hrp0089p3-p168 | Fat, Metabolism and Obesity P3 | ESPE2018

Beneficial Effect of Metformin Treatment in Obese Children and Adolescents

Todorova Zdravka , Stefanova Elissaveta , Kazakova Krassimira , Jordanova Desislava , Dimitrova Mihaela

Introduction: Obesity in children and adolescents is a growing global health problem. Obese children and adolescents provide the pediatric healthcare professionals management challenge. Obesity with insulin resistance, dyslipidemia and elevated blood pressure constitute the metabolic syndrome and each of these is an independent risk factor for cardiovascular disease, diabetes mellitus, non-alcoholic fatty liver disease. Lifestyle modification is a primary and main milestone in...

hrp0086p2-p168 | Bone & Mineral Metabolism P2 | ESPE2016

A Case of Genetically Proven Carbonic Anhydrase II Deficiency

Todorova Zdravka , Stefanova Elissaveta , Kazakova Krasimira , Yordanova Desislava , Litvinenko Ivan

Background: Carbonic anhydrase II (CAII) deficiency is extremely rare (<1:1 000 000) autosomal recessive disease, which is characterized by the triad of osteopetrosis, basal ganglia calcifications and renal tubular acidosis. In addition short stature, facial dysmorfism and different degree of mental retardation are possible features. Different mutations of the gene for CAII on 8q21.2 lead to impaired enzyme activity and typical clinical, biochemical and imaging manifestati...

hrp0084p2-346 | Fat | ESPE2015

Metformin Treatment for Obese Children and Adolescents with Insulin Resistance

Todorova Zdravka , Stefanova Elissaveta , Kazakova Krasimira , Yordanova Desislava

Background: Obesity in children is already a global health problem. Obese children and adolescents with insulin resistance provide the pediatric healthcare professionals management challenge. Obesity with insulin resistance, dyslipidemia and elevated blood pressure constitute the metabolic syndrome and each of these is an independent risk factor for cardiovascular disease (CVD). Metformin is well-established oral hypoglycaemic agent in the treatment of adult and young patients...

hrp0084p3-674 | Bone | ESPE2015

25-Hydroxy Vitamin D Levels in Patients with Chronic Diseases on Corticosteroid Treatment

Yordanova Desislava , Stefanova Elissaveta , Kazakova Krasimira , Todorova Zdravka , Dimitrova Mihaela

Background: Corticosteroids are medicines that are used to treat many chronic diseases. They are very effective anti-inflammatory drugs by suppressing the immune system, and are also used as a replacement therapy in conditions with low levels of endogenous cortisol. Glucocorticoid effects on bone metabolism include: reduced absorption of calcium in the intestine; increased calcium urinary excretion; increased bone resorption and reduced bone density. Corticosteroid treatment i...

hrp0084p3-1032 | Growth | ESPE2015

Impact of Recombinant Human GH on Height in Children with Chronic Kidney Disease

MIteva Polina , Roussinov Dimitar , Stefanova Elissaveta , Shumnalieva Russka

Background: Chronic kidney disease (CDK) is one of the most common indications for treatment with recombinant human GH (rhGH).Objective and hypotheses: The aim of our study was to investigate the effect of rhGH therapy in pediatric patients with different stages of CKD.Method: 49 children (35 boys and 14 girls) aged from 0–18 years (mean age 9.01±4.28) with proven CKD and height retardation were treated with rhGH by a sin...

hrp0082p3-d1-629 | Adrenals &amp; HP Axis | ESPE2014

Clinical and Genetic Diagnosis of Allgrove Syndrome

Todorova Zdravka , Stefanova Elissaveta , Litvinenko Ivan , Kazakova Krasimira , Yaneva Penka , Yordanova Desislava , Dimitrova Mihaela

Background: Allgrove sydrome (triple A, 4 A syndrome) is a rare autosomal recessive disorder, characterized by the triad of ACTH resistant adrenal insufficiency, alacrima and achalasia. In addition many patients show progressive neurologic impairment such as progressive paripheral polyneuropathy, hyperreflexia, nasal speech and disautonomia. It is now known that mutations of the ADRACALIN (AAAS) gene on the 12q13, that encodes the protein ALADIN, are responsible for the clinic...

hrp0082p3-d1-631 | Adrenals &amp; HP Axis | ESPE2014

Homozygous c.923dupT Combined with Heterozygous c.334G>A CYP21A2 Mutation: a Case Report from the Bulgarian CAH Screening Programme

Kostova Antoaneta , Stoeva Iva , Kirov Andrey , Dineva Ganka , Todorov Tihomir , Todorova Albena , Stefanova Elissaveta , Kazakova Krassimira , Aroyo Ani , Mitev Vanio

Background: This case underlines the importance of a newborn screening programme combined with genotyping for confirmation and prognosis of disease severity.Objective and hypotheses: Case presentation of a girl with three CYP21A2 mutations.Method: Girl, born from first uneventful pregnancy per vias naturalis. Birthweight 3200 g, birthlenght 50 cm. Intensive jaundice, start at d3, necessitating phototherapy. Discharged from...

hrp0092p3-108 | Fat, Metabolism and Obesity | ESPE2019

Vitamin B12 Levels in Children After Metformin Treatment

Yordanova Desislava , Todorova Zdravka , Dimitrova-Mladenova Mihaela , Stefanova Elisaveta

Background and Aims: Vitamin B12 is an essential micronutrient required for optimal hemopoetic, cardiovascular and neuro-cognitive functions. There are some literature data that Metformin induces vitamin B12 malabsorption, which may increase the risk of developing vitamin B12 deficiency and subsequently elevation of homocysteine levels. High concentrations of homocysteine has been associated with higher risk of coronary artery disease, arterial hypertension, h...

hrp0086p2-p543 | Fat Metabolism and Obesity P2 | ESPE2016

25-Hydroxyvitamin D Concentrations in Pubertal Children with Obesity

Yordanova Desislava , Stefanova Elisaveta , Kazakova Krasimira , Todorova Zdravka , Dimitrova Mihaela

Background: The prevalence of childhood obesity has been rapidly increasing worldwide and the last report of World Health Organisation define it as epidemic and one of the most serious global public health challenges for the 21st century. Obese children and adolescents are at an increased risk of developing various health problems including type 2 diabetes mellitus, hypertension, osteoarthritis, cardiovascular disease. Obesity is a risk factor for vitamin D deficiency. Vitamin...

hrp0082p3-d2-645 | Adrenals &amp; HP Axis (1) | ESPE2014

Untreated Congenital Hyperplasia with Central Precocious Puberty

Dimitrova Mihaela , Stefanova Elisaveta , Kazakova Krasimira , Yordanova Desislava , Todorova Zdravka

Background: Congenital adrenal hyperplasia (CAH) may cause early maturation of hypothalamic–pituitary–gonadal axis when the initiation of corticosteroid treatment is late or/and there is poor compliance. The latter sometimes leads to a lack of treatment. In most cases, if the child survives, he or she develops central precocious puberty.Case report: We present a 12-year-old boy born of a normal pregnancy and delivery. In the first months of lif...