BACKGROUND:Adverse reactions to intravenous immunoglobulins (IVIG) are divided by organ system involved, or by timing of onset–immediate which occur during infusion usually rate-related, true IgE-mediated anaphylaxis and delayed reaction which occur hours to days after the infusion.AIM:To describe the adverse events of patients given IVIG infusions.METHODS:Total number of patients receiving IVIG was 41 with 25 males (60.97%) and 16 females (39.02%), age 2 months-35 years. A total number of infusions was 1350.RESULTS:Total number of adverse reactions 15, 14 patients with immediate-type and 1 with delayed type. Total percentage of adverse reactions in a given sample was 1.1% of all IVIG infusions. Fever was the most common immediate type of reaction occurring in 11 patients (78.57%) followed by acrocyanosis 10 patients (71.42%), skin rash 9 patients (64.28%) and headache 8 patients (57.14). Delayed-type of reactions (like fever, headache and vomiting) was present in one patient. Majority of the adverse effects occurred at the infusion rate higher than 1, 5 ml/kg/hour, which is still within recommended speed.CONCLUSION:About 1.1% of IVG infusions where with adverse events. Most common manifestations where: fever, acrocyanosis, skin rash and headache, which occurred 1-6 hours from the beginning of the infusion. The occurrence of adverse reactions to IVIG was related to the infusion rates in a fashion that faster infusion rate gives more reactions. Adverse reactions were managed by reduction of the infusion rate and administration of medications such as paracetamol, antihistamines and steroids.

Multisystem Inflammatory Syndrome in Children (MIS-C) is characterized by an inflammation with fever, elevated inflammatory markers, conjunctivitis, rash, impaired coagulation, gastrointestinal symptoms and cardiac abnormalities that may progress to multiorgan failure. The presence of a positive COVID-19 antigen via a PCR test, serological testing for antibodies or close contact with a person diagnosed with COVID-19 helps differentiate MIS-C from other diseases. Gastrointestinal symptoms are recognized to be associated with COVID-19 infection or MIS-C in children, presenting as abdominal pain, gastrointestinal infection with watery stools, appendicitis, ileitis, pancreatitis and hepatitis, confusing the diagnosis with other gastrointestinal diseases. In this case report, we describe an 11 year old boy with MIS-C, who presents acute phlegmona of the appendix for which he undergoes appendectomy, accompanied with acute pancreatitis. These manifestations of MIS-C in our patient resolved without additional complications after a 2 month follow up. We call attention to MIS-C presenting in pediatric patients with fever and abdominal pain which might be caused by appendicitis and pancreatitis, and we recommend abdominal imaging and additional laboratory investigation to promote earlier diagnosis.

Introduction: Hematuria is very common in childhood but if it persists in multiple urine examinations it deserves further detailed evaluation. Hematuria is the increased excretion of erythrocytes in the urine. It can be macroscopic or microscopic. It is a finding of more than 5 erythrocytes/hpf in the urine sediment.This study aims to analyze demographic and etiological characteristics of hematuria in children, to determine the diagnostic value of urine calcium, proteinuria, and ultrasound findings in both forms of hematuria, microscopic and macroscopic.Material and methods: The study includes 150 children aged 1-16 years, with confirmed hematuria in the January 2020 -February 2022 period at the University Children's Hospital -Skopje. Patients are divided into two groups: the group with macroscopic and the group with microscopic hematuria. The two groups are compared in terms of ultrasound findings, urine calcium, and proteinuria. Familial urinary screening for hematuria was also performed.Results: Of 150 children, 59.33% had microscopic and 40.67% macroscopic hematuria.The most common proven etiology in microscopic hematuria is familial hematuria (34.83%), while in macroscopic hematuria the most common cause is glomerulonephritis (39.34%). Hypercalciuria was found in 5 (6%) of the examined children. Proteinuria is significantly higher in the gross hematuria group. Of the 80 screened families, 35 were found to have a familial form of hematuria.Conclusion: This study indicates the frequency of familial hematuria and the importance of familial screening. The values of urine calcium and ultrasound finding do not have a statistically significant difference between the two groups, while proteinuria is higher in macroscopic hematuria (p <0.05).