Italian Journal of Pediatrics最新文献

{"title":"Post-traumatic growth and influencing factors of parents with children with Duchenne muscular dystrophy: a cross-sectional survey study.","authors":"Li Xu, Meili Liu, Yuewei Chen, Liwen Wu, Siyi Gan, Jianhui Xie, Jos M Latour","doi":"10.1186/s13052-025-01840-z","DOIUrl":"10.1186/s13052-025-01840-z","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to identify the post-traumatic growth status and influencing factors of parents with children with Duchenne muscular dystrophy (DMD).</p><p><strong>Methods: </strong>We adopted a cross-section survey study. Between February and December 2022, 181 parents responded to the survey including a participants' characteristics section, post-traumatic growth assessment scale, caregiver burden scale, and social support assessment scale. Multiple linear regression analysis was used to investigate influencing factors of post-traumatic growth.</p><p><strong>Results: </strong>The mean score of post-traumatic growth of parents was 56.66 (SD ± 18.67). Post-traumatic growth was positively correlated with social support (r = 0.452, P < 0.01) and negatively correlated with care burden (r = -0.207, P < 0.01). Multiple linear regression showed that the child's age, course of disease, self-care ability, parent's working condition, residence, education, number of children, and health status were the main influencing factors for the post-traumatic growth of parents (P < 0.001).</p><p><strong>Conclusion: </strong>The post-traumatic growth of parents with children with DMD was at a moderate level. Healthcare professionals should pay attention to the psychological state of parents with children with this rare disease and promote post-traumatic growth through psychological mindfulness interventions, strengthening family and social support, and providing care knowledge and skills.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"51"},"PeriodicalIF":3.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic treatment of acute and recurrent otitis media in children: an Italian intersociety Consensus.","authors":"Guido Castelli Gattinara, Marcello Bergamini, Giovanni Simeone, Lamberto Reggiani, Mattia Doria, Daniele G Ghiglioni, Alberto Terminiello, Federica Cosentino, Laura Cursi, Daniele Donà, Elena Chiappini, Luisa Galli, Andrea Lo Vecchio, Alfredo Guarino, Alberto Villani, Giuseppe Di Mauro, Nicola Principi, Susanna M R Esposito, Maria Carmen Verga","doi":"10.1186/s13052-025-01894-z","DOIUrl":"10.1186/s13052-025-01894-z","url":null,"abstract":"<p><p>Acute Otitis Media (AOM) typically affects previously healthy children and can be recurrent. This inter-society consensus aims to provide evidence-based recommendations for the antibiotic therapy of mild, severe and recurrent otitis media in previously healthy children in Italy.A systematic literature review was conducted to identify the most recent/relevant evidence. The Embase, Scopus, PubMed, and Cochrane databases were used with the terms \"children,\" \"acute otitis media\", \"recurrent otitis media\", and \"antibiotics,\" from 2012 to April 2024, with no language restrictions. The review focused on studies conducted in high-income countries involving antibiotic therapy in children over 3 months of age diagnosed with AOM or Recurrent AOM (RAOM). The GRADE ADOLOPMENT was used to assess the possibility of adopting or adapting recommendations from two evidence-based guidelines: 'NICE guideline Otitis media (acute): antimicrobial prescribing', updated to 2022 and SIP Intersocietal GL 2019 \"Management of acute otitis media in paediatric age: diagnosis, therapy and prevention\" The certainty of the evidence was assessed using the GRADE approach. Final recommendations were formulated through a Delphi consensus process with an expert panel.All major randomised trials and international guidelines promote the appropriate use of antibiotics and advocate a therapy with narrow-spectrum molecules (amoxicillin). The amoxicillin-clavulanic acid is only envisaged when there is a risk of infection by β-lactamase-producing bacteria. In healthy children, amoxicillin should be initiated as a first-line treatment only after a 48-72-h period of appropriate \"watchful waiting\", during which symptoms are treated while monitoring the patient clinically to see if symptoms resolve. Amoxicillin-clavulanate or second-generation cephalosporins should be reserved for non-immunized children, those with immune deficiencies or those with underlying conditions. In these cases, the use of a clavulanic acid-protected amoxicillin is preferred even though there is no specific scientific evidence to support this choice.The recommended amoxicillin dosage is 90 mg/kg/day, divided into three doses, though two doses may be considered to improve compliance. A five-day duration of therapy is advised.In conclusion the diagnosis of AOM/RAOM relies primarily on clinical assessment, which often introduces uncertainty in distinguishing between viral and bacterial infections whereby there remains significant potential to improve antibiotic utilisation. Future studies could play a key role in enhancing the management of AOM/RAOM in children, ensuring that antibiotic treatments are appropriate and effective.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"50"},"PeriodicalIF":3.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two dramatically different clinical scenarios of neonatal Echovirus-11 infection in late preterm male twins: a case report and review of the literature.","authors":"Simona Perniciaro, Caterina Proietti, Angela Bossi, Roberta Maragliano, Carla Facco, Federica Novazzi, Nicasio Mancini, Massimo Agostino Agosti","doi":"10.1186/s13052-025-01880-5","DOIUrl":"10.1186/s13052-025-01880-5","url":null,"abstract":"<p><strong>Background: </strong>Enterovirus is a well-known cause of infection in all age groups, with particular importance for neonates with both vertically and horizontally transmission. Neonatal clinical manifestations are highly variable and mostly is asymptomatic, but severe infections are described such as myocarditis, meningitis, encephalitis, hepatitis, coagulopathy, pneumonia and viral sepsis. Since 2022, The World Health Organization has recently reported an increasing number of severe neonatal infection associated with a new variant of Echovirus-11 (E-11). Many of the infants described with E-11 infections in a case reports series were preterm, male and twins. Despite the criticality of neonatal disease, the clinical management remains primarily supportive and therapeutic options are unfortunately few.</p><p><strong>Case presentation: </strong>We present the case of male dichorionic diamniotic late-preterm twins, born in December 2023 at Filippo del Ponte Hospital in Varese (Northen Italy) with early Echovirus-11 infection. They had two dramatically different clinical scenarios and one of them developed a severe and fatal hemorrhage-hepatitis syndrome.</p><p><strong>Conclusions: </strong>Our experience has the purpose to emphasize public health attention to Echovirus-11 neonatal infections and their rare dramatically neonatal clinical presentations. Prematurity, host genetic predisposition and vertical transmission seem to be strong risk factors for severe infections, but it still need to be elucidated. According to previous Italian report, a surveillance protocols in all cases with unexpected clinical presentations and sequencing complete genome in order to better understand typing and molecular characterization of emerging and re-emerging pathogenic variants and new strains are strongly recommend in Italy.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"49"},"PeriodicalIF":3.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current practices in neonatal pain management: a decade after the last Italian survey.","authors":"Paola Lago, Elisabetta Garetti, Patrizia Savant Levet, Immacolata Arenga, Anna Pirelli, Anna Chiara Frigo, Daniele Merazzi","doi":"10.1186/s13052-025-01896-x","DOIUrl":"10.1186/s13052-025-01896-x","url":null,"abstract":"<p><strong>Background: </strong>Neonates admitted to neonatal intensive care units (NICUs), as well as maternity nurseries, typically undergo painful invasive procedures during their hospital stay. We aim to report on current bedside analgesia/sedation and pain assessment practices, 10 years after the previous Italian survey.</p><p><strong>Methods: </strong>This study employed a cross-sectional electronic survey. A 21-item questionnaire was distributed to directors of birth centers and NICUs to ascertain the policy for pain assessment and management in their respective units. A separate questionnaire was dispatched to neonatologists and nurses registered with the Italian Society of Neonatology. They reported on the analgesic strategies implemented for various painful bedside procedures. Both non-pharmacological and pharmacological analgesia interventions, as well as pain assessment, were analyzed. A regression model was utilized to identify factors that predict pain management practices.</p><p><strong>Results: </strong>Data on pain management practices were collected from the directors of 153 NICUs and birth centers. Of these, 88.9% reported pain control following guidelines and 47.7% confirmed the presence of a local pain specialist promoting pain management in their unit. A minority, ranging from 16.3% to 41.8%, reported the use of a pain scale, a finding corroborated by the 200 doctors and 239 nurses who responded. At least one non pharmacological intervention (i.e., pacifier, sweet solution, or sensory saturation) was reported in 97.8% of the heel lances performed in the NICU and 96.5% in the maternity nursery, meanwhile for intramuscular injections in 73.8% and 70.3%, respectively. Additionally, it was reported that 22.9% of laryngoscopies were still performed without analgesia. Observations were made over 297 mechanical ventilation and 277 non-invasive ventilation courses, with non-pharmacological analgesia administered in 56.4% and 86.9% and the use of analgesic or sedative drugs in 81.7% and 17.1% of the cases, respectively. Furthermore, routine pain assessment was only undertaken in 68.0% and 64.9% of the cases.</p><p><strong>Conclusions: </strong>We found a largely common propensity among Italian directors, neonatologists, and nurses to perform analgesic interventions for the most frequently encountered invasive neonatal painful procedures, though the practices are still highly variable. The availability of written guidelines and local pain specialists are confirmed as factors that contribute to the proper management of pain. However, pain assessment is still inadequate and urgently needs to be implemented to allow for tailored pain and stress control and prevention in all infants.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"48"},"PeriodicalIF":3.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel KDM5C mutation associated with intellectual disability: molecular mechanisms and clinical implications.","authors":"Yunlong Meng, Xinyao Wang, Kangyu Liu, Xingkun Tang, Haining Li, Jianjun Chen, Zilin Zhong","doi":"10.1186/s13052-025-01887-y","DOIUrl":"10.1186/s13052-025-01887-y","url":null,"abstract":"<p><strong>Background: </strong>Among the disease-causing genes associated with X-linked intellectual disability (XLID), KDM5C is one of the most frequently mutated ones. KDM5C is a widely expressed gene that is most highly expressed in the brain. KDM5C modulates the transcriptional activity of genes through demethylation of H3K4, thereby regulating neural development and normal function. We identified a gene from a Chinese family and found that a nonsense mutation of KDM5C was co-segregated with the intellectual disability (ID).</p><p><strong>Methods: </strong>The candidate mutant genes of patients with ID phenotype were screened by Whole Exome Sequencing (WES), and DNA Sanger sequencing was performed for genetic analysis. Pathogenicity prediction tools were used to evaluate the pathogenicity of new mutations. The fusion plasmid was constructed and transfected into the cells, and the changes of mRNA and protein levels of the mutants were detected by semi-qRT-PCR and Western Blot, and the subcellular localization changes of mutant proteins were detected by Immunofluorescence technique.</p><p><strong>Result: </strong>The nonsense mutation in KDM5C (c.2785 C > T, p. R929X) was identified by whole exome sequencing (WES) and confirmed by Sanger sequencing, resulting in a truncated protein. The mutation was determined by pathogenicity prediction tool able to find non-sense mediated mRNA decay (NMD). Semi-qRT-PCR and Western Blot showed that the mRNA levels of the mutant gene were down-regulated, while the protein level was up-regulated. Additionally, the subcellular localization of the mutant protein changed.</p><p><strong>Conclusions: </strong>The KDM5C mutation found in our study leads to changes in protein levels through NMD and/or protein degradation, and produces residues lacking nuclear localization, thus altering the subcellular localization of the protein. These results may lead to changes in the expression of KDM5C target genes, ultimately contributing to the clinical phenotype observed in the patients.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"47"},"PeriodicalIF":3.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Learn from international recommendations and experiences of countries that have successfully implemented monoclonal antibody prophylaxis for prevention of RSV infection.","authors":"Sara Manti, Eugenio Baraldi","doi":"10.1186/s13052-025-01901-3","DOIUrl":"10.1186/s13052-025-01901-3","url":null,"abstract":"","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"46"},"PeriodicalIF":3.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Televisit with TytoHome™ device in medically complex child in long-term mechanical ventilation: a pilot study.","authors":"Alessandro Onofri, Nicola Ullmann, Elisabetta Verrillo, Maria Giovanna Paglietti, Martino Pavone, Renato Cutrera","doi":"10.1186/s13052-025-01885-0","DOIUrl":"10.1186/s13052-025-01885-0","url":null,"abstract":"<p><strong>Background: </strong>During the pandemic, the pneumology team at Bambino Gesù Children's Hospital highlighted that telemedicine was a valuable tool for remotely managing the medical needs of children with medical complexity (CMC). Following the telemedicine experience during the emergency phase, a telemedicine service was established, and new tools were tested to optimize televisits and the overall eHealth approach for patients. In this context, the TytoHome™ device was tested for performing objective examinations remotely. This pilot study, conducted at our hospital, explored the management of CMC patients on long-term mechanical ventilation via the telemedicine platform and the TytoHome™ device.</p><p><strong>Methods: </strong>This study involved the treatment of 10 pediatric patients over one year using this approach. The patients were already receiving care at our hospital and were undergoing long-term mechanical ventilation (LTV) at home-4 on invasive mechanical ventilation (IMV) and 6 on non-invasive ventilation (NIV). A database was developed to collect patient data, including personal details, vital parameters, objective examinations, audio quality, and patient satisfaction. A descriptive analysis was subsequently performed using the data collected during the earlier stages of the study.</p><p><strong>Results: </strong>The utility of the TytoCare device for medically complex children was evaluated. The families were \"satisfied\" with the remote follow-up visits, and healthcare personnel rated the audio quality of the visits as \"good.\"</p><p><strong>Conclusions: </strong>In conclusion, the remote management of these patients using the Tyto device offered several advantages. In our experience, Tyto proved to be a useful tool for the remote medical management of complex patients.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"45"},"PeriodicalIF":3.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ixekizumab as a successful treatment in pediatric generalized pustular psoriasis.","authors":"Maria Esposito, Paolo Antonetti, Emanuele Vagnozzi, Andrea De Berardinis, Roberta Bertelli, Francesco Brancati, Maria Concetta Fargnoli","doi":"10.1186/s13052-024-01835-2","DOIUrl":"10.1186/s13052-024-01835-2","url":null,"abstract":"<p><strong>Background: </strong>Generalized Pustular Psoriasis (GPP) is an autoinflammatory, multisystemic disease, characterized by widespread eruption of neutrophilic pustules on erythematous base, accompanied by systemic symptoms such as fever, leukocytosis, arthralgia, and general malaise. Globally, the disease is rare, particularly in children. If not adequately diagnosed and treated, systemic inflammation and multiorgan involvement can be life-threatening. The pathogenesis of GPP mainly involves the innate immune system, with inflammatory processes and neutrophil activation driven primarily by IL-36, but also by IL-1, TNF-alpha, IL-17 A. In particular, IL-17 A acts as a potent inducer of neutrophil recruitment. We report the case of a 7-years-old girl with GPP successfully treated with Ixekizumab, an IL-17 A antagonist.</p><p><strong>Case presentation: </strong>A 7-years-old girl with an history of plaque psoriasis came to our attention for the sudden appearance of erythematous patches surmounted by pustules on the trunk and lower limbs, following repeated episodes of purulent tonsillitis. We started therapy with cyclosporine at a dosage of 3,5 mg/kg/day, with no clinical benefit and progression of manifestations to a sub-erythrodermic state after 2 weeks. Blood tests showed neutrophilic leukocytosis, and the patient experienced hyperpyrexia and malaise. Since ixekizumab was recently approved for pediatric use in patients with moderate to severe plaque psoriasis, we started therapy with 80 mg Ixekizumab, combined with prednisone at a dosage of 12.5 mg/day, gradually tapered until discontinuation after 15 days. A second dose of Ixekizumab 40 mg was administered at week-4, according to the indication of ixekizumab in pediatric plaque psoriasis. At week-8 the patient achieved complete remission of skin manifestations and normalization of blood count. After achieving a stable remission, at week 36 we decided to increase the administration interval to 6 weeks. The patient is still on therapy with ixekizumab 40 mg every 6 weeks, maintaining complete remission during a 52-week follow-up, without safety concerns.</p><p><strong>Conclusions: </strong>This report supports the use of ixekizumab as a safe and effective option, both in the short and long-term, in the treatment of GPP, even at pediatric age. Larger studies are needed to confirm this positive, real-life experience.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"41"},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of intracardiac thrombotic complication in patients with severe Mycoplasma pneumoniae pneumonia.","authors":"Xiao Li, Bo Zhai, Yu Tang, Lei Zhang, Jing Wang, Chunna Xu, Lili Dong, Yanqiong Wang, Yanyan Su, Zhen Dong, Haiming Yang, Yuelin Shen","doi":"10.1186/s13052-025-01890-3","DOIUrl":"10.1186/s13052-025-01890-3","url":null,"abstract":"<p><strong>Background: </strong>Intracardiac thrombus (ICT) is the rarest yet most severe complication of severe Mycoplasma pneumoniae pneumonia (SMPP) in children. This study aims to elucidate the clinical characteristics of patients with SMPP-related ICT.</p><p><strong>Methods: </strong>We retrospectively enrolled 68 children with SMPP (18 cases of ICT, 50 cases of non-ICT) who were admitted from January 2014 to January 2024. We compared their demographic data, clinical symptoms, laboratory tests, imaging findings, treatment strategies, and prognoses. Additionally, we summarized data from 33 confirmed SMPP-related ICT cases reported in 12 references.</p><p><strong>Results: </strong>In our cohort, the ICT group exhibited higher incidences of tachypnea, chest pain, inflammation, and elevated D-dimer levels. They also presented more severe radiological findings and had longer hospital stays compared to the non-ICT group. The chordae tendineae-attached was the most common type (61.1%). Pathological examinations revealed ICT sizes ranging from 480 to 31,500 mm³. A favorable prognosis was observed in 94.4% of ICT patients. Clinical features did not significantly differ between various ICT types. In the overall cohort (51 cases), the right ventricle was the predominant location (68.6%). Notably, 66.7% of patients had concurrent extracardiac thrombosis, with pulmonary thrombosis being the most common subtype (41.2%).</p><p><strong>Conclusions: </strong>The clinical characteristics of SMPP-related ICT are non-specific, often coexisting with severe pulmonary lesions and significantly elevated inflammatory markers. All ICT types were chordae tendineae or wall-attached, rather than mobile. These findings suggest that an inflammation storm induced by SMPP may play a significant role in the pathogenesis of in situ thrombosis within the heart and major blood vessels.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"42"},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesion.","authors":"Junshan Zhao, Yingying Ma, Li Xin, Lijun Wang, Hongliang Gao","doi":"10.1186/s13052-025-01891-2","DOIUrl":"10.1186/s13052-025-01891-2","url":null,"abstract":"<p><strong>Background: </strong>Kawasaki disease (KD) primarily affects young children and can lead to coronary artery lesions. Intravenous immunoglobulin (IVIG) treatment is essential; however, it may fail in 10-20% of cases, increasing the risk of complications. Complete blood count (CBC) tests can help assess disease severity and predict risks. This study investigated the impact of IVIG on peripheral blood cells, including neutrophil count, platelet-lymphocyte ratio, hemoglobin level, mean platelet volume (MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), in children with KD complicated by coronary artery lesions (CALs).</p><p><strong>Methods: </strong>This retrospective analysis included children diagnosed with typical KD. The neutrophil count, hemoglobin level, platelet-lymphocyte ratio, MPV, ESR, and CRP were compared between those with (CAL⁺) and without (CAL^-) CALs during the acute phase, as well as at 7 days, 1 month, and 2 months after normalizing body temperature with IVIG.</p><p><strong>Results: </strong>A total of 76 children with KD were analyzed, including 30 with CAL⁺. CAL⁺ and CAL^- patients exhibited elevated neutrophil counts during the acute phase, with no significant differences (P > 0.05) between groups. After IVIG treatment, CAL^- patients demonstrated a more pronounced reduction in neutrophil count (P < 0.05) than CAL⁺ patients. Hemoglobin levels differed significantly during the acute phase (P < 0.05) but were comparable post-treatment (P > 0.05) between CAL⁺ and CAL^- patients. The platelet-lymphocyte ratio varied significantly between groups during the acute phase and 1-month post-treatment (P < 0.05). Mean ESR and CRP levels were significantly elevated at all time points in the CAL⁺ group compared with the CAL^- group. No significant differences in MPV were observed between groups.</p><p><strong>Conclusions: </strong>After IVIG treatment, CAL^- patients demonstrated a more important reduction in neutrophil count than CAL⁺ patients after IVIG. Pediatric patients with KD and CAL⁺ showed lower hemoglobin and platelet-lymphocyte ratio and higher ESR and CRP compared with CAL^-, suggesting that they may serve as indicators for CAL in pediatric patients with KD.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"44"},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}