Serenay Çetinoğlu

Objective: Pediatric intestinal pseudo-obstruction (PIPO) is a rare, severe, and heterogeneous gastrointestinal motility disorder associated with intestinal failure, recurrent hospitalizations, and significant morbidity and mortality. This study aimed to evaluate the clinical features, management strategies, and long-term outcomes of children diagnosed with PIPO at a tertiary referral center. Methods: This retrospective single-center study included pediatric patients diagnosed with PIPO between 2011 and 2025. Diagnosis was established according to ESPGHAN consensus criteria. Demographic characteristics, clinical presentation, genetic findings, nutritional support, surgical interventions, intestinal transplantation, and long-term outcomes were retrospectively reviewed. Results: A total of 32 patients with PIPO were included, of whom 56.2% were female and 43.7% had early-onset disease. Genetic testing was performed in 22 of 32 patients; clinically significant variants were identified in 16 (50% of the total cohort), most commonly ACTG2 mutations. Prior abdominal surgery before referral was present in 84.3% of patients. During follow-up, 56% remained parenteral nutrition dependent, five patients underwent intestinal transplantation, and the overall mortality rate was 21.8%. Conclusions: PIPO is a highly heterogeneous disorder associated with substantial morbidity, prolonged nutritional support requirements, repeated surgical interventions, and significant mortality. Early diagnosis, genetic evaluation, multidisciplinary management, and timely referral to specialized intestinal failure and transplantation centres are likely to support more individualised management and may help prevent avoidable complications in affected children.

Introduction:: Ataxia-telangiectasia (AT) is an autosomal recessive neurodegenerative disease characterized by progressive cerebellar ataxia, oculocutaneous telangiectasia, humoral and cellular immunodeficiency, sensitivity to ionizing radiation, and a tendency to malignancy. The aim of this study was to evaluate the demographic characteristics, immunodeficiency status, laboratory findings, and prognosis of children with AT based on a single-center experience. Patients and Methods:: Nineteen pediatric patients diagnosed with AT between 2003 and 2024 were retrospectively analyzed at a single tertiary center. Results:: The study included 11 male and 8 female patients, with a mean follow-up duration of 72.6 ± 41.3 months. The mean ages at symptom onset and diagnosis were 30.47 ± 23.7 months and 82.32 ± 26.5 months, respectively. The most common presenting symptoms were gait instability, ocular telangiectasia, and recurrent respiratory tract infections. Immunological evaluation revealed IgA deficiency in 57.9% of the patients and IgG deficiency in 15.8%. A hyper-IgM AT phenotype was identified in two patients (10.5%). During follow-up, bronchiectasis and hepatosteatosis developed in 26.3% of the patients. One patient (5.2%) developed type 2 diabetes mellitus, and malignancy occurred in three patients (15.7%). Overall, 6 patients (31.5%) died during the follow-up period. Conclusion:: Ataxia-telangiectasia is a rare multisystem disorder associated with significant morbidity and mortality. Early diagnosis, comprehensive multidisciplinary follow-up, regular malignancy surveillance, and preventive strategies for recurrent sinopulmonary infections are essential for improving clinical outcomes and prognosis in affected patients.

Background/Aims: Endoscopic and histopathological evaluation are important in the diagnosis and follow-up of inflammatory bowel disease (IBD), but they are invasive methods. This study aimed to evaluate the use of ultrasonography (USG), a noninvasive examination, in diagnosing and monitoring children with IBD. Materials and Methods: The patients included IBD and non-IBD who underwent a prospective diagnostic colonoscopy. After colonoscopy, bowel wall thickness (BWT) of the patients was measured using USG. Ultrasonographic, endoscopic, histological, and laboratory findings were then compared. Results: Of the 62 patients who underwent colonoscopy, 25 (40.3%) were female. The mean age of the patients was 14.7 ± 3.5 years. Forty-three (69.4%) patients were diagnosed with ulcerative colitis, 12 (19.4%) with Crohn’s disease. Seven (11.3%) patients had normal colonoscopy findings. The BWT of the terminal ileum, left colon, and sigmoid colon were significantly higher in children with IBD. The BWT cut-off was detected as 2.55 mm in the terminal ileum, 3.35 mm in the right colon, 2.5 mm in the left colon and 2.25 mm in the sigmoid colon. When BWT in the terminal ileum and left colon increased, histopathological inflammation was significantly detected. A moderate positive correlation was observed between the C-reactive protein, erythrocyte sedimentation rate, and platelet values and the BWT values. Conclusion: Ultrasonography can be useful in the diagnosis of IBD patients. Specifically, BWT was found to be particularly sensitive and specific during the inflammatory period. Cite this article as: Kökbaş İ, Hasbay E, Aksoy B, et al. The role of intestinal ultrasonography in children with inflammatory bowel disease. Turk J Gastroenterol. Published online January 26, 2026. doi: 10.5152/tjg.2026.25401.

Background/Objectives: Early cow’s milk formula (CMF) exposure in the neonatal period has been proposed as a risk factor for cow’s milk protein allergy (CMPA), although evidence remains inconsistent. This study evaluated the association between CMF use within the first 72 h and later CMPA. Methods: This retrospective study included 106 CMPA infants and 106 controls. CMPA was diagnosed according to ESPGHAN 2024 guidelines using clinical assessment, a 2–4-week elimination diet, and a supervised oral food challenge. Demographic and feeding data were collected, and logistic regression identified independent predictors. Results: Early CMF exposure was more common in the CMPA group (76% vs. 59%; p = 0.006). Multivariate analysis confirmed early CMF exposure as an independent risk factor (aOR: 2.35; 95% CI: 1.18–4.68). A subgroup with CMF intake limited to the first 72 h followed by exclusive breastfeeding was markedly overrepresented among CMPA cases (47% vs. 12%; p < 0.001). Early CMF exposure did not significantly impact IgE versus non-IgE phenotype distribution. Family history of atopy also remained a strong predictor. Conclusions: Early CMF exposure during the first 72 h and family history of atopy were key risk factors for CMPA. Supporting breastfeeding initiation and avoiding unnecessary early CMF supplementation may help reduce CMPA incidence.

Background: Leucine rich α-2 glycoprotein (LRG) is a glycoprotein that is an acute-phase protein produced by neutrophils, macrophages, hepatocytes, and intestinal epithelial cells. This study aimed to determine the serum LRG (s-LRG) and urine LRG (u-LRG) expression levels in children with inflammatory bowel disease (IBD) and evaluated their correlation with clinical disease activity, other inflammatory markers, laboratory results, and endoscopic activity scoring. Methods: This prospective observational study was conducted at a tertiary centre and included children aged 2–18 years with IBD. Clinic activity scoring was used to assess clinical disease activity. Haemoglobin levels, platelet counts, albumin, C-reactive protein, and erythrocyte sedimentation rate were analysed in the blood sample. LRG levels were measured in both blood and urine samples. The endoscopic assessment was scored according to the simple endoscopic score and Mayo endoscopic score. Serum and urine LRG levels were measured using commercial enzyme-linked immunosorbent assay kits. Disease activation was defined based on clinical activity scoring, laboratory results, and endoscopic evaluation. The results were compared between the active IBD and remission groups. Results: Forty-two (50%) patients with active IBD and forty-two (50%) patients in remission were included in this study. The serum levels of LRG were elevated in the patients with active IBD compared with the levels in the patients with IBD in remission (p = 0.020). However, there was no difference in the u-LRG level between the two groups (p = 0.407). In patients with IBD, positive correlations were observed between s-LRG, platelet count, C-reactive protein (CRP), and the erythrocyte sedimentation rate. The serum LRG was negatively correlated with albumin and haemoglobin levels. Urine LRG was not correlated with s-LRG in any patients with IBD included or in patients with active IBD. The cutoff value for s- LRG (77.03 μg/mL) had a sensitivity and specificity of 40.4% (95% CI 25.6–56.7%) and 88.1% (95% CI 74.3–96.0%), respectively. It was found that s-LRG was a more significant parameter than CRP in predicting disease activation. Conclusions: This prospective study demonstrated that the s-LRG level is a useful biomarker for predicting disease activation in children with IBD and appears to be a more significant parameter than the CRP level. However, the u-LRG level is not effective in predicting disease activation in children with IBD.

Background: Leucine rich α-2 glycoprotein (LRG) is a 50 kDa glycoprotein that is an acute-phase protein produced by neutrophils, macrophages, hepatocytes, and intestinal epithelial cells. This study aimed to determine the serum LRG (s-LRG) and urine LRG (u-LRG) expression levels in children with inflammatory bowel disease (IBD) and evaluated their correlation with clinical disease activity, other inflammatory markers, laboratory results, and endoscopic activity scoring. Methods: This prospective observational study was conducted at a tertier centre and included children with IBD . Disease activation was defined based on clinical activity scoring, laboratory results, and endoscopic evaluation. Serum and urine LRG levels were measured via commercial enzyme-linked immunosorbent assay kits. The results were compared between the active IBD and remission groups. Results: Forty-two (50%) patients with active IBD and 42 (50%) patients in remission, were included in this study. Serum LRG concentrations were elevated in the active IBD patients compared with those in IBD patients in remission (p = 0.020). However, there was no difference in the u-LRG level between the two groups (p = 0.407). In patients with IBD, positive correlations were observed between s-LRG, platelet count, C-reactive protein (CRP), and the erythrocyte sedimentation rate . The serum LRG was negative correlated with albumin and hemoglobin levels. Urine LRG was not correlated with s-LRG in any IBD patients included or in IBD patients with active IBD. The cutoff value for s- LRG (77.03 μg/mL) had sensitivity and specificity of 40.4% (95% CI 25.6–56.7%) and 88.1% (95% CI 74.3–96.0%), respectively. It was found that s-LRG was a more significant parameter than CRP in predicting disease activation. Conclusion: This prospective study demonstrated that the s-LRG level is a useful biomarker for predicting disease activation in children with IBD and appears to be a more significant parameter than the CRP level. However, the u-LRG level is not effective in predicting disease activation in children with IBD.