Distinct cytokine and chemokine profiles in autism spectrum disorders

2016-2017 > Academic research: refereed > Publication in refereed journal201804_a bcmaVersion of RecordPublishe

Membranous lupus nephritis in Chinese children - a case series and review of the literature

We retrospectively reviewed the cases of 13 lupus nephritis children with pure membranous glomerulonephritis (MGN; Group A) and ten children with mixed proliferative and membranous nephritis (Group B). The children were identified through a territory-wide survey of patients between 1990 and 2003. All were ethnic Chinese. Age at diagnosis ranged from 3.7 to 18.6 years (Group A) and from 9.6 to 22.1 years (Group B). Female-to-male ratios were 12:1 (Group A) and 9:1 (Group B). Group A patients were more often nephrotic than Group B patients (11/13 vs. 5/10, p = 0.17). The glomerular filtration rate (GFR) at presentation was normal in all but two patients (one from each group). For induction, Group B patients consistently received prednisolone and cyclophosphamide; in contrast, the cytotoxic regimens in Group A patients varied from cyclophosphamide (five patients), mycophenolate mofetil (two patients), azathiorpine plus cyclosporine (one patient), and azathioprine alone (one patient). After a median follow-up of 7.6-7.8 years, one Group A patient had died of fulminant lupus. One survivor in Group B had a GFR < 90 ml/min per 1.73 m(2). Proteinuria persisted in five Group A patients and two Group B patients. In conclusion, Group B patients had good prognosis in terms of survival and proteinuria control. The only death occurred in Group A, and five of the 12 survivors in this group had persistent proteinuria. Further studies are needed to define the best treatment for pure lupus MGN

Evaluating different imaging strategies in children after first febrile urinary tract infection

We conducted a retrospective multicenter review to estimate the prevalence of urological abnormalities in Chinese children with first febrile urinary tract infection (UTI) and to evaluate the selective imaging strategy recommended by the NICE guideline for detecting underlying abnormalities. Atypical UTI was defined as in the NICE UTI guideline. Overall, 576 boys and 244 girls aged below 24 months were reviewed. All underwent ultrasound (US) and micturating cystourethrogram (MCUG) and 612 underwent DMSA scans. US was abnormal in 73 (8.9%) and vesicoureteral reflux was shown in 195 patients (23.8%). A total of 126 patients were considered to have remediable urological abnormalities requiring additional surgical or medical interventions. The NICE guideline yielded excellent negative predictive values (NPV) of 100-94.4% in girls but 91% in boys. If all boys underwent US and DMSA and only those with atypical UTI or abnormal US or DMSA proceeded to MCUG, then the NPV increased to 95.2% and 97.4% for boys aged below and above 6 months, respectively. These revised strategies would substantially save invasive studies-DMSA and MCUG in 27 and 74% of girls aged below and above 6 months, respectively, or MCUG in 23 and 59% of boys aged below and above 6 months, respectively.link_to_subscribed_fulltex

One-year follow up of melamine-associated renal stones in Sichuan and Hong Kong

Background: An outbreak of melamine-associated renal stones occurred in mainland China in 2008, which led to large scale community screening of renal stones in Hong Kong. We hypothesised Hong Kong children screened positive did not suffer from melamine-associated renal stones. Methods: This one-year follow-up study compared the clinical features, renal ultrasound findings, and urinary interleukin 8 (IL-8) and monocyte chemoattractant protein 1 (MCP-1) to urinary creatinine ratios between 44 Sichuan children admitted to hospital for melamine-associated renal stones and 22 Hong Kong children screened positive with renal stones. Results: The mean age (±SD) in months of the Sichuan children (25.7±23.8) was significantly lower than that of Hong Kong children (75.0±42.1, p<0.0001). The melamine concentration in the milk consumed by the Sichuan children was significantly higher than that by Hong Kong children. All 44 Sichuan children and only 15 of the 22 Hong Kong children consumed melaminetainted milk product (MTMP). All except one of the 15 Hong Kong children had their daily melamineintake below the WHO tolerable daily intake of 0.2 mg melamine/Kg body weight. At diagnosis, the median number of stones and the mean largest stone size in the Sichuan children (4, 6.3 mm) were significantly higher than that in Hong Kong children (1, 3.8 mm, p<0.01). By 12 months follow-up, 28% and 48% of the Sichuan and Hong Kong children still had renal stones respectively. Urinary IL-8/creatinine ratio was significantly higher in Sichuan children with stones than other groups at 6 and 9 months followup. By 12 months follow-up, no such difference was observed among any groups. The above findings did not differ significantly whether the comparison with the Sichuan children was with the whole cohort of 22 Hong Kong children or the 15 who had consumed MTMP. In contrast, the 2 groups of Hong Kong children with and without MTMP consumption were similar in their demographics and clinical features. Conclusions: Hong Kong children had significantly different clinical features including MTMP consumption as compared to Sichuan children, suggesting Hong Kong children did not suffer from melamine-associated renal stones.link_to_subscribed_fulltex