BackgroundCeliac disease (CD) is an autoimmune disease characterized by immunemediated inflammatory damage of the small intestinal mucosa, precipitated by the ingestion of gluten-containing foods. Since human leucocyte antigen DQ2 (HLA-DQ2) is a marker of nonresponsiveness to hepatits B virus (HBV) vaccine, CD may also be associated with this nonresponsiveness.ObjectivesThe aim of this study was to compare the responses to HBV vaccine between children with CD and healthy children. We also investigated the relationship between the patients’ responses to hepatitis B vaccine, the clinical presentation of CD, and dietary compliance in the patients.Patients and MethodsWe recruited 52 children with CD and 20 age- and sex-matched healthy children who received HBV vaccination according to the standard immunization schedule. The production of specific antihepatitis B surface antigen (HBsAg) antibodies was evaluated in all patients and control participants. Subjects with less than 10 IU/L anti-HBs were consided nonresponders to the vaccination.Results31 of the 52 patients (59.6%) were female and 21 (40.4%) were male. The mean age of the CD patients was 10.7 ± 4 years (range, 4–18 years). Anti-HBs titers were positive in 32 (61.5%) patients and negative in 20 (38.5%) patients, while they were positive in 18 (90%) of the children in the control group (P < 0.05). We found statistically significant differences between negative anti-HBs titers, clinical presentation of CD, and dietary compliance in patients with CD (P < 0.05).ConclusionsNonresponsiveness to hepatitis B vaccination was more frequently found in children with CD than in the control group. Therefore, the response to HBV vaccination should be investigated in children with CD, and a different immunization schedule may need to be developed. Further, compliance to the prescribed gluten-free diet (GFD) may improve the immune response to HBV vaccination in children with CD.

Objective: Helicobacter pylori infection can cause disease from mild to severe that may be accompanied by micronutrient deficiencies. We aimed to investigate serum zinc, copper, magnesium and selenium levels in Helicobacter pylori positive children. Materials and Methods:Thirty-four children, with chronic abdominal pain and diag-nosed to be Helicobacter pylori-positive and 20 healthy children with the same demo-graphic characteristics were included in the study. Serum zinc, copper and magnesium levels were measured in the flame unit of atomic absorption spectrophotometer, selenium levels were measured in the graphite unit of the same atomic absorption spectrophotometer.Results: Serum zinc levels were significantly higher and serum magnesium levels were significantly lower (p<0.05) in Helicobacter pylori positive children than those of the control group. Although copper levels were lower in patient group than in control group, this difference was not statistically significant (p>0.05). There was no significant difference between serum selenium levels of two groups. Conclusion:We concluded that in Helicobacter pylori-positive children, many trace elements and mineral metabolism may change. Keywords:Helicobacter Pylori, zinc, copper, magnesium, selenium Özet Amaç: Helicobacter pylori enfeksiyonu mikro besin eksikliklerinin eşlik ettiği hafif şiddetten ağır tablolara kadar değişebilen hastalıklara sebep olabilir. Biz bu çalışmada Helicobacter pylori pozitif çocuklarda serum çin-ko, bakır, magnezyum ve selenyum düzeylerini araştırılmayı amaçladık. Gereç ve Yöntem:Kronik karın ağrısı olan ve Helicobacter pylori pozitifliği saptanan otuz dört hasta çocuk ve hasta grubu ile aynı demografik özelliklere sahip sağlıklı 20 çocuk çalışmaya dahil edildi. Serum çinko, bakır ve magnezyum düzeyleri atomik absorpsiyon spektrofotometresi alev ünitesinde, serum selenyum seviyeleri ise aynı spektrofotometrenin grafit fırın ünitesinde ölçüldü. Bulgular:Çalışmamız sonucunda Helicobacter pylori pozitifliği saptanan çocuklarda kontrol grubuna göre serum çinko düzeylerini istatistiksel olarak anlamlı de-recede yüksek, Magnezyum düzeylerini ise düşük bulduk (p<0,05). Bakır düzeyleri kontrol grubunda daha yüksek olmasına rağmen istatistiksel olarak anlamlı değildi (p>0,05). Serum selenyum düzeyleri açısından her iki grup arasında istatistiksel anlamlı bir farklılık yoktu. Sonuç:Helicobacter pylori pozitif çocuklarda, birçok eser element ve mineral metabolizmasında değişiklikler olabileceğini söyleyebiliriz.

Peutz-Jeghers syndrome (PJS) is a rare disorder characterized by benign intestinal hamartomatous polyps and mucocutaneous pigmentation, and with an increased risk for intestinal and extra-intestinal neoplasms. Sertoli cell tumors in boys with PJS have been increasingly recognized as a cause of prepubertal gynecomastia. However, an association between nephrocalcinosis and PJS has not been reported before. We report on a 7.25-year-old boy with PJS, bilateral gynecomastia, Sertoli cell tumor and nephrocalcinosis, and present the outcome of 1-year treatment with the aromatase inhibitor testolactone. The patient presented with bilateral breast and testis enlargement, and mucocutaneous pigmentation. Testicular ultrasound revealed parenchymal multiple microcalcifications. Histopathological examination was consistent with Sertoli cell tumors. Nephrocalcinosis due to idiopathic renal hypercalciuria was also detected. The aromatase inhibitor testolactone was begun in an attempt to prevent acceleration in skeletal maturation. One-year treatment with testolactone reduced the breast base diameter from 7 to 3 cm, and bone age advanced 1.2 years during this period. Our case demonstrates that waiting for the effect of aromatase inhibitors on gynecomastia before making a decision for mastectomy may be a reasonable option. We also consider that the association between PJS and nephrocalcinosis may be a coincidence.

Girifl ve (7,8±2,6 vs. 11,3±0,9 g/dL, p<0,05

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