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Background/Objectives: Immunoglobulin A (IgA) vasculitis (IgAV), classically known as Henoch–Schönlein purpura (HSP), is a type of nonthrombocytopenic small-vessel vasculitis. HSP is the most frequent kind of systemic vasculitis in children, characterized by purpura, arthritis or arthralgia, gastrointestinal pain, and kidney dysfunction. The aim of our research was to investigate and observe the clinical characteristics of children diagnosed with HSP and to explore the correlation between infectious diseases and HSP. Furthermore, this retrospective study considered other factors, such as demographic characteristics (sex, area/environment, and age), and their effect on the pediatric population diagnosed with HSP. Methods: To answer this question, we conducted a five-year hospital-based retrospective study that included 144 hospitalized children who were diagnosed with HSP during hospitalization. Measurements of immunological panels (IgA, IgM, IgG, and IgE), C3, C4, C-reactive protein, fibrinogen, and hematite sedimentation rate (VSH) determined using blood samples revealed that there is a strong correlation between the elements of the immunological panel and the HSP manifestations. Results: Additionally, elevated IgG and normal IgA serum levels in pediatric HSP patients are strongly associated with infectious diseases. Conclusions: Notably, patients with infectious diseases exhibited high IgG and normal IgA serum levels post-treatment and a higher risk of relapses.

Elevated immunoglobulin E (IgE) levels are commonly associated with allergies. However, high IgE levels are also found in several other infectious and non-infectious disorders. Elevated IgE levels typically suggest allergies, eczema, or recurrent skin infections. Hyperimmunoglobulin E (hyper-IgE) levels typically reflect a monogenic atopic condition or inborn immune defects with an atopic phenotype. The aim of our research is to investigate and observe the clinical characteristics of children with increased IgE levels who have previously manifested infectious diseases. Furthermore, the retrospective study considers other factors, such as demographic characteristics (sex, area/environment, and age), and their effect on IgE serum levels. To answer this question, we conducted a one-year hospital-based retrospective study that included 200 hospitalized children who had at least two viral or bacterial infections in the six months preceding hospitalization. Measurements of IgE and allergen panels (respiratory and digestive) using blood samples revealed that individuals who tested positive for the body’s synthesis of hyper-IgE were not observably allergic to any potential allergens despite having higher total serum IgE. According to the results, there was a strong correlation between elevated IgE serum levels and a history of infectious diseases among the patients.

The use of disinfectants, particularly those containing quaternary ammonium compounds (QUACs), has dramatically escalated globally since the coronavirus disease 2019 pandemic. We report a case that highlights the risks associated with ingesting low-concentration QUAC solutions and emphasize the importance of effective management in resolving severe lesions without sequelae. A 17-month-old boy experienced severe respiratory failure after ingesting a disinfectant containing benzalkonium chloride (BAC). The child was initially treated at a local emergency department and was subsequently transferred to a pediatric poison center. Upon evaluation, the child was found to have grade III-A corrosive esophageal lesions and chemical pneumonitis. Several complications, including massive pneumothorax and candidemia, occurred during the clinical course of the disease. However, with timely medical intervention and appropriate supportive care, the patient completely recovered without any long-term sequelae. The properties of BAC and the comprehensive management approach may have been responsible for the patient’s full recovery, despite the potentially life-threatening effects of ingesting disinfectants.

Obiective. Studiul de față și-a propus două obiective principale: evaluarea caracteristicilor psihologice ale adolescenților cu intoxicații acute voluntare internați într-un departament de toxicologie pediatrică și estimarea rolului evaluării psihologice în managementul acestor pacienti. Material şi metodă. Studiul cuprinde analiza retrospectivă a tuturor pacienților cu intoxicație acută voluntară internați în clinica noastră în perioada 1 octombrie 2017-30 septembrie 2018. Au fost luate în considerare următoarele criterii: vârstă, sex, numărul de spitalizări cu acest diagnostic și evaluarea psihologică efectuată în timpul spitalizării. Rezultate. În perioada menționată, în Secția de Toxicologie și Terapie Intensivă a Spitalului Clinic de Urgență pentru Copii „Grigore Alexandrescu” din Bucureşti au fost internați 181 de pacienți cu diagnosticul de intoxicație acută voluntară, având vârsta cuprinsă între 10 și 18 ani. A existat un procent similar de fete în comparație cu băieții (58,1% față de 41,9%), iar majoritatea pacienților (n = 137, 75,7%) erau din mediul urban. Din numărul total al pacienților, 22 (12,1%) au avut două sau mai multe spitalizări cu diagnosticul de intoxicaţie acută voluntară. În 13 cazuri (7,2%), pacienții erau cunoscuți cu tulburări psihice anterioare: 8 pacienți cu depresie, 2 cu tulburare de conduită și 3 cu tulburări asociate consumului cronic de substanțe de abuz. Analizând rezultatele evaluarii psihologice la acești pacienți, am constatat că principala tulburare psihologică a fost reacția emoțională, fiind identificată la 98 de pacienți (54,1%). Tentativa de suicid a fost identificată la numai 31 de pacienți (17,1%), dintre care numai 10 au primit recomandarea de transfer intr-o clinică de psihiatrie. Concluzii. Evaluarea psihologică a pacienților cu intoxicație acută voluntară este esențială în timpul spitalizării în secția de toxicologie pentru identificarea problemelor psihice reale. Reacția emoțională este principala tulburare psihologică la pacienții cu intoxicații acute voluntare.Tentativa reală de suicid este o tulburare gravă, fiind întâlnită doar la un număr destul de mic de pacienți, în studiul nostru fiind diagnosticată doar la 17% din totalul intoxicațiilor acute voluntare.

Postpartum depression remains a significant healthcare priority due to the social and family consequences. Research has shown that both mothers and fathers experience significant psychological changes during pregnancy and postnatally, including depressive disorders. Underdiagnosed in most cases, the short and long-term consequences involve infant and child development, family’s life and social disruption. Because this pathology may lead to deviation from behavioural and social norms, we want to emphasize that timely and appropriate diagnostic can improve the effectiveness of treatments and avoid complications. This may contribute to optimal social, emotional and behavioural child development that may occur consecutively to family members” emotional and psychological manifestations.

Objective. The present study has two main objectives: to evaluate the psychological characteristics of adolescents with voluntary acute poisoning in a pediatric toxicology department and to estimate the role of psychological evaluation in the management of these patients. Material and method. The study includes the retrospective analysis of all patients with voluntary acute intoxication, admitted to our clinic between October 1, 2017 and September 30, 2018. The following criteria were considered: age, gender, number of hospitalizations with this diagnosis and psychological evaluation. performed during hospitalization. Results. During the mentioned period, in the Toxicology and Intensive Care Department of the Emergency Clinical Hospital for Children “Grigore Alexandrescu” in Bucharest, 181 patients were admitted with the diagnosis of voluntary acute poisoning, aged between 10 and 18 years. There was a similar percentage of girls compared to boys (58.1% compared to 41.9%), and most patients (n = 137, 75.7%) were from urban areas. Of the total number of patients 22 (12.1%) had two or more hospitalizations with the diagnosis of voluntary acute intoxication. In 13 cases (7.2%), patients were known to have previous psychiatric disorders: 8 patients with depression, 2 with behavioral disorder and 3 with disorders associated with chronic substance abuse. Analyzing the results of the psychological evaluation in these patients we found that the main psychological disorder was the emotional reaction, being identified in 98 patients (54.1%). The suicide attempt was identified in only 31 patients (17.1%) of whom only 10 received the transfer recommendation in a psychiatric clinic. Conclusions. Psychological evaluation of patients with acute voluntary intoxication is essential during hospitalization in the toxicology section to identify real psychological problems. Emotional reaction is the main psychological disorder in patients with acute voluntary intoxication. The actual suicide attempt is found only in a relatively small number of patients, in our study being diagnosed only at 17% of the total voluntary acute poisoning.

Introduction Acute liver failure (ALF) is a syndrome defined by jaundice, coagulopathy (INR > 1.5) and hepatic encephalopathy in patients with no evidence of prior liver disease. Toxins and drugs are a frequent cause of ALF in children. Material and methods The aim of our study was to establish the causes of toxic ALF in children followed up in our hospital in the period of January 2000 to August 2018. We retrospectively studied all hospital records of patients who developed ALF after mushroom/drug exposure and had been admitted to our hospital, the main pediatric toxicology center in north-western Romania. Results In the last 18 years, 123 patients were admitted to our clinic with toxic ALF (89 patients secondary to mushroom ingestion and 34 patients after drug exposure). In the 2000-2012 period accidental mushroom poisoning was the leading cause of toxic ALF. Unfortunately, during the last years, voluntary drug ingestions have increased dramatically. The most commonly incriminated drug was acetaminophen (52.94%). Conclusions ALF in mushroom poisoning is associated with a high mortality in children, despite optimal medical therapy. This etiology was one of the most important causes of death in our cohort. The difficulty in accessing emergency liver transplantation is an obstacle common to many Eastern European pediatric centers. Fortunately, in the last 5 years the incidence of mushroom intoxications has decreased in our area. It is worrying that over the last few years there has been an increased incidence of toxic ALF after drug exposure (for suicidal purposes or due to lenient regulations for prescribing hepatotoxic medications).

Introduction. The actual prevalence of toxic nephropathies in children is not fully known, because renal functional and structural changes caused by nephrotoxins are nonspecific. The objective of the study was to evaluate the aetiology and renal involvement in severe poisoning with lethal potential in children. Methods. We retrospectively analyzed a group of patients, aged between 0-18 years, with deaths due to acute intoxication, who were investigated at the National Institute of Legal Medicine “Dr. Mina Minovici” Bucharest, Romania, during a 9 years period. We analyzed the aetiology of deaths by poisoning in children, the aetiology and the frequency of nephrotoxic injury and the pathological aspects of nephrotoxic poisonings. Results. From a total of 69 children deaths due to acute intoxication, the most common cause of death was acute poisoning with carbon monoxide (23 cases). The other etiologies were represented by multidrug poisoning – 9 cases, organophosphorus intoxications – 9 cases, and intoxications with illicit drugs – 8 cases. Acute renal injury was present in 20 patients, mainly in acute multidrug poisoning. The most common aspect was tubular nephrosis in 15 cases, followed by the appearance of acute tubular necrosis in 10 cases, tubulo-interstitial nephritis in 1 case, and non-specific aspects with renal stasis in the remaining 6 cases. Conclusions. Kidney involvement in pediatric poisoning is rare, but when acute kidney injury occurs, the prognosis of the intoxication becomes severe. Renal injury was present in 30% of cases, either by direct kidney damage with acute tubular necrosis, or by association of haemodynamic, cardiogenic, or septic shock.

Background: Acute liver failure (ALF) is a rare disease, associated with high mortality, despite optimal medical therapy without emergency liver transplantation. Knowing the possible cause of ALF plays a vital role in the management, as the child could benefit from effective specific therapies in emergencies. Methods: We have analyzed the etiology and outcome of ALF in children followed-up in a tertiary care hospital between January 2012–December 2018. The patients were grouped into different age categories: neonates (0–1 month), infants (1–12 months), children (1–14 years), and teenagers (14–18 years). Results: 97 children (46 males, 47.42%, the mean age of 7.66 ± 8.18 years) were admitted with ALF. The most important causes of ALF were in neonates and infants, infections (72.72%), and metabolic disorders (43.47%), in children and adolescents were the toxic causes (60% and 79.41%). The mortality rate was 31.95% (31 patients), mainly in ALF due to infections or metabolic disorders. Conclusions: In neonates and infants, the main causes of ALF were infections and metabolic diseases, while in older children and teenagers, were toxin-induced liver injuries. The mortality among neonates and infants was significantly higher than in other ages. Early recognition and immediate therapeutic intervention could improve the outcome of these patients.