Background: Diabetes mellitus type 1 (T1DM) is one of the childhood diseases with growing prevalence. Various accompanying autoimmune diseases were seen with type 1 diabetes. The most common autoimmune diseases with T1DM are autoimmune thyroiditis and celiac disease. In some reports, autoimmune hepatitis has been reported in association with DM-1. Objectives: The aim of this study was to evaluate autoimmune hepatitis autoantibodies in children with T1DM. Materials and methods: In this crosssectional study, 202 children with T1DM were evaluated (47.5% were males and 52.5% were girls). Liver enzymes, autoimmune hepatitis related autoantibodies such as anti-nuclear antibodies (ANA), anti-smooth muscle (ASMA) and anti liver and kidney microsomal antibodies (LKM-1) were measured. Liver ultrasound was done for participants and biopsy of liver was taken for children with increased echogenicity of the liver, hepatomegaly or elevated liver enzymes. Results analyzed by statistical software spss-16, Descriptive statistics and chi-square test, paired T-TEST. Level of less than 5% was considered statistically significant. Results: In 6 patients ANA and in 4 patients (2%) ASMA was positive,1 patient was ASMA positive but ANA negative. None of the patients were Anti LKM-1 positive. 3 patients had positive ANA and ASMA, and increased liver echogenicity on ultrasound simultaneously. Histological evaluation was showed that 2 patients had findings in favor of autoimmune hepatitis. Conclusion: Auto antibodies were positive in 10 cases. ANA was positive in 6 (2.97%) of all cases. ASMA was positive in 4 (1.98%) cases. Increased echogenicity was found in 3 cases. Histological evaluation showed 2 patients had biopsy confirmed autoimmune hepatitis. AIH-2 was not seen among our cases.

Antecedentes: La diabetes mellitus tipo 1 (DM1) es una de las enfermedades infantiles con mayor prevalencia. Se observaron varias enfermedades autoinmunes acompañantes con diabetes tipo 1. Las enfermedades autoinmunes más comunes con DM1 son la tiroiditis autoinmune y la enfermedad celíaca. En algunos reportes, se ha encontrado hepatitis autoinmune en asociación con DM-1. Objetivos: El objetivo de este estudio fue evaluar los autoanticuerpos de hepatitis autoinmunes en niños con DM1. Materiales y métodos: En este estudio transversal, se evaluaron 202 niños con DM1 (47,5% eran hombres y 52,5% eran niñas). Se midieron las enzimas hepáticas, los autoanticuerpos autoinmunes relacionados con la hepatitis, como los anticuerpos antinucleares (ANA), el músculo liso (ASMA) y los anticuerpos microsomales hepáticos y renales (LKM-1). Se realizó una ecografía hepática para los participantes y se tomó una biopsia del hígado para niños con mayor ecogenicidad del hígado, hepatomegalia o enzimas hepáticas elevadas. Los resultados fueron analizados por el software estadístico spss-16 usando estadística descriptiva y prueba de chi-cuadrado, T-TEST pareado. Se consideró estadísticamente significativo un nivel menor del 5%. Resultados: En 6 pacientes con ANA y en 4 pacientes (2%) ASMA fue positiva, 1 paciente fue ASMA positiva pero ANA negativa. Ninguno de los pacientes fue anti LKM-1 positivo. 3 pacientes tuvieron ANA y ASMA positivas, y aumentaron la ecogenicidad hepática en la ecografía simultáneamente. La evaluación histológica mostró que 2 pacientes tenían hallazgos a favor de la hepatitis autoinmune. Conclusión: Los autoanticuerpos fueron positivos en 10 casos. ANA fue positivo en 6 (2,97%) de todos los casos. La ASMA fue positiva en 4 (1,98%) casos. Se encontró mayor ecogenicidad en 3 casos. La evaluación histológica mostró que 2 pacientes tenían biopsia confirmada de hepatitis autoinmune. AIH-2 no fue visto entre nuestros casos.

Background: Esophageal stricture is one of the most important complication of the caustic ingestion. Objective: The aim of this study was to evaluate complications of balloon dilatation among children with esophageal stenosis. Material and methods: In this retrospective study 82 children were included. Children who underwent balloon dilatation for esophageal stenosis were included in our study. Duration of study was 14 year starting from 2001. Mean age of the cases was 3.95±0.4 year (Min: 15 days, Max: 14 year). Chart review and telephone calling were the methods of data collection. Data was analyzed using SPSS. Results: In this study, 47% of the patients were male and 53% of the cases were female. Caustic ingestion (33.7%) was the most common etiology for the esophageal stricture. Vomiting (87.8%) was the most common presenting symptom. Among our cases, 76.8% had no compliant after esophageal dilatation. Chest pain was the most common compliant after esophageal dilatation. Response rate was similar among boys and girls. Toddler age had the best treatment response after esophageal dilatation. Conclusion: Among our cases, 76.8% had no post procedural compliant after esophageal dilatation. Esophageal perforation was seen in 4.9% of the cases. Chest pain was the most common post dilatation complication.

Antecedentes: La estenosis esofágica es una de las más importantes complicaciones de la ingesta de caústicos. Objetivo: El objetivo del estudio fue evaluar las complicaciones de la dilatación endoscópica con balón en niños con estenosis esofágica. Material y métodos: En este estudio retrospectivo se incluyeron 82 niños. Se incluyeron todos los niños que se sometieron a una dilatación endoscópica con balón por estenosis esofágica. La duración del estudio fue 14 años iniciando en el año 2001. La edad media de los pacientes fue 3,95 +/- 0,4 años (Min. 15 días, Máx. 14 años). La recolección de datos se realizó revisando las historias clínicas y con llamadas telefónicas. Los datos se analizaron con el Sistema SPSS. Resultados: En este estudio, 47% de los casos fueron varones y 53% fueron mujeres. La ingesta de caústicos fue la causa más frecuente de estenosis esofágica (33,7%). El síntoma más común fueron los vómitos (87,8%). Entre nuestros casos, 76,8% no presentaron molestias luego de la dilatación esofágica. El dolor torácico fue la molestia más común luego de la dilatación esofágica. La tasa de respuesta al tratamiento fue similar entre hombres y mujeres. Los niños pequeños tuvieron la mejor respuesta al tratamiento luego de la dilatación esofágica. Conclusiones: Entre nuestros casos, 76,8% no presentaron molestias luego de la dilatación esofágica. La perforación esofágica se presentó en 4,9% de los casos. El dolor torácico fue la complicación más común posterior a la dilatación.

Introduction: The aim of this study was to evaluate complications after percutaneous endoscopic gastrostomy among children who underwent percutaneous endoscopic gastrostomy in Nemazee hospital. Materials and methods: All children who underwent percutaneous endoscopic gastrostomy were included in the current study. Place of the study was department of pediatric gastroenterology of Nemazee children hospital of Shiraz university of medical sciences. Duration of the study was 5 year starting from 2008. All drugs such as aspirin, NSAIDS, and heparin were discontinued 1-7 days before procedures. All patients were kept NPO 6-8 hours before procedure according to the age. Single dose antibiotic was prescribed for all cases before procedure. During procedure, all patients were sedated using propofol and or midazolam. Some patients required intubation. Results: Of 39 cases who underwent PEG, 4 (10.2%) patients showed complication. The most common indication for PEG insertion were neurologic problem (84.6%) and metabolic disease (10.2%). Of our patients, 84.6% of the cases had the weight below third percentile. Conclusion: The most common indication for percutaneous endoscopic gastrostomy was cerebral palsy. The complication rate in our study was 10.2%. Celulitis was the most common complication

Introducción: El objetivo de este estudio fue evaluar las complicaciones luego de una gastrostomía endoscópica percutánea (PEG) en niños realizada en el hospital Nemazee. Material y métodos: Se incluyeron al estudio todos los niños que se realizaron PEG en el hospital. El lugar del estudio fue el departamento de gastroenterología pediátrica del Hospital para niños Nemazee de la Universidad Shiraz de ciencias médicas. La duración del estudio fue cinco años, iniciando en el año 2008. Todas las drogas como aspirina, AINES y heparina fueron suspendidas entre 1 a 7 días previos al procedimiento. Todos los pacientes estuvieron entre 6 a 8 horas del examen en ayunas dependiendo de la edad. Se prescribió una dosis de antibioterapia profiláctica en todos los casos previo al procedimiento. Durante el procedimiento, todos los pacientes fueron sedados usando propofol y/o midazolam. Algunos pacientes necesitaron intubación. Resultados: De 39 casos que se sometieron a PEG, 4 (10,2%) tuvieron alguna complicación. La indicación más frecuente de PEG fueron los problemas neurológicos (84,6%) y luego las enfermedades metabólicas (10,2%). De nuestros pacientes, 84,6% de los casos estuvieron por debajo del tercer percentile. Conclusión: La indicación más común de gastrostomía endoscópica percutánea fue la parálisis cerebral. La tasa de complicación en nuestro estudio fue 10,2%. La celulitis fue la complicación más común

RESUMO CONTEXTO: A doença celíaca é uma enteropatia causada pelo glúten na dieta. A combinação de dados sorológicos, genéticos e histológicos proporcionou a descrição de outras categorias desta doença. OBJETIVO: Há pacientes com anemia por deficiência de ferro que não respondem ao tratamento com ferro mesmo que repetido por muitas vezes. O objetivo deste trabalho foi investigar a presença de doença celíaca nestes indivíduos. MÉTODOS: Realizado estudo prospectivo com cruzamento secional transversal, de agosto de 2011 a fevereiro de 2013, em uma clínica de cuidados pediátricos afiliados a Shiraz University Medical Sciences, com 184 crianças incluindo 92 pacientes com anemia por deficiência de ferro que responderam ao tratamento com ferro suplementar, 45 não respondedores e 47 indivíduos sadios, com idade máxima de 18 anos, todos com consentimento informado dos pais. Todos participaram da triagem sorológica (com anticorpos anti-TTG e anticorpo antiendomísio) para doença celíaca. Pacientes com pelo menos um teste de sorologia positiva foram submetidos a biópsia da mucosa múltipla do bulbo e duodeno. RESULTADOS: Entre os 184 participantes, 19 (10,3%) tinham teste sorológico positivo para doença celíaca, incluindo 13 (28,9%) pacientes no grupo com a anemia por deficiência de ferro refratária, 5 (5,4%) pacientes no grupo com anemia por deficiência de ferro tratados e respondedores e 1 paciente do grupo saudável. A frequência de teste sorológico positivo no grupo com anemia por deficiência de ferro resistente ao tratamento foi destacadamente maior do que os outros dois grupos (P<0,001). Entre os pacientes com teste sorológico positivo para doença celíaca submetidos a endoscopia e biópsia, não foi vista nenhuma evidência histológica de doença celíaca. Foram diagnosticados como potencial doença celíaca. CONCLUSÃO: Potencial frequência de doença celíaca em pacientes com anemia por deficiência de ferro refratária foi maior do que nos controles. Portanto, recomendamos testes sorológicos de triagem para a detecção precoce, minimizando as complicações da terapia de ferro repetidas para este grupo.

ABSTRACT BACKGROUND: Celiac disease is an enteropathy caused by dietary gluten. The combination of serologic, genetic and histologic data has led to description of other categories of this disease. OBJECTIVE: There are a number of patients with iron deficiency anemia (IDA) that do not respond to iron treatment and may be repeated for many times, Therefore, we aimed to investigate celiac disease in this group. METHODS: In this cross sectional transverse prospective study from August 2011 to February 2013, in a Pediatric care clinic affiliated to Shiraz University of Medical Sciences, 184 children including 92 IDA patients who responded to treatment using iron supplement, 45 non-responding iron deficient patients, and 47 healthy individuals, with the maximum age of 18 years, with written consent from their parents, participated in serologic screening (with Anti-TTG antibody and anti-Endomysial antibody) for celiac disease. Patients with at least one positive serology test underwent multiple mucosal biopsy from bulb and duodenum. RESULTS: Among 184 participants, 19 (10.3%) subjects had positive serologic test for celiac disease, including 13 (28.9%) patients in the group with refractory IDA, 5 (5.4%) patients in the group with treated IDA, and 1 patient in the healthy group. The frequency of positive serologic test in the group with IDA resistant to treatment was prominently higher than the other two groups (P<0.001). Among the patients with positive serologic celiac test who underwent endoscopy and biopsy, no histologic evidence of celiac disease was seen. They were diagnosed as potential celiac disease. CONCLUSION: Frequency of potential celiac disease in patients with refractory IDA was higher than control the subjects. Therefore, we recommend serologic screening for early detection and minimizing the complications of celiac disease and repeated iron therapy for this group.

Abstract Introduction and aim: The aim of this study was to evaluate nutritional status in children without prior hospital admission or evidence of chronic disease. Subjects and methods: The current study is a cross-sectional and observational study which was conducted for assessing the nutritional status of children. In this study, consecutive sampling was used, with a sample size about 400 children aged 6 months to 18 years at first hospital admission. All subjects were hospitalized consecutively in the Pediatric Emergency Department of the Nemazee Teaching Hospital of Shiraz University of Medical Sciences (Shiraz, Islamic Republic of Iran). All children with evidence or history of chronic diseases such as liver cirrhosis, microcephaly, macrocephaly due to congenital infection or abnormal skull shape, patients with muscular or neurological problem, with prolonged steroid usage, nephrotic syndrome, cardiac problem, and protein loosing enteropathy were excluded from the study. The duration of the study was six months, starting from January 2016. Results: In the current study, 430 (225 boys and 175 girls) cases were included. Mean age was 5.39 (SEM 0.23) for boys and 5.78 (SEM 0.38) for girls. According to H/A criteria (current height/ideal height), 194 (48.5%) patients were stunted, 75 (18.8%) were mild, 49 (12.3%) were moderate and 70 (17.5%) were severe. According to W/A data (current weight/ideal weight), 188 (47%) of the patients studied were malnourished. Of these cases, 118 (29.5%) had mild malnutrition; 54 (13.5%), moderate; and 16 (4%), severe. According to body mass index (BMI), 40 (10%) patients were overweight, four (16%) were obese, and four (1%) were severe obese. In relation to middle upper arm circumference (MUAC), 56 (14%) patients were malnourished, 33 (8.3%) were at risk, 14 (3.5%) presented moderate malnutrition, and 9 (2.3%), severe malnutrition. Conclusion: Prevalence of malnutrition among children without prior admission was 48.5% (according to H/A). According to W/A, 47% of children had different degrees of malnutrition.

Resumen Introducción y objetivo: el propósito de este estudio fue evaluar el estado nutricional de los niños ingresados por primera vez en el hospital y sin historia de enfermedad crónica. Pacientes y métodos: se trata de un estudio transversal, observacional para valorar el estado nutricional al ingreso. La muestra estuvo constituida por algo más de 400 niños, de entre 6 meses y 18 años, ingresados por primera vez en el hospital. Se trataba de pacientes ingresados de forma consecutiva desde el servicio de Urgencias del hospital Nemazee de la Universidad Shiraz, en la República Islámica de Irán. Se excluyeron los pacientes con historia de enfermedad crónica como cirrosis hepática, microcefalia, macrocefalia por infección congénita o forma craneal anómala, pacientes con enfermedades musculares o neurológicas, con uso prologado de corticoides, síndrome nefrótico, cardiopatía o enteropatía pierde-proteínas. La duración del estudio fuere de seis meses, a partir de enero de 2016. Resultados: se incluyeron 430 niños (225 varones y 175 niñas). La edad media fue de 5,39 años (SEM 0,23) para los varones y de 5,78 (SEM 0,38) en las niñas. De acuerdo al peso para la talla ideal, 194 (48,5%) tenían desnutrición crónica, 75 (18,8%) leve, 49 (12,3%) moderada y en 70 (17,5%) era grave. Según el porcentaje del peso ideal, 188 pacientes (47%) presentaban desnutrición aguda, de los cuales en 118 (29,5%) era leva, en 54 (13,5%) moderada y en 16 (4%), grave. Según el índice de masa corporal (IMC), 40 (10%) tenían sobrepeso, 16 (4%) eran obesos y cuatro (1%) presentaban obesidad mórbida. Según el perímetro del brazo (MUAC), 56 (14%) tenían desnutrición, 33 (8,3%) estaban en riesgo de desnutrición, 14 (3,5%) presentaban desnutrición moderada y 9 (2,3%) intensa. Conclusión: la prevalencia de desnutrición en los niños ingresado por vez primera fue del 48,5%. De acuerdo al peso para la edad en 47% de los niños había algún grado de desnutrición.

Caustic ingestion is a major health concern in both developed and developing countries, that may lead to serious esophageal injury. The clinical presentation of caustic ingestion in children vary from asymptomatic to serious and fatal sequelae, such as perforation and stricture formation. Objective: Due to the lack of a comprehensive study in our area, this study has evaluated clinical and endoscopic manifestations and complications of caustic ingestion in children in south of Iran. Materials and methods: In this retrospective study, we reviewed 75 children with caustic ingestion who admitted in Nemazee Hospital of Shiraz University of Medical Science during 6 years (2006-2011). Sign and symptoms were recorded for each case. Results: The most common symptoms were dysphagia, oral lesions, vomiting, and drooling. Esophageal injuries were detected in both acid and alkali ingestion, but gastric injuries was significantly more in acid ingestion. During follow up period, 20% of all cases developed esophageal stricture. Conclusion: Dysphagia, oral lesions, vomiting, and drooling were the most common findings. Esophageal stricture was found in 20% of cases during 3 months of follow up.

La ingestión de cáusticos es una gran preocupación de salud tanto en países desarrollados como en vías de desarrollo, que puede llevar a lesiones esofágicas graves. La presentación clínica de la ingestión de cáusticos en niños varía desde asintomática hasta tener secuelas fatales, como perforación y/o estenosis. Objetivo: Debido a la ausencia de estudios en nuestra área, este estudio ha evaluado las manifestaciones clínicas, endoscópicas y las complicaciones de la ingesta de cáusticos en niños en el sur de Irán. Materiales y métodos: En estudio retrospectivo, revisamos 75 niños con ingesta de cáusticos que ingresaron al Nemazee Hospital of Shiraz University of Medical Science durante 6 años (2006-2011). Los signos y síntomas fueron recolectados para cada caso. Resultados: Los síntomas más frecuentes fueron disfagia, lesiones orales, vómitos y salivación. Las lesiones esofágicas se detectaron tanto en ingestión de ácido como de álcali, pero las lesiones gástricas fueron definitivamente más frecuentes con la ingestión de ácidos. Durante el periodo de seguimiento el 20% de los casos desarrolló estrechez esofágica. Conclusión: La disfagia, lesiones orales, vómitos y salivación fueron los hallazgos más comunes. La estrechez esofágica se encontró en el 20% de los casos durante los tres meses de seguimiento de los pacientes.

RESUMO Contexto - A infecção por Helicobacter pylori, bacilo gram negativo, tem estreita associação com gastrite antral crônica. Objetivo - Neste estudo, avaliou-se a precisão do teste respiratório da urease (UBT) com isótopos de carbono 13 em comparação com a histopatologia do antro gástrico para detecção da infecção por H. pylori em crianças com dispepsia. Métodos - Estudo transversal realizado no laboratório especializado no Centro de Pesquisa Gastroenterológica de Shiraz e do Hospital de Nemazee, Iran, durante um período de 12 meses. Este estudo investigou a sensibilidade, a especificidade e valores preditivos positivos e negativos da UBT em comparação com testes baseados em biópsia. Incluímos uma seleção consecutiva de 60 crianças que preencheram os critérios de Roma III para dispepsia. Todas as crianças foram encaminhadas para a realização de UBT com isótopos de carbono 13 (C13) assim como endoscopia. Biópsias foram tiradas do antro do estômago e duodeno. O diagnóstico patológico era considerado o teste padrão. Resultados - A idade média dos participantes foi 10.1±2.6 (intervalo de 7 a 17 anos). Do nosso total de 60 pacientes, 28 (46,7%) tiveram resultados positivos UBT e 32 (53,3%) tiveram resultados negativos de UBT. Dezesseis (57,1%) de 28 pacientes que tiveram UBT positiva foram H. pylori positivo e 12 (42,9%) foram negativos. A sensibilidade e especificidade do C13-UBT para detecção da infecção por H. pylori foi de 76,2% e 69,2%, respectivamente. Conclusão - A sensibilidade e especificidade do C13-UBT para detecção da infecção por H. pylori foi de 76,2% e 69,2%, respectivamente. Recomenda-se outro estudo multicêntrico de nosso país.

ABSTRACT Background - Helicobacter pylori infection is the gram negative bacillus with the close association with chronic antral gastritis. Objective - In this study, we evaluate the accuracy of urea breath test (UBT) with carbon isotope 13 in comparison with histopathology of gastric antrum for detection of H. pylori infection in children with dyspepsia. Methods - This cross-sectional study was performed at specialized laboratory of Shiraz Gastroenterohepatology Research Center and Nemazee Hospital, Iran, during a 12-months period. This study investigated the sensitivity, specificity, and positive and negative predictive values of UBT in comparison with biopsy-based tests. We included a consecutive selection of 60 children who fulfilled Rome III criteria for dyspepsia. All children were referred for performing UBT with carbon isotope 13 (C13) as well as endoscopy. Biopsies were taken from antrum of stomach and duodenum. The pathologic diagnosis was considered as the standard test. Results - The mean age of the participants was 10.1±2.6 (range 7-17 years). From our total 60 patients, 28 (46.7%) had positive UBT results and 32 (53.3%) had negative UBT results. Pathologic report of 16 (57.1%) out of 28 patients who had positive UBT were positive for H. pylori and 12 (42.9%) ones were negative. Sensitivity and specificity of C13-UBT for detection of H. pylori infection were 76.2% and 69.2% respectively. Conclusion - Sensitivity and specificity of C13-UBT for detection of H. pylori infection were 76.2% and 69.2% respectively. Another multicenter study from our country is recommended.

ContextoA peritonite bacteriana espontânea é definida como uma infecção do fluido ascítico sem evidente origem intra-abdominal cirurgicamente tratável. A peritonite bacteriana espontânea é uma das complicações graves em pacientes com cirrose e ascite. Sem tratamento antibiótico precoce, esta complicação é associada com alta taxa de mortalidade. Portanto, o diagnóstico precoce e tratamento de peritonite bacteriana espontânea são necessários para a sobrevivência. O reagente de esterase de leucócitos pode rapidamente diagnosticar a peritonite bacteriana espontânea.ObjetivoEste estudo teve como objetivo descobrir a acurácia diagnóstica do teste com tiras de esterase de leucócitos para o diagnóstico de peritonite bacteriana espontânea.MétodosUm estudo transversal hospitalar unicêntrico foi realizado entre julho de 2013 e agosto de 2014 em crianças com cirrose hepática e ascite que foram admitidas no Departamento de Gastroenterologia Pediátrica no Hospital de Nemazee afiliado à Universidade de Ciencias Médicas de Shiraz (Irã). Todos os pacientes foram submetidos a paracentese abdominal, e o líquido ascítico foi processado para contagem de células, teste de tira de reagente de esterase de leucócitos (Combiscreen SL10) e cultura. Peritonite bacteriana espontânea foi definida como tendo uma contagem de polimorfonucleares (PMN ≥250/m3) no líquido ascítico. Sensibilidade, especificidade, valor preditivo positivo negativo do teste de esterase de leucócitos foram calculados de acordo com a fórmula.ResultadosForam analisados um total de 150 amostras de líquido ascítico de pacientes cirróticos; (53,2%) eram do sexo masculino e sua média de idade (4,33±1,88 anos). A atresia biliar (n=44, 29,4%) e hepatite neonatal idiopática (n=29, 19,3%) foram as etiologias mais frequentes de cirrose. Além disso, dor abdominal (68,6%) e distensão (64%) foram as queixas mais comuns de apresentação. De todos os casos, 41 (27,35%) foram diagnosticados com peritonite bacteriana espontânea (PMN ≥250/mm3). A sensibilidade e especificidade do teste de reagente de esterase de leucócitos segundo PMN ≥250mm3 foi de 87,80% e 91,74% e, para os resultados de cultura de líquido ascítico, de 88,23% e 77,44%. Valor preditivo positivo e valor preditivo negativo do teste em PMN ≥250mm3 foi de 80% e 95,23% e em casos com cultura positiva 33,33% e 98,09%, respectivamente. A eficiência do teste de reagente esterase de leucócitos no diagnóstico de peritonite bacteriana espontânea, de acordo com resultados de ≥250mm3 e cultura PMN, foi de 90,66% e 78,66%.ConclusãoO teste de tiras de esterase de leucócitos pode ser usado como um teste rápido para diagnóstico de peritonite bacteriana espontânea, devido a sua alta validade diagnóstica.

BackgroundSpontaneous bacterial peritonitis is defined as an ascetic fluid infection without an evident intra-abdominal surgically treatable source. Spontaneous bacterial peritonitis is one of the severe complications in patients with cirrhosis and ascites. Without early antibiotic treatment, this complication is associated with high mortality rate; therefore, early diagnosis and treatment of spontaneous bacterial peritonitis is necessary for survival. Leukocyte esterase reagent can rapidly diagnose the spontaneous bacterial peritonitis.ObjectiveThis study aimed to find out the diagnostic accuracy of leukocyte esterase dipstick test for the diagnosis of spontaneous bacterial peritonitis.MethodsA single centered hospital-based cross-sectional study was conducted during July 2013 to August 2014 on children with cirrhotic liver disease and ascites who were admitted in the Department of Pediatric Gastroenterology in Nemazee Hospital affiliated to Shiraz University of Medical Sciences (Iran). All patients underwent abdominal paracentesis, and the ascitic fluid was processed for cell count, leukocyte esterase reagent strip test (Combiscreen SL10) and culture. Spontaneous bacterial peritonitis was defined as having a polymorphonuclear count (PMN ≥250/m3) in ascitic fluid. Sensitivity, specificity, positive predictive value and negative predictive value of leukocyte esterase test were calculated according to the formula.ResultsTotally, 150 ascitic fluid sample of cirrhotic male patients (53.2%) and their mean age (4.33±1.88 years) were analyzed. Biliary atresia (n=44, 29.4%) and idiopathic neonatal hepatitis (n=29, 19.3%) were the most frequent etiology of cirrhosis. Also, abdominal pain (68.6%) and distension (64%) were the most common presenting complaint. Of all cases, 41patients (27.35%) were diagnosed to have spontaneous bacterial peritonitis (PMN ≥250/mm3). Sensitivity and specificity of leukocyte esterase reagent test according to PMNs ≥250mm3 were 87.80% and 91.74%, also on ascitic fluid culture results were 88.23% and 77.44%. Positive predictive value and negative predictive value of this test in PMNs ≥250mm3 were 80% and 95.23% and in cases with positive culture 33.33% and 98.09% were obtained, respectively. Efficiency of leukocyte esterase reagent test in diagnosing spontaneous bacterial peritonitis, according to PMNs ≥250mm3 and culture results were 90.66% and 78.66%.ConclusionThe leukocyte esterase strip test may be used as rapid test for diagnosis of spontaneous bacterial peritonitis due to its high diagnostic validity.