Bullous pemphigoid is a rare autoimmune disease. The estimated incidence among children is approximately 0.2-0.5 cases per million per year. The disease is characterized by the formation of tense blisters filled with serous fluid, often accompanied by intense pruritus. The clinical course and localization of eruptions in infants and older children differ; however, a common feature is the involvement of the palms and soles in both age groups. The etiology remains unclear to date, but data suggest that such an atypical immune response may be triggered by non-specific maternal antibodies or foreign antigens. The cornerstone of treatment is the use of systemic corticosteroids with a gradual dose reduction. Aim - to describe a clinical case of bullous pemphigoid with an emphasis on the diagnostic algorithm and treatment strategy. Clinical case. A four-month-old patient was hospitalized with a rash characterized by multiple bullae on the palms, soles, and fingers, along with numerous papular elements on the trunk. Against the background of systemic corticosteroid therapy, a temporary improvement was observed during the first three days; however, new elements of the rash appeared a few days later. Following a diagnostic biopsy and direct immunofluorescence (DIF), the diagnosis of bullous pemphigoid was confirmed. Conclusions. Bullous pemphigoid is a rare disease in the pediatric population. Nevertheless, delayed diagnosis and improper treatment strategies can lead to serious consequences. This case underscores the necessity of immunomorphological studies for definitive diagnosis. The study was performed in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from the child’s parents for the study and publication of the data. The authors declare no conflict of interest.
Aim - to investigate the relationships between indicators of stress-regulating systems depending on the mental state of children and adolescents with type 1 diabetes mellitus (T1DM) during the period of military actions in Ukraine. Materials and methods. A total of 93 patients with T1DM (44 boys, 49 girls) aged 9-18 years were examined. Patients were stratified into three groups: 1 - normal mental health, 2 - non-pathological stress reactions, and 3 - mental disorders. Serum levels of cortisol (C), malondialdehyde (MDA), carbonylated proteins (CP), and superoxide dismutase activity (SODs) were measured. In whole blood, serotonin (S), glutathione peroxidase activity (GPx), and cellular superoxide dismutase activity (SODc) were assessed. Results. Mental health status in adolescents with T1DM was associated with changes in stress-regulating systems, with sex-specific features. In patients with normal mental health, increased levels of C, S, MDA, SODs, and SODc were observed. Non-pathological stress reactions were characterized by elevated CP and reduced SODc and GPx activity. In adolescents with mental disorders, increased CP, decreased S, and reduced SODs and SODc activity were found. In girls, correlations in the first two groups reflected compensatory-adaptive mechanisms, whereas in those with mental disorders an imbalance between stress-regulating indicators was evident. In boys, even with normal mental health, findings suggested tension within the stress-limiting systems, progressing to exhaustion in groups with impaired mental state, alongside the accumulation of stress-realizing markers. Conclusions. Stress-regulating systems are closely associated with mental health status in children and adolescents with T1DM during wartime. The imbalance between stress-limiting and stress-realizing systems is most pronounced in those with mental disorders, particularly in boys. The study was conducted in accordance with the Declaration of Helsinki and approved by the local ethics committee. Informed consent was obtained. No conflict of interest was declared by the authors.
Foodborne diseases remain a significant global public health concern, contributing substantially to morbidity and mortality, particularly among young children, older adults, and immunocompromised individuals. Their pathogenesis involves both infectious injury and toxin-mediated intestinal and systemic effects. In addition to rehydration and etiotropic therapy, enterosorption represents a pathogenetically justified approach aimed at intraluminal detoxification through binding and elimination of pathogens, toxins, and metabolic byproducts from the gastrointestinal tract. Aim - to analyze current scientific evidence on the efficacy, safety, and mechanisms of action of enterosorbents in food-related diseases and to determine the most suitable therapeutic option. Modern enterosorbents are characterized by a large active surface area, high sorption capacity, and broad adsorption spectrum. Preparations based on highly dispersed silicon dioxide have attracted particular attention due to their pronounced protein-binding properties, ability to adsorb microbial cells and toxins, and potential antimicrobial and antidiarrheal effects. Clinical studies suggest that their inclusion in комплексive therapy of acute intestinal infections and functional gastrointestinal disorders, including pediatric practice, may contribute to faster symptom resolution and reduction of intoxication severity. An important advantage of silicon dioxide–based enterosorbents is their favorable safety profile, as they are minimally absorbed from the gastrointestinal tract and are excreted unchanged. Further research is warranted to clarify clinical indications, optimize dosing regimens, and evaluate long-term therapeutic outcomes in different patient populations. The authors have no conflicts of interest to declare.
Aim - is to investigate bowel emptying disorders in children with acquired pathology of the anal canal and rectum, taking into account proctogenic pain, and to substantiate approaches to their comprehensive diagnosis and treatment. Material and methods. The study included 286 sick children who had bowel emptying disorders against the background of acquired pathology of the anorectal region, which was established during the examination: proctitis in 51 (17.83%), hemorrhoids in 125 (43.71%), anal fissure in 67 (23.43%) and cryptitis in 43 (15.03%). There were 141 boys (49.30%), girls 145 (50.70%). Results. The studies have established clear age-related characteristics of the incidence with a peak in the group of 4-9 years (28.67%). It was established that bowel emptying disorders in children are manifested by the formation of pathological stereotypes of defecation, in particular, defecation in a diaper (17.48%), feces smearing (15.38%) and defecation in uncomfortable conditions (13.64%), which indicates a significant influence of proctogenic pain. It is proven that proctogenic pain is the leading clinical syndrome and is observed in 85.32% of patients, with intense pain during defecation prevailing (44.75%), and unbearable pain for anal fissure (18.88%) and hidden pain (21.69%). It was found that children develop a negative attitude towards the examination: pronounced negativity towards the examination was noted in 27.27% of cases, towards discussion of constipation - in 20.27%, and smearing - in 13.64%, while adequate perception of the situation is observed only in 17.83% of patients. Conclusions. Violations of bowel emptying are accompanied by the formation of pathological behavioral stereotypes: emptying into a diaper (17.48%), smearing (15.38%) and defecation in uncomfortable conditions (13.64%). Proctogenic pain is the leading syndrome (85.32%), with a predominance of intense pain (44.75%) and unbearable pain with anal fissure (18.88%), and together with a negative attitude to the examination (27.27%) and discussion of problems (20.27%) forms a vicious circle of “pain - fear - avoidance of defecation - progression of pathology”, which determines the need for a comprehensive approach to treatment. Conservative treatment methods had good results in 98.95%, and surgical treatment was performed in 1.05% patients with hemorrhoids. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patients was obtained for conducting the studies. No conflict of interests was declared by the authors.
Neurogenic bowel dysfunction (NBD) in children with spinal cord lesions, particularly in those with spina bifida, represents a significant clinical problem that markedly affects quality of life, social integration, and long-term outcomes, requiring a multidisciplinary management approach. Aim - to analyze and summarize current evidence on the pathophysiology, clinical manifestations, and management strategies of NBD in children. This review summarizes current concepts of NBD pathophysiology, including impaired colonic innervation, altered motility, and sensory dysfunction leading to chronic constipation and fecal incontinence. The clinical presentation is described in relation to the level of neurological impairment. A stepwise management approach is presented, including dietary modifications and behavioral interventions, pharmacological treatment (osmotic and stimulant laxatives), rectal interventions (suppositories, microenemas, transanal irrigation), and surgical options in refractory cases. Particular attention is paid to the safety and long-term use of laxatives in pediatric patients. Current clinical guidelines for the management of children with NBD are reviewed, including recommendations from the Spina Bifida Association and other international bodies. Conclusions. Neurogenic bowel dysfunction in children requires an individualized, stepwise approach based on age, level of neurological impairment, and clinical severity. Early implementation of comprehensive management strategies, including behavioral, pharmacological, and when necessary invasive interventions, improves symptom control and quality of life. Multidisciplinary care and adherence to current clinical guidelines are essential for optimal patient outcomes. The authors declare no conflict of interest.
