Egyptian Journal of Pediatric Allergy and Immunology最新文献

{"title":"Impact of COVID-19 on children with rheumatic diseases: a retrospective cohort analysis","authors":"Rasha H. El-Owaidy, E. Hossny, D. El-Ghoneimy, Zeinab M. El-Sayed, S. Reda, I. El-Hakim, Hanan Ibrahim, I. Ragab, Nesrin S. Radwan, G. Shousha, Amal Lotfy, A. Elmekkawy, A. Sobh, N. Osman, Mariam Abdelnaby, Roba Al-Gaweesh, Rana Zakaria, Mostafa El-Amin, Y. El-Gamal","doi":"10.21608/ejpa.2022.264504","DOIUrl":"https://doi.org/10.21608/ejpa.2022.264504","url":null,"abstract":"Background: Data concerning impact of COVID-19 on children with rheumatic disorders in developing countries are limited. Methods: We conducted a retrospective analysis, examining the medical records of 49 children (15 males, 34 females) with rheumatologic disorders who got infected with SARS-CoV2. They were recruited, over a period of 17 months, from the Children's Hospitals of Ain Shams, Mansoura and Assiut Universities in Egypt. Data recorded were the type and duration of rheumatologic, antirheumatic treatment received, and COVID-19 presentation including severity, and outcome. Complete blood count (CBC), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), lactate dehydrogenase enzyme (LDH), serum ferritin, and D-dimer levels were recorded. Results: Our series included 25 SLE, 16 JIA, two polyarteritis nodosa, two dermatomyositis, two mixed connective tissue disease, one systemic sclerosis, and one HSP patients. They had median (IQR) age of 13 (10-14) years. Twenty-nine (59.2%) patients had active disease flare. Forty-one (83.7%) patients were on corticosteroids, and 35 (71.4%) were on add-on immunosuppressives. Twenty-nine patients were hospitalized with median (IQR) admission duration of 25 (14-38) days. They included 8 mild/asymptomatic, 4 moderate, 6 severe, and 11 critical COVID-19 cases. Seven cases with critical COVID-19 passed away with mortality rate of 14.3 %. The deceased cases had higher neutrophil/lymphocyte ratio (p=0.003), higher CRP levels (p= 0.041) and higher D-dimer (p=0.001) and ferritin levels (0.002) as compared to survivors. Conclusion: Although reported to be milder in children, COVID-19 seems to have higher mortality among children with rheumatic disorders compared to rates reported in the general population. We could not find evidence for the impact of immunosuppressive treatment on COVID-19 related mortality, yet our findings need to be validated by wider scale prospective studies.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45839572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The spectrum of urological disease in familial Mediterranean fever: amyloidosis and beyond","authors":"Ahmad Hassan, G. Shousha, Z. El-Sayed","doi":"10.21608/ejpa.2022.264468","DOIUrl":"https://doi.org/10.21608/ejpa.2022.264468","url":null,"abstract":"Introduction Familial Mediterranean fever (FMF) is the most common inherited monogenic autoinflammatory disease that gained the attention of researchers for decades. Population from East Mediterranean origin are mainly affected. Prevalence of FMF in endemic countries varies from 1:500 to 1:1,000; Turkey has the highest number of patients followed by Israel and Armenia. The most commonly incriminated genotypes are recessive gain-of-function mutations of the Mediterranean fever (MEFV) gene. MEFV gene, M694V, was proved to carry greater risk of developing secondary amyloidosis, a potentially lethal complication. Authors claimed that environmental factors and country of origin might augment the risk of amyloidosis in infants and children with FMF.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46307638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: editors-in-Chief","authors":"","doi":"10.21608/ejpa.2022.264503","DOIUrl":"https://doi.org/10.21608/ejpa.2022.264503","url":null,"abstract":"","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48639791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KAT2B expression on CD4+T lymphocytes in pediatric systemic lupus erythematosus","authors":"E. Hossny, D. El-Ghoneimy, M. Hamza, N. Radwan, Mariam Abdelnaby","doi":"10.21608/ejpa.2022.264505","DOIUrl":"https://doi.org/10.21608/ejpa.2022.264505","url":null,"abstract":"(pSLE) is multifactorial and includes genetic predisposition and modifiable environmental factors. Lysine Acetyl transferase 2B (KAT2B), is one of the histone acetylases that regulate the gene transcription. It was linked to autoimmune diseases with variable expression in relation to various disease parameters. We sought to investigate the KAT2B expression on peripheral blood mononuclear cells (MNCs) in patients with pSLE and its relation to biomarkers of lupus flare, major organ involvement, SLE disease activity index (SLEDAI), and therapeutic modalities used . Methods: This cross-sectional comparative study comprised 30 patients with SLE who fulfilled at least four of the System Lupus International Collaborating Clinics (SLICC) classification criteria. Thirty age- and sex-matched healthy children were included as a control group. The patients were subjected to clinical evaluation including the SLEDAI, and lupus flare laboratory markers. KAT2B expression on MNCs was measured by ELISA in the pSLE patients as well as the control group . Results: KAT2B expression on the MNCs was significantly lower among the pSLE patients than the healthy controls (p <0.001). Patients with moderate and severe lupus activity had significantly lower KAT2B expression on MNCs than those with mild activity as judged by the SLEDAI (p=0.03). The KAT2B expression was not significantly correlated to the studied biomarkers of lupus activity (ESR, anti-DNA or C3) but was negatively correlated to the extent of renal affection in terms of the 24 hours urinary protein level (p=0.024). The findings are limited by the sample size. Conclusion: From this pilot study, the low expression of KAT2B on MNCs seems to be linked to pediatric SLE disease activity. Wider scale and prospectively designed studies are needed to validate this observation and to explore the effect of disease remission on KAT2B expression in pSLE activity.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43895668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of Urinary Ceruloplasmin as a Marker in Juvenile SLE","authors":"E. Hossny, Mohammad A Sharaf, N. Wahba, Abdulrahman Warsame","doi":"10.21608/ejpa.2022.231501","DOIUrl":"https://doi.org/10.21608/ejpa.2022.231501","url":null,"abstract":"There is substantial evidence that lupus nephritis (LN) is primarily related to type-III hypersensitivity reactions leading to immune complex deposition at the mesangial, subendothelial, and/or subepithelial space near the renal glomerular basement membrane. The search for a non-invasive urinary marker of lupus nephritis is an appealing point of research. There are few studies that have evaluated the role of urinary ceruloplasmin (CP) as a biomarker for LN. Being expressed at high levels by parietal epithelial cells of Bowman’s capsule it could possibly detoxify molecules as they pass through the glomerular filter. CP is a highly effective antioxidant that can prevent oxidative damage to lipids, DNA, and proteins. However, it is unlikely that a single biomarker can replace clinical parameters to monitor disease progression and detect early renal flares.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45479181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum survivin expression in systemic-onset juvenile idiopathic arthritis in relation to disease activity and macrophage activation","authors":"Hanan Abd El-Lateef, Aisha Yehia, Sahar Abd Elmaksoud, E. Hossny","doi":"10.21608/ejpa.2022.101356.1032","DOIUrl":"https://doi.org/10.21608/ejpa.2022.101356.1032","url":null,"abstract":"an auto-inflammatory disease that might be complicated by the life-threatening macrophage activation syndrome (MAS). Survivin, antiapoptotic protein, is associated with significant tissue damage and/or poor response to treatment. We sought to investigate its potential role as indicator of disease activity and predictor of MAS in SoJIA . Methods: We conducted a prospective controlled study that comprised 22 physician-diagnosed SoJIA patients and 20 healthy age and sex matched children as a control group. Patients were subjected to clinical and laboratory assessment every 2 months for one year to detect disease relapse or MAS. Serum survivin was measured at enrollment and in case of activity or MAS development. Other inflammatory markers of activity and MAS were also assayed including CRP, ESR, serum ferritin, ferritin/ESR ratio and triglycerides . Results: Over one year of follow up, ten Patients (45.5%) developed both systemic and articular activity with or without MAS, one patient (4.5%) developed systemic activity only, 5 patients (22.7%) had only articular activity and six patients (27.3%) remained in remission. Serum survivin, ferritin, ESR and the ferritin/ESR ratio were high during activity and even higher in the patients who developed MAS. Ferritin/ESR ratio above three had a 100% sensitivity and 83% specificity in the diagnosis of MAS [Area under the curve (AUC) = 0.96]. Serum survivin level above 25 pg/ml had 100% sensitivity and 90% specificity in detection of disease activity [AUC = 0.96] and a serum level above 67 pg/ml had 100% sensitivity and 94.7% specificity in the prediction of MAS [AUC = 0.99] . Conclusion: Survivin might be a potential marker of SoJIA disease activity with special value in the prediction of MAS. Our conclusions are limited by the sample size .","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46165160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum nitric oxide and malondialdehyde as potential activity and severity markers of oxidative stress in juvenile idiopathic arthritis","authors":"Y. El-Gamal, Sahar Abd Elmaksoud, Maher Saad, Hanan Abd El-Lateef","doi":"10.21608/ejpa.2022.126121.1038","DOIUrl":"https://doi.org/10.21608/ejpa.2022.126121.1038","url":null,"abstract":"juvenile idiopathic arthritis (JIA).Nitric oxide (NO) is a free radical and malondialdehyde (MDA) is a product of polyunsaturated fatty acid peroxidation and both are possibly implicated in the pathogenesis of chronic synovitis . Objective: We sought to investigate the role of serum NO and MDA as markers for oxidative stress in JIA and their relation to activity and therapeutic modalities used . Methods: This comparative prospective study included 20 children with pediatric JIA enrolled consecutively from the Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University. They were compared to 20 matched healthy control subjects. They underwent clinical evaluation and measurement of serum NO and MDA by enzymatic immunoassay was performed in both groups . Results: A significant positive correlation was found between serum NO and MDA concentrations and JIA activity (p=0.0150; p=0.037 respectively).Patients who had arthralgia, arthritis and/or morning stiffness had significantly higher Serum NO and MDA concentrations. According to ROC analysis, serum NO level above 158.9 μ mol/L and serum MDA level above 6.75 m mol/L had 100% sensitivity and specificity in prediction of disease activity (AUC= 0.99-1.0).Patients treated with methotrexate (MTX) had significantly higher MDA concentrations and a significant positive correlation between serum NO and MTX dosage . Conclusion: Serum NO and MDA levels were significantly elevated among patients during disease activity which may suggest a significant role in the etiopathogenesis of JIA. Further studies are needed to validate their usefulness as predictors of JIA outcome .","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43612100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of serum levels of interferon beta (INF-Ɓ) and nucleotide-binding oligomerization domain 2 (NOD2) gene polymorphism in relation to asthma phenotypes in children","authors":"M. Zedan, Engy Osman, Nashwa K. Abosamra, A. Osman, H. Rizq, Esraa Zeinhom","doi":"10.21608/ejpa.2021.93052.1029","DOIUrl":"https://doi.org/10.21608/ejpa.2021.93052.1029","url":null,"abstract":"disease resulting from an interaction between multiple factors. Interferon-beta (INF-β) induces robust antiviral and immunomodulatory response to interfere with viral replication. The implication of nucleotide-binding oligomerization domain 2 (NOD2) was highlighted in many allergic diseases . Objective: The purpose of this study was to investigate the serum levels of INF-β and NOD2 single nucleotide gene polymorphism (SNP) among Egyptian asthmatic children who presented with wheezy and cough phenotypes . Methods: A group of 131 Egyptian asthmatic children (67 wheezy phenotype and 64 cough phenotype) together with 39 controls were enrolled and analyzed for the genotypes of NOD2 (rs2066845) polymorphisms using real time PCR via TaqMan assays. Serum INF-β levels were determined by ELISA technique . Results: Serum INF-β levels were significantly lower in both wheezy and cough phenotypes compared to control group (Z=1.19, p=0.233). Concerning the studied NOD2 SNP (rs2066845), both GG and GC genotypes showed significantly higher frequencies among asthmatic cases compared to healthy controls (p= 0.002, 0.021, respectively). Also, serum INF-β levels were significantly lower in both wheezy and cough asthma phenotypes with GG genotype compared to controls (p= 0.012, 0.015, respectively) of the same genotype. No significant differences were observed between the two studied asthma phenotypes regarding serum levels of INF-β, genotypes or allele frequency of NOD2 gene . Conclusion: Asthmatic children have lower levels of INF-β compared to controls, which might indicate a potential role of IFNs-based therapies for asthma. The study also provided possible evidence of the impact of rs2066845 G allele on asthma development","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49124950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Periostin Level in Children with Bronchial Asthma","authors":"M. Gabri, Ahmed A Sedik, A. Ismail, Wafaa Sayed, H. Aly, E. Zaki","doi":"10.21608/ejpa.2022.61587.1021","DOIUrl":"https://doi.org/10.21608/ejpa.2022.61587.1021","url":null,"abstract":"Children with acute or chronic systemic illness, those with upper or lower respiratory tract Background: Periostin is a systemic inflammatory biomarker secreted in large quantities from lung fibroblasts under stimulation by interleukin (IL) 13 and IL-4 activity. Several studies also suggested a relation between serum periostin level and eosinophilic inflammation in asthma. Thus, we sought to determine serum periostin level in children with bronchial asthma in correlation with asthma severity and pulmonary function tests . Methods: This controlled cross-sectional study was conducted on 50 children with bronchial asthma and 30 age-matched healthy controls who were recruited from the Children’s Hospital, Aswan University, during the period from May 2018 to April 2019. The enrolled patients were subjected to clinical evaluation, pulmonary function testing, complete blood counting, total serum immunoglobulin E (IgE) estimation, and periostin level measurement by ELISA at the time of asthma exacerbation . Results: Asthmatic cases had significantly higher serum levels of periostin (113.2 ± 56.17 ng/ml) and total IgE (408.86 ± 287.3 IU/ml) in comparison to controls (52.43 ±11.15 ng/ml) and (44.8 ±21.22 IU/ml), respectively; p <0.001. Periostin and total IgE levels were higher in severe than in mild and moderate, and in uncontrolled than well-controlled asthma cases (p <0.001). Serum periostin levels correlated positively with the total IgE, asthma severity, asthma control, and eosinophil count in the asthmatic patients, and negatively with the neutrophil count and all spirometry parameters. Serum periostin had 100 % specificity and 72 % sensitivity at a cut-off level >75 ng/ml in the diagnosis of bronchial asthma . Conclusion: Serum periostin could be a useful biomarker in diagnosing bronchial asthma in association with asthma severity .","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45386757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pediatric systemic lupus erythematosus on the health-related quality of life","authors":"E. Hossny, A. Youssef, N. Radwan, M. Al-Ashkar","doi":"10.21608/ejpa.2022.231500","DOIUrl":"https://doi.org/10.21608/ejpa.2022.231500","url":null,"abstract":"Immunology and Rheumatology Unit, Children’s Hospital, Ain Shams University, Cairo. They were subjected to HRQOL assessment using the SLE specific QOL (SLEQOL) scales which encompass 40 items comprising physical functioning, activities, symptoms, treatment, mood, and self-image. The higher the total score the worst is the HRQOL of the patient. We also used the SMILEY scoring questionnaire, which consists of 26 items for children with SLE up to 18 years of age, in assessment of the patients’ QOL . Results: The patients’ ages ranged between 12-18 years (mean ± SD = 12.2 ± 1.9 years); 57 were females and 3 were males. All domains of the SLEQOL were significantly altered in patients evaluated during disease activity. The SMILEY scores, as well, were significantly affected by disease activity and correlated positively to the total SLEQOL score results. Most of our series (59 out of 60) had lupus nephritis, 31 (51.7%) had lupus arthritis, 12 (20.0%) had lupus carditis, and 5 (8.3%) had lupus cerebritis. The SLEQOL score in patients with lupus nephritis and arthritis were comparable (142.86 ± 33.74 and 143.1 ± 33.34 respectively). The scores were worse in lupus cerebritis and carditis (158.6 ± 49.9 and152.75 ± 39.98, respectively). Conclusion: We observed a significant impact of pSLE on the HRQOL especially during disease activity. Patients with lupus cerebritis and carditis had the worst QOL status and this might be related to the physical impairment and/or intensity of immunosuppressive medications. Wider-scale prospectively designed studies would better validate our conclusions. HRQOL assessment should be implemented in the care of pSLE patients on regular basis","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47970968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}