Primary immunodeficiency commonly coincides with uncontrolled inflammation and autoimmune symptoms as evidence for immune dysregulation. These phenomena can be explained by different mechanisms, such as loss of immune tolerance against self antigens and continuous stimulation due to the lack of antigen elimination. This immune dysregulation causes increased chronic inflammation, and the consequences are tissue damage and autoimmunity in potentially any organ. In this article, we discuss the most important known mechanisms and highlight those characteristic clinical features, that can be useful for diagnosis and personalized treatment in everyday practice.

The prevalence of Sexually Transmitted Diseases in Europe is unknown. In the United States at least each fourth college student is suffering from at least one infectious episode. Some of them are symptomeless and are able to infect further sexual partners. The general practitioner has to define risk factors concerning his or her adolescent patient. Yearly screening this population (chlamydiasis, trichomoniasis, Papanicolau test) is necessary. The preventive measures include education, preexposition prophylaxis, diagnosing and treating the infected persons and their sexual partners.
Sexual assault necessitates detailed microbiological investigation and empirical antiinfective treatment of the most frequent diseases (gonorrhoea, chlamydiasis, trichomoniasis).

According to several documents of WHO the Hungarian government realizes a successful intersectorial cooperation to foster holistic health promotion in all Hungarian educational institutions. Child health care experts have to know this process well, as their professional help is indispensable for the pedagogues. The paper shows present processes in holistic school health promotion and outlines the needed helping functions of public health institutions and experts.

Objective: Evaluation of the results of 2 hour extra PE / week and a connected, new screening approach as a complex prevention model after 10 years.
Method: Semi-annual measurement of anthropometry, fitness, heart rate and blood pressure during exertion, multivariate statistical and individual evaluation of 13 199 pupils based on 55 000 measuring series.
Results:
1. The screening „stress test” at PE classes were found to be suitable for the early recognition of pre-, masked- and sustained hypertension, thereafter for compliance follow-up
2. Comparison of results before the programme and 10 years after introduction predicts considerable CVD risk reduction.
3. New feature is the analytical software for web-based information for all stakeholders (fit-test.hu)
Conclusion: The complex and low-budget school-based method introduced here seems to be a promising opportunity for the reduction of CVD morbidity and mortality later, at adult age.

EGPA is defined as a small-vessel vasculitis of unknown etiology potentially involving any organ and associated with detection of antineutrophil cytoplasmic antibodies (ANCA) in more than 1/3 of patients. Microscopically, the typical
triad is necrotizing vasculitis, granulomas, and extravascular eosinophilia. Delayed diagnosis and severe organ involvement determines the prognosis, with sometimes fatal outcome. The mainstay of treatment is corticosteroids;
cytotoxic agents are added in patients with poor prognostic factors . EGPA is extremely rare in childhood, our 11 year-old patient was diagnosed after several weeks observation. He was admitted with a history of asthma, allergic
rhinitis, granulomatous skin symptoms and blood eosinophilia. On the basis of laboratory data (peripheral eosinophilia) associated with skin biopsy this disease was eventually diagnosed.

Pseudomonas aeruginosa sepsis is rare in healthy children. Ecthyma gangrenosum is a characteristic cutaneous manifestation of the disease. We reviewed 2 peadiatric cases of Pseudomonas aeruginosa septicaemia. Our first patient presented with fever, otitis and several skin lesions, the second patient presented with a history of fever and diarrhoea.
Blood and wound cultures grew Pseudomonas aeruginosa in both patients. After receiving prolonged intravenous antimicrobial therapy, both children improved and were discharged from hospital. In our cases no underlying immune deficiency was found. Early institution of antimicrobial therapy is important. Recognition of the characteristic skin lesions helps choosing the appropriate antibiotic regimen.

The diagnosis and therapy of gastroesophageal reflux disease are symptom based in children. In many cases it is difficult to differentiate it from other diseases with similar symptoms. In the two presented cases patients had atypical appearance of gastroesophageal reflux disease however primary esophageal motility disorder and anatomical stenosis
were discovered during the thorough examinations. In the latter case eosinophil esophagitis was proved by histological
examination. These cases point out, that gastroesophageal reflux disease patients with atypical presentation could
have other underlying diseases.

Introduction: Celiac disease is one of the most common disease patterns occurring with malabsorption, the symptoms of which became more diverse in the last few decades. In the following, a rare case resulting from gastrointestinal motility disorder accompanied by non-mechanical intestinal obstruction will be report.
Case-report: A 19 months old girl admitted for 3 kg of weight loss accompanied by fever, exsiccation, coughing, abdominal pain and respiratory infections returning after 3 weeks. Her laboratory results showed elevated inflammatory
activity (C-reacive protein, CRP: 90,2 mg/L, white blood cell count: 17,7 G/L). The background of fever proved to be bilateral otitis media, that was treated successfully by parenteral antibiotic therapy. The abdominal imaging
examinations performed because of fatigue, abdominal distension and pressure sensitivity remaining after the normalization of fluid balance showed ileus. The necessity of acute surgical procedure was ruled out by several
surgical consilii. The performed tissue transglutaminase immunglobulin A measurement showed extremely high values (36315 U/L, ref. range: 0-20 U/L). Upper endoscopy visualised blunted villus pattern in the duodenum, the hystological examination of which proved Marsh IIIC stage subtotal villous atrophy. With gluten-free diet, the general condition of the child normalized, her weight increased significantly, the abdominal distension decreased, she became more open.
Conclusion: A wide variety of clinical presentations can be seen in children with celiac disease, which can lead to delay in diagnosis. The disease should be considered in case of acute surgical disease patterns, too, even if it is obvious
that infection can be (also) in the background. Setting up a diagnosis and starting the gluten-free diet is essential.

Traumatic renal artery thrombosis (RAT) is a rare and serious complication of blunt abdominal injuries. The warm ischemic sensitivity of the kidney is very high, the timing of care is therefore an excessively significant factor. Despite early intervention, the outcome of this type of injury is most often the loss of the affected kidney. By presenting two of our cases, and reviewing the international literature we wish to describe the main points of this disease, and highlight its special characteristics in childhood.