Case Report: Hypereosinophilia (HE) is eosinophil count >500/μL. The association of HE with acute lymphoblastic leukemia (ALL) is extremely rare, with an incidence of less than 1%. HE may precede the common symptoms and signs of ALL by several months or weeks. In some cases, the symptoms may be due to eosinophilic organ or system infiltration, and these findings may be different from the classical ALL symptoms, thus delaying the diagnosis. Here, we report a male patient who presented with HE and was diagnosed as PreB-ALL.A 9-year-old boy patient was admitted to Inonu University Turgut Özal Medical Center with complaints of testicular pain and swelling. The patient's hemogram showed HE, but there was no leukocytosis or cytopenia.. No atypical cell was observed in peripheral smear. On scrotal ultrasonography (USG), the left epididymal head had a mildly heterogeneous appearance and the patient was treated for epididymitis with suspicion of epididymitis. Approximately one week later, the patient presented with fever . The patient's peripheral smear showed 36% blasts, 38% eosinophils, 2% monocytes, 6% lymphocytes, 10% segments and 8% bands. Bone marrow aspiration was performed for the diagnosis of acute leukemia and PreB-ALL was diagnosed. Control testicular USG was evaluated as testicular involvement of leukemia. During follow-up, the patient had nausea, vomiting, dizziness, decreased visual field, nuchal rigidity, and outward gaze limitation. Magnetic resonance (MR) venography revealed thrombosis in the inferior sagittal sinus and anticoagulant therapy was initiated. The patient with central nervous system symptoms was considered to have leukemic involvement and his treatment was adjusted.ALL is a condition that can cause HE. The prognosis is poor in ALL patients presenting with HE. HE may occur before the classical ALL symptoms therefore the diagnosis of ALL should also be considered in patients presenting with HE.

Introduction:In this study, we prospectively investigated changes in serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and full white blood cell (WBC) counts during the diagnosis and treatment of paediatric patients with appendicitis. We also investigated the effects of the COVID-19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients.Materials and Methods:A non-perforated appendicitis group (n = 110), a perforated appendicitis group (n = 35) and an appendicitis + COVID-19 group (n = 8) were formed. Blood samples were taken upon admission and every day until the three studied parameters returned to normal values. To investigate the effects of the COVID-19 pandemic on paediatric appendicitis patients, the perforated appendicitis rates and the times from the onset of the first symptoms to the operation before and during the pandemic were compared.Results:WBC, IL-6, and hsCRP dropped below the upper limits on the second postoperative day in the non-perforated appendicitis group, four to six days postoperatively in the perforated appendicitis group, and three to six days postoperatively in the appendicitis + COVID-19 group. These parameters were not within normal range in patients who developed complications during follow-up. The time from the onset of abdominal pain to the surgery was significantly longer during than before the pandemic in both the non-perforated appendicitis group and the perforated appendicitis group.Conclusions:Our results show that WBC, IL-6, and hsCRP are useful laboratory parameters that can complete clinical examinations in the diagnosis of appendicitis in paediatric patients and the identification of complications that may develop postoperatively.

Aim: Gaucher disease is a rare lysosomal storage disease. Enzyme replacement therapy has proven to be very effective in reversing the risk of hepato-splenomegaly, cytopenia, osteopenia and reducing the risk of avasculer osteo necrosis, especially in children and young adults. The aim of this study is to draw attention to this rare disease and increase awareness. Material and Methods: All medical records of 8 patients diagnosed with Gaucher disease between 2008 and 2020 in our clinic were reviewed. Result: Five of the cases were female (62.5%), average age at diagnosis; was 7.9 years. When complaints at the time of admission are examined, we found that, 3 patients admitted with swelling in the abdomen, one admitted with abdominal pain, and 4 patients had been referred to our center due to organomegaly detected during the examination. In physical examination 8 patient had splenomegaly. The mean level of glucocerebrosidase enzyme of the patients was found to be 0.61mmol/l/h (normal range of glucocerebrosidase >3.2mmol/l/h). Considering the genetic analysis of the patients, 5 patients had homozygous and 3 patients had heterozygous mutations. One patient with portal hypertension who did not respond to enzyme replacement therapy at the time of admission underwent liver transplant. Conclusion: Early diagnosis and treatment are important to live with in mind that this disease, which is rare in societies where consanguineous marriage is common and can result in serious morbidity and early death, can be seen more frequently.