A single-center report of COVID-19 disease course and management in liver transplanted pediatric patients

Background In 2019, SARS-CoV-2 causing COVID-19 emerged. Severe COVID-19 symptoms may evolve by virtue of hyperactivation of the immune system. Equally, immunocompromised patients may be at increased risk to develop COVID-19. However, treatment guidelines for children following liver transplantation are elusive. Methods As a liver transplantation center, we diagnosed and followed up 10 children (male/female: 8/2) with a median age of 8.5 years (IQR: 5.2–11.0), with COVID-19 post-liver transplant between March 2019 and December 2020. COVID-19 diagnosis was based on PCR test and or florid X-ray findings compatible with COVID-19 in the absence of other cause. We retrospectively collected clinical and laboratory data from electronic patient records following written consent from patients/parents. Results Nine patients were diagnosed as definitive (PCR positive) with one patient being diagnosed as probable COVID-19. Seven patients recovered without any support whereas three were admitted for non-invasive oxygenation. Lymphopenia and/or high levels of serum IL-6 were detected in four patients. Six patients mounted anti-SARS-CoV-2 antibodies at median 30 days (IQR: 26.5–119.0) following COVID-19 diagnosis. Antibiotic therapy, favipiravir, anakinra, and IVIG were used as treatment in 4,1,1 and 2 patients, respectively. Furthermore, we kept the tacrolimus with or without everolimus but stopped MMF in 2 patients. Importantly, liver allograft function was retained in all patients. Conclusions We found that being immunocompromised did not affect disease severity nor survival. Stopping MMF yet continuing with tacrolimus was an apt treatment modality in these patients

Chilo iridescent virus (CIV) ORF 012L encodes a protein with both exonuclease and endonuclease functions

SANDALLI, Cemal/0000-0002-1298-3687WOS: 000385252100008PubMed: 27496102Chilo iridescent virus (CIV) is the type member of the genus Iridovirus within the family Iridoviridae. the virions of CIV contain a single linear dsDNA molecule that is circularly permuted and terminally redundant. the genome of CIV contains an open reading frame (ORF 012L) encoding a protein homologous to exonuclease II of Schizosaccharomyces pombe. in this study, we focused on the characterization of CIV ORF 012L. the target ORF was cloned into the pET28a vector, expressed in E. coli strain BL21 (DE3) pLysS with an N-terminal His tag and purified to homogeneity by using Ni-NTA affinity chromatography. Biochemical characterization of the purified CIV 012L confirmed that this viral protein is a functional 5'-3' exonuclease that digests 3'-biotin-labelled oligonucleotides and linear double-stranded DNA (dsDNA) molecules from their 5' termini in a highly processive manner. CIV 012L also has a potent endonuclease activity on dsDNA in vitro. in addition, CIV 012L converted supercoiled plasmid DNA (replicative form I, RFI) into the open circular form (RFII) and then open circular form into linear form (RFIII). Endonuclease activity of CIV 012L was optimal in the presence of 10 mM Mg2+ or 30 mM Mn2+ ions and at 150 mM NaCl or KCl salt concentrations. the highest endonuclease activity was obtained at pH 8, and it reached a maximum at 55 A degrees C. the CIV 012L protein showed deficiencies for both double- and single-stranded RNAs.Scientific Research Projects Unit of Karadeniz Technical UniversityKaradeniz Technical University [2008.111.004.2]This study was funded by the Scientific Research Projects Unit of Karadeniz Technical University (Project No.: 2008.111.004.2)

Recognizing immunodeficiency in children with recurrent infections: What are the predictive factors?

The aim of this study was to evaluate the children presenting with the complaint of recurrent infections and to determine the possible predictive factors foreseeing the requirement for further investigations

Poncet’s Disease: Reactive Arthritis Due to Tuberculosis

Poncet's disease (PD) is a rare aseptic form of polyarthritis occurring with active tuberculosis (TB) infection. Signs and symptoms of arthritis resolve with antituberculous treatment. Clinicians, especially in the countries of high disease burden, should be aware of PD as one of the differential diagnoses, even in patients without typical symptoms of TB. Here we report a case of migratory polyarthritis diagnosed as active pulmonary TB and Poncet's disease

Poncet's Disease: Reactive Arthritis Due to Tuberculosis

Poncet's disease (PD) is a rare aseptic form of polyarthritis occurring with active tuberculosis (TB) infection. Signs and symptoms of arthritis resolve with antituberculous treatment. Clinicians, especially in the countries of high disease burden, should be aware of PD as one of the differential diagnoses, even in patients without typical symptoms of TB. Here we report a case of migratory polyarthritis diagnosed as active pulmonary TB and Poncet's disease

Transient hypogammaglobulinemia of infancy: predictive factors for late recovery

This study evaluates the clinical/immunological features and outcomes of 91 patients with the diagnosis of transient hypogammaglobulinemia of infancy(THI). Mean age at diagnosis was 8.4 +/- 5.2 months. IgG levels normalized at 30.6 +/- 11.88 months. Sixty three patients (69.3%) resolved in their first 3 years of life and 28 patients (30.7%) thereafter. In the univariate analysis, presence of atopy, occurrence of recurrent infections (> 6/year) and hospitalization, initial low IgA and IgM levels were found to be associated with the late recovery. Patients with longer breastfeeding duration recovered earlier. Recovery time for Ig levels was found to be longer in patients who received IVIG (n= 55, 60.4%). This study confirmed that delayed resolution in THI is not rare. Frequent infections, initial low IgA and/or IgM levels and presence of atopy were found as associated factors for the late recovery. Breastfeeding should be encouraged and IVIG should be used in well selected patients

Posaconazole with Combination Salvage Treatment in Pediatric Immunocompromised Patients

Objective: Posaconazole is a recently developed wide-spectrum antifungal medication for which insufficient data is available regarding its potential pediatric use as a salvage therapy for systemic fungal infections in Turkey. The present study makes a retrospective review of the use of posaconazole as a salvage therapy

Clinical Findings of Pediatric HIV Infection in a Tertiary Center in Turkey

Background: Paediatric HIV infection is different from the adult type of disease in many ways, including transmission routes, clinical findings and treatment strategies