers; Corticosteroids; Immunosuppressants; Nephritis

  • Source: Revista Alergia México. 72:193-204

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How useful are the biochemical tests in guiding the diagnostic workup of infantile cholestasis? Background: The objective of our study was to determine whether biochemical tests, frequently requested at first presentation of infants with cholestasis, have a role in focusing investigations toward certain disease entities. Methods: All infants with cholestasis (2008 to 2020) were identified and reviewed for final diagnosis and serum levels of alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), lactate, cholesterol, ferritin, alpha-fetoprotein (AFP), total bile acids (TBAs), and hypoglycemia at first presentation. Results: ALT levels were normal in all infants with Dubin–Johnson syndrome. A normal TBA (0–10 μmol/L) in an infant with normal-GGT cholestasis was consistent with bile acids synthesis disorders (BASDs). There was a dichotomy pattern of "high-GGT cholestasis" [associated with biliary obstruction, Alagille syndrome, ciliopathies, mitochondrial hepatopathies] and "low GGT cholestasis", [associated with mutations in ATP8B1 , ABCB11 , TJP2 , USP53 , LSR , MYO5B , VIP AS39 , NR1H4 , BASD, galactosemia, gestational alloimmune liver disease (GALD), and endocrine causes]. Plasma lactate level was significantly elevated in infants with mitochondrial hepatopathies and hemophagocytic lymphohistiocytosis (HLH) [median 5.8 mmol/L and 7.7 mmo/L, respectively; P < 0.001]. The highest ferritin concentrations were in infants with HLH and GALD [medians 4883 μg/L and 2098 μg/L, respectively; P < 0.001]. The most marked elevation of AFP was consistent in all infants with mitochondrial hepatopathies, tyrosinemia, and GALD (median: 99637 ng/mL, 40000 ng/mL; 22566 ng/mL) as compared to causes of biliary obstruction (median: 3662 ng/mL). Hypoglycemia with preserved liver synthetic function was associated with metabolic or endocrine disorders. Conclusion: Although none of these biochemical tests is diagnostic in itself, they can be actionable

Subjects: *Predictive tests; *Ferritin; *Alpha fetoproteinsSaudi Arabia

  • Source: Saudi Journal of Gastroenterology. Nov/Dec2025, Vol. 31 Issue 6, p373-382. 10p.

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Child sexual abuse is a severe form of child maltreatment. In 2007, the WHO estimated that 20% of women and 5–10% of men had experienced sexual violence during childhood. This study aimed to describe the sociodemographic characteristics and modus operandi of perpetrators in cases of child sexual abuse managed in the Department of Forensic Medicine at Annaba University Hospital. We conducted a descriptive cross-sectional study over a 15-month period on a series of suspected child sexual abuse cases. Epidemiological data concerning the perpetrators were collected through interviews with victims or their legal guardians, as well as with the judicial police officers in charge of the investigations. The total number of identified perpetrators was 104. Most abusers were men aged 30 years or younger (71.2%), single (77.9%), from disadvantaged social backgrounds, and either unemployed (34.6%) or in low- income occupations (22.1%). The aggressors were frequently under the influence of alcohol (51.9%) and/or psychotropic substances (57.7%) at the time of the assault. While the day was not specifically chosen, the perpetrator typically selected the location, often an isolated public place (43.6%), with most assaults occurring during the day (47.9%). The aggression was violent in 73.4% of cases, involving verbal coercion (66.7%) or physical force (59.4%). The use of violence varied with the child's age: offenders tended to use a more 'seductive' approach with children aged six years or younger (7.2%), whereas physical and verbal coercion predominated among victims aged 12 years and older (62.3%). Although our study does not claim to be representative of all child sexual abuse perpetrators in the region, it provides valuable insights. It highlights that abusers are often known to the child and that socioeconomic vulnerability appears to play a significant role in the occurrence of abuse. These findings underscore the importance of further research focusing on offenders' psychological profiles, trauma histories, and judicial backgrounds.

Subjects: thyroid cancer; papillary; follicular

  • Source: Batna Journal of Medical Sciences, Vol 12, Iss 4 (2025)

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