Baştuğ F, Nalçacıoğlu H, Baş VN, Tekatlı-Çelik B, Çetinkaya H, Yel S. Acute renal failure due to severe hypercalcemia and nephrocalcinosis treated with two doses of pamidronate in an infant with Williams-Beuren syndrome. Turk J Pediatr 2018; 60: 210-215. Infantile hypercalcemia has been reported in 15% of infants and children with Williams-Beuren syndrome (WBS) and has generally mild clinical symptoms. However, the need for pamidronate treatment in a few infants with severe hypercalcemia associated with WBS has been reported in literature. Many disorders, such as primary hyperoxaluria, associated with nephrocalcinosis can lead to renal failure, but there are only a few reports in infants with WBS who have decreased renal function and nephrocalsinosis. We present a 23-month-old girl with WBS (confirmed with fluorescent in situ hybridization probes) who presented with acute renal failure with severe symptomatic hypercalcemia and nephrocalcinosis, which responded to two infusions of pamidronate.

The purpose of this study is to detect the predictive power of the modified early warning score with rapid lactate level (ViEWS-L) on mortality in critical patients over the age of 65 years admitted to the emergency department (ED). A total of 616 non-traumatic patients admitted to the Uludag University Faculty of Medicine ED who were 65 years of age or older were included in this study (Ethics board number: 2015-4/8). In this prospective study; the ViEWS-L score of the patients were calculated. The results have been evaluated with rate of mortality in the first 24 h starting from submission. The area under the ROC curve was found 0.872 and the cut-off value to detect mortality was found 10.83 for the ViEWS-L score. In the model obtained by the univariate binary logistic regression analysis, ViEWS-L score was found statistically significant and it was determined that mortality risk increased 1.286 times for each unit increase in the score of ViEWS-L score. As a result of this research, it was found that ViEWS-L scoring system is effective in determining the mortality of 65 years and older patients.

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Crimean-Congo Hemorrhagic Fever (CCHF) and Leptospirosis are endemic in our region. Hantavirus infections may be confused with similar clinical picture zoonotic infections. Two patients with fever, malaise, cough, phlegm, nausea, vomiting, thrombocytopenia, renal failure, elevated transaminases, and a history of mouse contact were hospitalized in our clinic with a presumptive diagnosis of leptospirosis, pneumonia, CCHF and Hantavirus infections. Empirical antibiotic treatment was initiated and CCHF and leptospirosis was ruled out with laboratory tests. Hantavirus immunoglobulin (Ig)-G and Ig-M antibodies were detected positive by immunofluorescent antibody (IFA) method in both cases but, Dobrova virus was detected in only one patient with immunoblotting methods. Both patients were discharged after treatment. Hantavirus infections may be misdiagnosed as zoonotic infections since they have similar clinical picture. It should be considered in the differential diagnosis of patients with a history of contact with mouse.