The natural history of atopic dermatitis (AD) is variable. Generally the dermatitis disappears during the first years of life, but it is often followed by the appearance of allergic respiratory diseases (ARDs). Our aim was to establish the risk factors for developing an ARD in children with AD. We followed up for 4 years 78 children (51 boys, 27 girls) with mild (26%), moderate (48%), and severe (26%) AD (clinical score proposed by Rajka and Langeland). In all the patients IgE serum levels were checked and skin prick tests (SPTs) were performed at the first examination. The SPTs were repeated in 68 children at the end of the study. The children with severe AD had significantly higher IgE serum levels than those with mild or moderate AD. SPTs at the first observation were positive in 47% of cases, mostly in patients with severe AD, with a prevalence of food allergens, particularly in younger patients. At the second observation, SPTs were positive in 65% of cases, including 100% of children with severe AD. Inhalants were the most common allergens. An ARD appeared in 38% of all patients: in 75% of those with severe AD and in 54% of those with a positive first SPT. Allergic screening should be carried out at an early age, especially in severe AD, since SPT positivity to food allergens, associated with severe clinical AD symptoms and a high IgE serum level, identifies those children ages 0-3 years at high risk of development of ARD.

Air Pollutants↗

PubMedDate not supplied

What syndrome is this?

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Histiocytic Sarcoma↗

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Zinc affects the metabolism of thyroid hormones in children with Down's syndrome: normalization of thyroid stimulating hormone and of reversal triiodothyronine plasmic levels by dietary zinc supplementation.

Levels of circulating thyroid stimulating hormone (TSH), tetraiodothyronine (T4), 3,5,3'-triiodothyronine (T3), and 3,3',5' triiodothyronine (reversal T3 or rT3) were measured in 25 children with trisomy of chromosome 21, also known as Down's syndrome (DS), and in 14 normal children. In subjects with DS TSH levels were increased, while plasmic levels of rT3 were decreased. No alteration in T3 and T4 levels was observed. Before zinc supplementation, plasmic levels of zinc and thymulin, a zinc dependent thymic hormone, were significantly decreased in DS children. After four months of dietary supplementation with zinc sulphate, a normalization of plasmic zinc, thymulin and TSH levels was observed. Plasmic levels of rT3 significantly increased, and after zinc treatment no difference was detectable between DS children and normal children. Clinical evaluation of the health status of DS children showed that zinc supplementation decreased the incidence of infectious diseases and improved school attendance. Thus, the increased efficiency of the immune system and the normalization of some endocrine parameters by zinc supplementation suggests that zinc deficiency may play a crucial role in some of the pathological manifestations associated with the syndrome, such as infections and malfunctioning of the thyroid gland.

Adolescent↗

PubMedDate not supplied

[The adolescent celiac].

A group of 81 teenage coeliac patients were recently followed to monitor their compliance with a gluten free diet and also to correlate this with: their general wellbeing, height and weight, antigliadin and antiendomisyal antibody levels and jejunal mucosa patterns. Fifty two patients (64.1%) were on a strict gluten free diet; 18 (22.3%) admitted an occasional gluten intake; 11 (13.6%) were on a normal diet. Symptoms were more frequent in non-compliers that in compliers. There was no appreciable difference between the groups in regard to height and body-mass index, but patients on a normal diet were lighter than the others. Small bowel biopsy was performed on 18 patients with various histological findings. Antigliadin antibodies and antiendomysium antibodies were good indications of a patient's gluten free diet compliance and mucosal damage.

Adolescent↗

PubMedDate not supplied

Anti-D treatment in thrombocytopenia refractory to conventional therapies.

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Combined Modality Therapy↗

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Effective pre-emptive therapy with Ganciclovir and specific immunoglobulins for CMV infection in a bone marrow transplanted patient.

BACKGROUND: A 29-year-old man, who underwent allogeneic bone marrow transplantation (BMT) for acute non lymphoid leukemia (ANLL), presented with blood pancytopenia and mild hypoxemia on day +39, without signs of acute graft versus host disease (GVHD). METHODS AND RESULTS: Cytomegalovirus (CMV) antigens were detected on WBCs and cells from bronchoalveolar lavage by immunofluorescence (IF) with specific murine monoclonal antibodies. Prompt treatment with Ganciclovir and high titer CMV immunoglobulins was followed by disappearance of the laboratory findings of CMV infection. Therapy was well tolerated and no side effects were recorded except for hematological depression that did not reverse after withdrawal of the therapy. The patient is relatively well on day + 210. CONCLUSIONS: Detection of CMV antigenemia appears to be a valuable tool for deciding whether to start CMV therapy with potentially toxic antiviral drugs in BMT patients in early engraftment, with or without overt signs of CMV infection.

Adult↗