Journal of Pediatric Perspectives

Case Report: Werner Syndrome with Non-Alcoholic Fatty Liver Disease and Elevated Liver Function Tests in a 17-Year-Old Male

Mohammad Ali Kiani; Hamidreza Kianifar; Sayyad Ali Jafari; Maryam khalesi; Niloofar Rahimpour; Sayyed Amir Hossein Ghazizadeh Hashemi; Arefeh Abavisani

Volume 13, Issue 2 , February 2025, , Pages 19331-19336

https://doi.org/10.22038/jpp.2025.86623.5530

Abstract

Background: Werner syndrome (WS) is a rare autosomal recessive disorder characterized by premature aging and various metabolic complications. Non-Alcoholic Fatty Liver Disease (NAFLD) ... Read More

Evaluation of the Effect of Rosuvastatin on Portal Hypertension and Variceal Bleeding in Children with Compensated Cirrhosis

Maryam Marefat; Mohammad Ali Kiani; Masoud Mahdavirashed; Monavar Afzalagaie; Saeed Mohammadi; Hamidreza Kianifar; Seyyed Ali Jafari; Maryam Khalesi

Volume 13, Issue 1 , January 2025, , Pages 19254-19264

https://doi.org/10.22038/jpp.2025.85036.5516

Abstract

Background: Portal hypertension, a complication of chronic liver disease in children, can lead to severe gastrointestinal bleeding and an increased need for hospitalization and endoscopic ... Read More Background: Portal hypertension, a complication of chronic liver disease in children, can lead to severe gastrointestinal bleeding and an increased need for hospitalization and endoscopic treatment, potentially resulting in death. Statins, known for their anti-inflammatory, antioxidant, and anti-fibrotic effects, are used in the treatment of many chronic diseases. This study aimed to investigate the effects of rosuvastatin on improving portal pressure and esophageal varices while reducing bleeding associated with these conditions in children with cirrhosis.Methods: This randomized clinical trial was conducted in children with compensated liver cirrhosis at Akbar Children's Hospital in Mashhad, Iran, between March 2023 and November 2024. Initially, endoscopy and Doppler ultrasound were performed on 32 patients aged 7–17 years. The control group received standard treatments for portal hypertension, while the intervention group received rosuvastatin tablets in addition to standard treatments. After a 6-month period, Doppler ultrasound and control endoscopy were repeated. All clinical, laboratory, sonographic, and endoscopic data were analyzed by a statistician, and the results were reported.Results: The study included 32 children with cirrhosis (16 in the control group and 16 in the intervention group). The number of cases showing a decrease in ultrasonographic parameters of portal hypertension (SA-RI and RRA-RI) was higher in the rosuvastatin group (p=0.14 and 0.37). The grades of esophageal varices decreased by 26.7% and 20% in the control and rosuvastatin groups, respectively (p=0.66). Esophageal variceal bleeding occurred in 13.3% of cases in the control group and in 25% of cases in the rosuvastatin group,with no statistically significant difference between the two groups (p=0.41).Conclusion: Over the 6-month follow-up period, rosuvastatin did not demonstrate a beneficial effect in reducing portal hypertension and variceal bleeding in children with compensated liver cirrhosis.

A Case Report of Moyamoya Syndrome and Achalasia in an 11-Year-Old Boy with a Family History

Mohammad Ali Kiani; Arefeh Abavisani; Hamid Reza Kianifar; Ali Jafari; Maryam Khaleesi; Sayyed Amir Hossein Ghazizadeh Hashemi; Zahra Sabbagh

Volume 12, Issue 12 , December 2024, , Pages 19211-19218

https://doi.org/10.22038/jpp.2025.84594.5512

Abstract

Background and Objective: Moyamoya disease is a condition caused by the obstruction of intracranial vessels, which can lead to ischemic or hemorrhagic vascular events. Most patients ... Read More

Investigating the Diagnostic Value of Interleukin 33 Biomarker in the Diagnosis of Biliary Atresia in Infants with Cholestasis Admitted to Akbar Hospital in Mashhad

Forogh Ali Akbarniya Omran; Mohammadali Kiani; Hamid Ahanchian; Seyed Ali Jafari; Maryam Khalesi; hamidreza kianifar; Sayyed Amir Hossein Ghazizadeh Hashemi

Volume 12, Issue 9 , September 2024, , Pages 19008-19021

https://doi.org/10.22038/jpp.2024.84856.5514

Abstract

Background: Neonatal cholestasis is one of the important liver diseases in children; and infants are more prone to it due to the immaturity of the liver. It appears due to several reasons ... Read More Background: Neonatal cholestasis is one of the important liver diseases in children; and infants are more prone to it due to the immaturity of the liver. It appears due to several reasons and its treatment is determined based on its cause. If the cause is not diagnosed in time and rapid treatment is not adopted, it will result in irreparable complications. Biliary atresia is the main cause of this disease and the most common symptom of the need for liver transplantation in children, which requires early diagnosis as a prognostic factor of the disease and its immediate differentiation from other causes of cholestasis. Considering the use of new diagnostic biomarkers, the present study was conducted with the aim of investigating the diagnostic value of serum interleukin 33 (IL-33) in infants with cholestasis and its relationship with clinical and laboratory data.Methods: This research is a cross-sectional study, conducted on infants referred to the gastroenterology clinic of Akbar Hospital in Mashhad during the years 2021 and 2022. According to the entry and exit criteria, cholestatic infants were included in the study in two groups with and without biliary atresia along with the control group (healthy infants). The basic information, clinical manifestations, and laboratory findings of infants were collected through a researcher-made checklist; and recorded in SPSS software version 24. Data description and analyses were done using descriptive indices, statistical tests, regression methods, and rock curve at a significance level of less than 0.05.Results: The participants included 78 infants with an average age of 2.80 ± 1.42 months, enrolled in three groups (26 cases each). The intervention groups consisted of patients with cholestasis with and without biliary atresia; and there was one group of healthy infants as the control group. The serum level of IL-33 biomarker was significantly higher in patients with biliary atresia than in patients without atresia (p=0.014); and in both groups, it was higher than that in the control group (p=0.001). The serum level of IL-33 had a significant positive correlation with laboratory indicators of AST, ALT and GGT (p<0.05). Interleukin-33 serum level at the cut-off point of 275 pg/ml can diagnose biliary atresia with a sensitivity of 84.6 and a specificity of 92.3%, so that the probability of biliary atresia in infants with IL-33 ≥ 275 is reported to be twice as often higher than that in infants with A serum levels lower than this value (p=0.011).Conclusion: The serum level of interleukin 33 was significantly higher in patients with biliary atresia than in patients without atresia as well as in healthy infants; and at the determined cut-off point, it had a favorable diagnostic value for identifying infants with biliary atresia.

The Impact of Silymarin on the Symptom Severity in Pediatric Patients with Inflammatory Bowel Disease: A Randomized Clinical Trial

Hamidreza Kianifar; Seyed Ali Jafari; Maryam Khalesi; Mohammadali Kiani; Tahereh Sadeghi; Mahmoud Reza Jaafari; Fatemeh Amani

Volume 11, Issue 10 , October 2023, , Pages 18274-18286

https://doi.org/10.22038/ijp.2023.75325.5373

Abstract

Background: Inflammatory Bowel Disease (IBD) is a multifactorial disease, posing significant challenges to public health. The aim of this study is to determine the effect of silymarin ... Read More

Gastric Inflammatory Myofibroblastic Tumor as a Cause of Gastric Outlet Obstruction in Children

Seyed Ali Jafari; Mahdi Rouhbakhsh; Hamidreza Kianifar; Mohammadali Kiani; Maryam Khalesi; Nadia Danaei; Fatemeh Basirinezhad

Volume 11, Issue 2 , February 2023, , Pages 17443-17447

https://doi.org/10.22038/ijp.2023.68757.5126

Abstract

Gastric inflammatory myofibroblastic tumor (IMT) is a rare tumor that is almost seen in children with a wide range of clinical features. However, radiologic imaging and gastro endoscopy ... Read More

Clinical and Laboratory Findings in Patients with Wilson’s disease Referred to Pediatric Gastroenterology Clinic in 2018-2019

Seyed Ali Jafari; Nasrin Mahdizade; Hamid Reza Kianifar; Mohammadali Kiani; Maryam Khalesi; Zahra Abbasi Shaye; Forough Rakhshanizadeh

Volume 11, Issue 1 , January 2023, , Pages 17266-17278

https://doi.org/10.22038/ijp.2022.69052.5113

Abstract

Background: Early diagnosis and treatment of Wilson's disease in childhood can reduce long-term and life-threatening complications in these patients. Considering the lack of a database ... Read More Background: Early diagnosis and treatment of Wilson's disease in childhood can reduce long-term and life-threatening complications in these patients. Considering the lack of a database of Wilson's patients in Iranian patients, the present study was carried out with the primary objective of determining clinical and laboratory presentations in children with Wilson's disease referred to Akbar Hospital in Mashhad.Methods: This cross-sectional descriptive study was conducted on children under 18 years of age with Wilson's disease who had presented to Akbar Children's Hospital in Mashhad during 2018-2019. The acquired information included demographic information, primary clinical symptoms (hepatic, cerebral, and psychological symptoms), and laboratory findings, including liver laboratory profile (AST, ALT, and ALP tests), coagulation tests, albumin, total serum protein, and direct and indirect bilirubin, and Wilson's diagnostic tests.Results: In total, 25 patients with an average age of 15.88±4.54 years were included in this study. Hepatosplenomegaly, Kayser–Fleischer ring, and jaundice were observed in 72%, 68%, and 48% of patients, respectively. Gender of patients was not significantly correlated with the clinical and laboratory findings of Wilson’s disease (P<0.05). 24-hour urine copper level was higher than 100 micrograms in 82.6% of patients. Serum ceruloplasmin level was lower than 200 mg/liter in 90% of patients. Serum ceruloplasmin levels in patients with ascites (P=0.04) and patients with lower limb edema (P=0.02) were higher than those in patients without these findings. Moreover, a lower 24-hour urinary copper level was detected in patients with seizures (P=0.03), and patients with depression (P=0.005) compared to patients without these conditions. The 24-hour urine copper levels were higher in patients with jaundice than in those without jaundice (P=0.01).Conclusion: Hepatosplenomegaly, Kayser–Fleischer ring, and jaundice are common symptoms in under 18-year-old patients with Wilson's disease. Considering the findings regarding the high levels of serum ceruloplasmin and copper in 24-hour urine in a significant

Assessment of the Initial Clinical Presentations of Patients with Celiac Disease

Seyed Ali Jafari; Atefeh Aatarian; Hamidreza Kianifar; Mohammadali Kiani; Maryam Khalesi; Forough Rakhshanizadeh

Volume 10, Issue 12 , December 2022, , Pages 17127-17134

https://doi.org/10.22038/ijp.2022.69054.5114

Abstract

Background: The prevalence of celiac disease, which is gastrointestinal enteropathy, is increasing. This study aimed to assess the clinical presentations of celiac disease in children. Methods: ... Read More

Differentiation of Biliary Atresia from the Intrahepatic Etiology of Infantile Cholestasis with Alagille Criteria

Maryam Khalesi; Moammad Ali Kiani; Seyed Ali Jafari; Monireh Yaghoubi; Seyed Hosein Ghavami Shahri; Ali Reza Attaei Nakhaie; Nafiseh pourbadakhshan

Volume 10, Issue 9 , September 2022, , Pages 16699-16704

https://doi.org/10.22038/ijp.2022.65670.4948

Abstract

Background: Biliary atresia (BA) is an important etiology of liver disease in pediatric patients which manifests as extrahepatic cholestasis. Alagille criterion is a combination of ... Read More

The Diagnostic Value of Different Sonography Findings and Color Doppler Sonography in Detecting Biliary Atresia in Infants and Neonates

Mohammad Ali Kiani; Seyed Ali Jafari; Homa Jajarmi Khayyat; Seyed Ali Alamdaran; Masood Mahdavi Rashed; Maryam Khalesi; Elham Bakhtiari

Volume 10, Issue 7 , July 2022, , Pages 16281-16290

https://doi.org/10.22038/ijp.2022.59436.4635

Abstract

Background: Biliary atresia (BA) is one of the most common etiologies of cholestasis in infants and toddlers. The most important factor in case of patients’ prognosis is its early ... Read More

Gastrointestinal symptoms of patients with autism spectrum disorder

Seyed Ali Jafari; Niloufar Sedghi; Maryam Khalesi; Hamidreza Kianifar; Mohammad Ali Kiani; Zahra Chaichi; Alireza Sargazi; Raheleh Derafshi

Volume 10, Issue 4 , April 2022, , Pages 15730-15736

https://doi.org/10.22038/ijp.2022.61877.4749

Abstract

Background: Concern about possible GI dysfunction in ASD is intensified by high rates of feeding concerns and consequent medical sequelae in ASD. Etiological factors contributing to ... Read More

Sodium and Calcium Levels as a Predictor for Hepatic Encephalopathy in Pediatric Patients with Chronic Liver Disease

Maryam Khalesi; HamidReza Kianifar; Davoud Entezari; Zahra Chaichi

Volume 10, Issue 3 , March 2022, , Pages 15594-15600

https://doi.org/10.22038/ijp.2022.61811.4744

Abstract

Background: Chronic liver disease (CLD) in children is a growing health problem with significant morbidity and mortality. There is a specific susceptibility to electrolyte imbalance ... Read More

Serum Anti TTG Level as a Predictor for Severity of Iintestinal Damage in Children with Celiac Disease

Seyed Ali Jafari; Maryam Khalesi; Hamidreza Kianifar; Hoda Shojaie; Mohammad Ali Kiani

Volume 9, Issue 12 , December 2021, , Pages 15076-15082

https://doi.org/10.22038/ijp.2021.59273.4619

Abstract

Background: This study aimed at evaluating how the patient’s clinical manifestations and his/her anti TTG level are correlated with the intensity of histological damage based ... Read More

The Relation between Karyotype Findings and Gonadotropin Levels in Pediatric Turner’s syndrome Patients

Fatemeh Zarei; Moein Mobini; reza Jafarzadeh Esfehani; Maryam Khalesi; Rahim Vakili

Volume 9, Issue 2 , February 2021, , Pages 13005-13011

https://doi.org/10.22038/ijp.2020.54327.4296

Abstract

Background Abnormal pubertal development and fertility are among the frequent complications in Turner’s syndrome. Although elevated level of gonadotropins in Turner’s syndrome ... Read More

Probiotics for the Treatment of Asthma: A Systematic Review and Meta-Analysis of Randomized Trials

Hamid Ahanchian; Fatemeh Khorasani; Mohammad Ali Kiani; Maryam Khalesi; Elham Ansari; Seyed Ali Jafari; Hamidreza Kianifar

Volume 8, Issue 5 , May 2020, , Pages 11271-11285

https://doi.org/10.22038/ijp.2019.36715.3195

Abstract

Background: Asthma is a growing problem worldwide and the limitations of the current therapy for allergic asthma highlight the need for novel therapeutics. We conducted a systematic ... Read More

Volume 13 (2025)

Volume 12 (2024)

Volume 11 (2023)

Volume 10 (2022)

Volume 9 (2021)

Volume 8 (2020)

Volume 7 (2019)

Volume 6 (2018)

Volume 5 (2017)

Volume 4 (2016)

Volume 3 (2015)

Volume 2 (2014)

Volume 1 (2013)

Author = Maryam Khalesi

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