Development of Hypersensitivity Reactions after Using Different Oral Iron Preparations

Gastrointestinal side effects after using oral iron preparations have been usually observed, but skin reactions and allergic angioedema due to hypersensitivity have been rarely reported in the literature. We delineated 4 patients who were referred to us and who had shown hypersensitivity reactions following oral iron use, and their response to alternate oral iron preparations was evaluated. Initially prick and intradermal skin tests, and then oral provocations, were algorithmically performed in 4 patients to diagnose allergy to oral iron salts. Two of 4 cases showed hypersensitivity reactions after oral provocation. We were able to prevent the possible allergic reaction, which probably depends on IgE-mediated hypersensitivity, by simply changing the initial oral iron preparation to alternate one

The Comparison of The Efficacy and Safety of Original and Biosimilar Filgrastim in Prevention of Chemotherapy-Induced Neutropenia in Children with Cancer

Conclusion: The biosimilar filgrastim, Leucostim, is as effective and safe as the original drug for prophylaxis of chemotherapy-induced neutropenia in children

Assessment of Humoral Immunity to Hepatitis B, Measles, Rubella, and Mumps in Children After Chemotherapy

Background:Cancer survival rates and longevity of patients after therapy have significantly improved during the last few decades. Therefore, lasting protection against infections should be provided.Procedure:A total of 162 children diagnosed with acute lymphoblastic leukemia, acute myelogenous leukemia, solid tumors, non-Hodgkin lymphoma, and Hodgkin lymphoma were enrolled in the study. Antibody levels against hepatitis B virus was assessed both at the time of diagnosis and within 6 months after completion of chemotherapy. However, measles, mumps, and rubella (MMR) antibodies levels were measured just within 6 months after completion of chemotherapy.Results:Anti-HBs antibody titers had decreased below the protective level after treatment in 25 of 96 patients having protective antibody levels for hepatitis B virus before therapy. In 66 patients without pretreatment protective levels of antibody, in spite of the immunization during chemotherapy, only 6 of them were found to be anti-HBS positive after treatment. In 153 patients previously vaccinated with MMR, 19 had protective antibody titers after treatment. MMR seropositivities were negatively correlated to age as expected.Conclusions:Our data demonstrate that a significant number of children lose preexisting humoral immunity against MMR and hepatitis B after completion of chemotherapy

Platelet function alterations and their relation to P-selectin (CD62P) expression in children with iron deficiency anemia

Iron deficiency anemia (IDA) may cause platelet aggregation dysfunction and this can be reversed by iron therapy. On the other hand, it has been reported that the platelet fractions carrying the platelet activation markers, CD62P and CD63, are increased in thalassemic patients and there is a significant correlation between the increased levels of soluble P-selectin and free iron in sickle cell disease. This study was performed to investigate the alterations of platelet functions and whether iron deficiency results in diminished expression of activation marker (P-selectin; CD62P) leading to platelet aggregation dysfunction in children with IDA. Hemoglobin, erythrocyte indices (mean erythrocyte volume and red blood cell distribution width), serum levels of iron, transferrin and ferritin, platelet aggregation tests (with ADP, collagen, and ristocetin), PFA-100 closure time, and CD62P expression were evaluated in fasting blood samples of 22 children with IDA and 20 children without anemia. CD62P expression was detected by flow cytometry in normal and 5 mu mol/l ADP-activated platelets. Mean closure times were longer in the patient group than control. In platelet aggregation tests, mean values of maximum aggregation times by ristocetin, ADP, and collagen were also more prolonged in patient group. Ristocetin-induced maximum aggregation rates (amplitude) were significantly higher in patients. However, ADP and collagen induction did not produce the same effect. CD62P expressions were significantly higher on activated platelets of the patient group, although they were similar in both groups before activation by ADP. These findings suggest that platelet aggregation and adhesion have been delayed in children with IDA; however, platelet function abnormalities are not associated with CD62P expression on platelet surface. Blood Coagul Fibrinolysis 22:98-101 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

Seven Patients With Transcobalamin Deficiency Diagnosed Between 2010 and 2014: A Single-Center Experience

Transcobalamin deficiency (OMIM 275350) is a rare autosomal recessive disease presenting with nonspecific clinical features in early infancy. We report the clinical and laboratory manifestations of 7 children diagnosed with transcobalamin deficiency. All patients were admitted between 2 and 4 months of age with anemia, thrombocytopenia, and hyperhomocysteinemia. The most common complaints at admission were pallor, weakness, and poor feeding. Genetic analysis was performed in 5 patients and it revealed the same homozygous mutation. We initially treated all patients with intramuscular injections of a maximum of 1 mg cyanocobalamin (CN-Cbl) daily and with a final dose of 1mg per week. Hemoglobin and platelet counts significantly decreased upon decrease or cessation of CN-Cbl therapy. The patients were reevaluated between 2 and 4 years of age and all had delay in speech and walking. In conclusion, 1 mg of intramuscular CN-Cbl every week suffices for hematological improvement but not for normal neurological development in patients who all had relapse due to decrease or cessation of treatment

Nutritional Status of Children with Cancer: A Single Center Experience

DISCUSSION AND CONCLUSION: Nutritional deficiency in children with cancer at the time of diagnosis is not much more than in children hospitalized due to acute infection. However, a temporary weight loss is observed in cancer patients during the follow up

The Seroprevalence of Hand-Foot-Mouth Disease in Preschool Children

Hand-foot-mouth disease (HFMD) is a systemic and mostly uncomplicated infectious disease caused by the virus of the enterovirus family and manifests as skin and mucosal lesions. Enterovirus 71 (EV71) and coxsackievirus A16 (CA16) are the most commonly detected infectious agents. It is generally observed in children under 5 years of age. In this study, our objective was to determine the seroprevalence of HFMD in preschool children in Sakarya region. A total of 380 children between 1 and 6 years of age were included in the study. Sociodemographic information, clinical findings, and possible risk factors were recorded on a data collection form. Later, serum anti-EV71 and anti-CA16 IgG (immunoglobulin G) antibodies were measured by ELISA. Amongst the 380 children, EV71 IgG positivity was 57.9% and CA16 IgG antibody positivity was 57.4%. There was no difference in seroprevalence between the genders (p > 0.05). Anti-EV71 and anti-CA16 IgG antibody positivity was significantly higher in children aged 1, 2, 3, and 4 years than in 5-year olds (p 50%) was observed in the preschool period in the Sakarya region, especially in children aged 1 to 4 years. To prevent infections for which there is no specific treatment, it is very important that the hygiene rules are complied with; in particular, children and their caregivers should pay attention to hand cleansing. We believe that more seroprevalence studies should be performed from different regions to show the status of the disease in our country