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Objective: to examine the frequency of hepatic transaminase elevations in infants with acute gastroenteritis Methods: Over a 8-weeks period, 35 of 130 infants admitted with acute gastroenteritis were found to have human rotavirus (HRV) gastroenteritis using stool antigen testing. Sera 130 infants were analyzed for alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), total and direct bilirubin, and creatinine .Results: Thirty four infants (26%) had elevated ALT and AST. ALT elevations were 1-3 times the normal in 24(~18%) and 6-20 times the normal in 10(~8% ) infants; the latter group showed the clinical and biochemical criteria of ischemic hepatopathy. In all infants transaminases normalized within 3-10 days. Transaminase elevations were not significantly associated with age, sex, duration of gastroenteritis or with any of the following symptoms; fever (>38), vomiting or blood in the stools. A border line significant association was detected between HRV stool positivity and elevated ALT&AST levels (40% HRV positive VS. 21% HRV negative odd ratio=2.5 95%CI 1-3.2 p=0.05). Infant with severe dehydration had an estimated 31.5 fold higher odds of having elevated ALT & AST compared with those no dehydration(57,4% respectively).Multivariate logistic regression analysis, showed that severe dehydration is still significantly associated with elevated Transaminase levels.Conclusion: our data suggest that liver injury during gastroenteritis in infants is quit frequent but always self limiting if the underlying perfusion disturbance caused by severe dehydration is corrected.Rotavirus positivity was marginally associated with elevated transaminase levels. MONO-SYMPTOMATIC CYSTIC FIBROSIS (CF):A CASE REPORT (5T)). Attending this result we performed other studies to exclude other possible CFTR-related signs, including respiratory infection and function or azoospermia. The chest radiography, spirometry, semen analysis and ultrasonography of the vas deferens and the seminal vesicles were normal. Tests for pancreatic endocrine and exocrine function were also normal. To complete the genetic evaluation, the siblings and both asymptomatic parents were tested because they are potentially at risk of similar disease. This genetic study showed that the father and the two siblings are carriers of the severe CFTR mutation (I507del) and the mother is carrier of the mutation IVS8 5T. Conclusion:The I507del mutation is a severe CFTR mutation. In contrast, the IVS8(5T) mutation is not associated with clinical cystic fibrosis but, in compound heterozigosity with a more severe mutation, can be causative of mono-or oligosymptomatic CFTR-related disorders. This is probably the first case report of an atypical CF in a patient with the compound heterozygosity I507del+IVS8 5T. It confirms the challenges and difficulties for diagnosing atypical CF and highlights the role of CFTR mutations in the pathogenesis of idiopathic pancreatitis.

There were 121 positive cultures positive, 79.3% in patients obeying the defined criteria and 91.7% with clinical predictors of positivity. Campylobacter was the most frequently identified agent (68.6%), followed by Salmonella. Campylobacter decreased within an increasing age whilst Salmonella showed an inverse pattern. Campylobacter was the most frequently identified agent throughout all seasons of the year, followed by Salmonella, except in the winter when Yersinia took the second place. Discussion Sticking to accepted criteria for stool collection and/ or to defined clinical features, increasing the yield of stool cultures. PO-0132 ACID REFLUX INTO THE OESOPHAGUS AND EXERCISE:A PROSPECTIVE STUDY IN CHILDREN C Pacchiarotti, M Barreto, M Campisano, F La Penna, A Bozzone, C Casini, I Caiazzo, A Crescenzi, MP Villa. NESMOS Department, Pediatric Unit Sant'Andrea Hospital, Roma, Italy 10.1136/archdischild-2014 Background and aims It has been reported that gastro-oesophageal reflux (GOR) can be induced by exercise, as described in adult subjects; studies in children are lacking. We sought whether the presence of acid in the oesophagus may increase with exercise and its potential relationship with atopy and lung function in children. Methods We recruited 45 patients (M/F: 30/15) aged 11 ± 2.7 years with reported exercise-induced respiratory symptoms; subjects were asked for frequency of gastrointestinal symptoms. All patients did lung function before and after 24-h gastro-oesophageal (GO) pH monitoring; they also underwent exercise testing (treadmill) before removing GO catheter. GO-pH was also analysed for 6 min intervals before, during and after exercise. The gastro-oesophageal reflux disease (GORD) was defined as a 24-hour reflux index (IR) ≥ 4.5% and/ or symptom index ≥ 50%. Total serum IgE levels were also assessed. Results GORD was found in 11/45 (24.4%) of our patients; these children had also a higher IR score during exercise than patients without GORD (7.1 ± 18.5 vs 0.5 ± 2.3, p < 0.05). A fall of GO-pH was recorded during exercise, greater in children with GORD as compared with those without (17.2 ± 42.2 vs 0.9 ± 6.4, p = 0.03). The exercise-induced fall in GO-pH was associated with frequent gastrointestinal symptoms and correlated with IgE levels and baseline FEV 1 % (IgE: r = -0.37, FEV1%: r = -0.31, p < 0.05 for both). Conclusions Our results suggest that oesophageal acidity increase with exercise, particularly in atopic children with frequent gastrointestinal symptoms and low baseline respiratory function. Background and aims Several study have been reported that modifying vagus nerve control of transient lower esophageal sphincter relaxation can induce improvement of gastroesophageal reflux disease (GERD). Our aim was to evaluate the efficacy of osteophatic treatment (OMT) in infants with GERD. Methods We enrolled 40 infants (M/F:24/16), age ranged 1-18 months (median 4 month) attending for persistent reflux. Each patient performed I-GERQ-R questionnaire and ultrasonography of the gastro-esophageal j...