Common Variable Immunodeficiency Mimicking Systemic-Onset Juvenile Idiopathic Arthritis: Differential Diagnosis

Primary immune deficiencies are a group of genetic disorders in which one or more components of the immune system are lacking or dysfunctional. Dysregulation in the immune response may lead to bone and joint abnormalities in patients with primary immune dificiencies, with arthritis being the most common. Common variable immunodeficiency is the most common symptomatic primary antibody deficiency syndrome. In this report, a male patient was described who presented with arhritis, intermittant fever and hepatosplenomegaly mimicking systemic onset juvenile idiopathic arthritis and finally was diagnosed with common variable immunodeficiency. This case suggested that serum immunoglobulin levels should be screened in patients with suspected juvenil idiopathic arthritis in order to rule out immunodeficiency states

Contact Dermatitis With Henna Tattoo

Allergic and irritant reactions to henna are rare, Para-phenylenediamine, which is sometimes added to obtain a dark, blackish henna, causes the majority of contact dermatitis reported related with tattoos. Allergic contact dermatitis due to temporary paint-on tattoo with black henna is described in two adolescents

The frequency of vitamin D insufficiency in healthy female adolescents

Aim: To establish the frequency and causes of vitamin D insufficiency in healthy female adolescents in Izmir, Turkey. Methods: 64 adolescents from alow-(Ikinci Inonu) and a high- (Ilica) socio-economic settlement were included. Parents' monthly income was classified as low, middle and high. The blood samples were drawn at the end of the summer and winter periods. Results: Vitamin D insufficiency percentages for the end-of-winter period were 59.4% in Ikinci Inonu and 15.6% in Ilica, and for the end of summer 25% and 15.6%, respectively. Calcidiol levels of cases from Ikinci Inonu were found to be lower compared with the levels of cases from Ilica (349/15 vs 599/24 nmol/l for end of winter, p = 0.000; 519/22 vs 659/28 nmol/l for end of summer, p = 0.03). Calcidiol levels of cases whose parental monthly income was low and whose mothers were illiterate were significantly lower than the others (489/18 vs 659/29 nmol/l for end of summer, p = 0.01; 339/16 vs 56 +/- 23 nmol/l for end of winter, p = 0.000; 45 +/- 13 vs 64 +/- 29 nmol/l for end of summer, p = 0.007; 36 +/- 17 vs 51 +/- 25 nmol/l for end of winter, p = 0.02; respectively)

The role of mean platelet volume predicting acute exacerbations of cystic fibrosis in children

Objective: The aim of this study is to evaluate the relationship between acute exacerbations and the mean platelet volume (MPV) trend in children with cystic fibrosis (CF), to predict the exacerbations. Methods: A total of 46 children with CF and 37 healthy children were enrolled in the study. White blood cell count (WBC), hemoglobin level, platelet count, mean platelet volume (MPV), and mean corpuscular volume (MCV) were retrospectively recorded. Results: Our study population consisted of 25 (54.3%) males and 21 (45.7%) females with CF and 20 (54.0%) males and 17 (46.0%) females in the healthy control group. The mean age of the CF patients was 6.32 ± 4.9 years and that of the healthy subjects was 7.02 ± 3.15 years. In the acute exacerbation period of CF, the MPV values were lower and WBC and platelet counts were higher than those in the healthy controls (P = 0.00, P = 0.00, P = 0.00, respectively). Besides, in acute exacerbation, the MPV values were lower and the WBC count was higher than the values in the non-exacerbation period (P 0= 0.01, P = 0.00, respectively). In the non-exacerbation period MPV was lower and platelet count was higher when compared to healthy subjects (P = 0.02, P = 0.04, respectively). Conclusion: This study suggests that MPV might be used as a simple, cost effective, diagnostic, predictive indicator for platelet activation in pediatric CF patients related to chronic inflammation, which might be helpful to discriminate or estimate exacerbations

A neglected problem of developing countries: Noncystic fibrosis bronchiectasis

Background:Bronchiectasis has been defined as the abnormal and permanent dilation of the bronchi. It is still an important problem in many developing countries. Aim:The aim of this study was to identify the chacteristics and underlying etiology of children followed with the diagnosis of noncystic fibrosis bronchiectasis. Materials and Methods:Children with bronchiectasis confirmed with high-resolution computed tomography were enrolled into the study. The data of the patients, including symptoms of the disease, age at the onset of symptoms, findings of physical examination, labrotory investigations performed in order to identify the etiology of bronchiectasis, etiology of bronchiectasis if found, radiologic findings and treatment modalities were noted. Results: Sixty-six children between 1 and 17 years were included in the study retrospectively. Forty-four of them were males (66.7) and 22 (33.3) were females. The most common presenting symptoms were cough (100) and sputum expectoration (50). An underlying etiology was identified in 44 (66.7) of the study subjects. The four most common underlying causes were found as infections (21.2), asthma (16.7), aspiration syndromes and/or gastroesophageal reflux disease (9.1) and immunodeficiency syndromes (7.6), respectively. Conclusion:Identifying an underlying etiology will have a significant effect on the management of noncystic fibrosis bronchiectasis. Defining the cause of bronchiectasis may also decrease its incidence, progression and complications

The determination of asthma, rhinitis, eczema, and atopy prevalence in 9-to 11-year-old children in the city of Izmir

The International Study of Asthma and Allergies in Childhood (ISAAC) phase II was designed to allow comparisons between populations in different countries and to investigate possible etiologic factors. This study was conducted to better delineate the prevalence and etiologic factors of asthma, rhinitis, and eczema in Izmir (Turkey) and to be included in the international comparisons by using a standard methodology of ISAAC phase II. The questionnaire was distributed to 2112 students in the 3rd, 4th, and 5th grades of 12 selected primary schools in urban and rural boroughs of Izmir. One thousand two hundred seventeen of these questionnaires were evaluated and physical examinations and skin-prick tests were performed on 1098 of these children. The prevalence values were 15.9% for recent wheezing and 4.8% for physician-diagnosed asthma. The prevalence of sneezing or runny or blocked nose in the past 12 months when the child did not have a cold or flu was 30%. The prevalence of physician-diagnosed allergic rhinitis was 17%. The prevalence of an itchy rash that was coming and going for at least 6 months was 7.2% and the prevalence of physician-diagnosed eczema was 4.9%. Atopic sensitization prevalence in the population was 8.8% with house-dust mite sensitization being the most frequent one. Secretion rales and sibilant -wheezing rhoncus were detected in 2.7% of children by chest auscultation. In 1.1% of children flexural dermatitis was detected. Objective tests are necessary for epidemiologic studies of the aforementioned diseases

Relation between serum IL-4, IL-13 and IFN-gamma levels and recurrence of wheezing episodes in infants with acute bronchiolitis

Lower respiratory tract infections are the most important factors among various causes which trigger wheezing in the first year of life. The factors associated with episodic wheezing in children with acute bronchiolitis are still subjects of research. Infections, environmental factors, immunologic mechanisms are sorted as etiologic risk factors of episodic wheezing. We aimed to investigate the relationship between serum interleukin (IL)-4, IL-13 and gamma-interferon (IFN-gamma) levels and recurrence of wheezing episodes in infants with acute bronchiolitis. One hundred twenty infants between 3 and 36 months with acute bronchiolitis enrolled in the study. Personal histories, clinical and laboratory data of infants were recorded. The patients were followed for a year. Venous blood samples were obtained to determine serum IL-4, IL-13, and IFN-gamma levels during acute bronchiolitis episode. The number of wheezing episodes was significantly higher in infants with a positive family history of allergy. A statistically significant correlation was determined between serum IL-13 levels of infants and number of wheezing episodes. High serum IL-13 levels and a positive history of allergy may have important roles in the recurrence of acute bronchiolitis

Effects of Ginkgo biloba on airway histology in a mouse model of chronic asthma

WOS: 000265735900011PubMed ID: 19118503Platelet-activating factor (PAF) is an inflammatory mediator involved in the pathophysiology of asthma, suggesting a therapy antagonizing its effects may play a role in the disease treatment. The aim of the study was to determine the effects of Ginkgo biloba, a PAF antagonist, on lung histology. Thirty-five BALB/c mice were divided into five groups; A, B, C, D, and the control. All mice except controls were sensitized and challenged with ovalbumin. Mice in group A (placebo) received saline; group B received G. biloba, 100 mg/kg; group C received G. biloba, 150 mg/kg; and group D received dexamethasone, 1 mg/kg via orogastric gavage for 7 consecutive days. Chronic structural changes and airway remodeling were evaluated by using light and electron microscopy in all groups. Evaluation of lung histology indicated that the number of goblet cells, mast cells, thicknesses of epithelium, and basement membrane were significantly improved in groups B and C when compared with group A. There was no statistically significant difference in thicknesses of subepithelial smooth muscle between groups A, B, and C. When doses of G. biloba were compared with each other, only the number of goblet cells was significantly lower in group C than in group B. When G. biloba and dexamethasone groups were compared with each other, thicknesses of basement membrane and subepithelial smooth muscle were found to be lower in group D than in groups B and C. G. biloba alleviates all established chronic histological changes of lung except smooth muscle thickness in a mouse model of asthma. (Allergy Asthma Proc 30:186-191, 2009; doi: 10.2500/aap.2009.30.3187

Stevens-Johnson Syndrome associated with brucella infection

Stevens-Johnson syndrome is a potentially fatal condition that manifests mainly on the skin and mucosal surfaces but also affects other vital organs. There are no report of Stevens-Johnson syndrome caused by brucella infection in the literature. In this article, a previously healthy boy, diagnosed as Stevens-Johnson syndrome associated with brucella infection, is reported