Biomedical subjects

Y C Lai

Publications and source records attributed to Y C Lai.

60 records · Page 4Linked to original sources

PubMedDate not supplied

X-linked agammaglobulinemia presenting as juvenile chronic arthritis: report of one case.

Bruton agammaglobulinemia (X-linked agammaglobulinemia, XLA), transmitted by X-linked recessive inheritance, affects only males. Twenty percent of patients with XLA may have arthritis. Septic arthritis may occur, but there is also a form of arthritis that is similar to rheumatoid arthritis or juvenile chronic arthritis. Here we report one case of XLA in a boy with non-erosive chronic right knee arthritis. There was no evidence of septic arthritis. Regular intravenous gammaglobulin replacement therapy and oral naproxen resulted in dramatic improvement in the arthritis. This case illustrates that XLA should be considered as a possible underlying cause of juvenile chronic arthritis in males.

Agammaglobulinemia↗

PubMedDate not supplied

Crisis in Gaucher disease simulating osteomyelitis: report of one case.

An 11-year-old boy with Gaucher disease developed acute bone pain of the left thigh, accompanied by fever and signs of inflammation. Initially he was treated as osteomyelitis with antibiotics. Cultures of blood and aspirate of a subperiosteal hematoma were negative for bacterial growth. Tc99m bone scan revealed relatively decreased uptake over the involved area, and the findings of magnetic resonance imaging were typical for Gaucher crisis. Although Ga 67 imaging was positive, the diagnosis of a bone pain crisis rather than an infection was made. Antibiotics were discontinued without sequelae. Differential diagnosis between Gaucher crisis and osteomyelitis is discussed.

Acute Disease↗

PubMedDate not supplied

Unilateral pulmonary vein stenosis with atrial septal defect: report of one case.

A male infant with stenosis of the left pulmonary veins and atrial septal defect is reported. He began to have repeated pulmonary infections, with poor response to medical treatment, when he was 6 months old. Localized stenosis of the left upper and lower pulmonary veins were diagnosed with cardiac catheterization at the age of 7 months. Transvenous balloon dilation was attempted, but failed. Surgical treatment with pericardial patch venoplasty of the left pulmonary veins and closure of the atrial septal defect successfully released the pulmonary venous obstruction. There has been a follow-up for more than one year, and no cardiopulmonary symptoms were reported.

Follow-Up Studies↗

PubMedDate not supplied

Bilateral internal carotid artery aneurysms with diffuse intracranial calcification: report of one case.

A 15-year-old girl with voice hoarseness and neck soreness for 4 months had a pulsating mass, sized 3 x 5 cm, adjacent to the right mastoid process. Physical examination revealed normal blood pressure recordings in 4 limbs and no stigmata of Marfan syndrome. Examination of the oral cavity showed bulging of the right pharyngeal wall medially, and the tongue deviated to the right at protrusion. Laboratory workups including complete blood counts, biochemistry, electrolytes, serological and immunological surveys revealed nothing particular. Echocardiography disclosed mild aortic dilatation. Computed tomography of the head and neck revealed bilateral carotid aneurysms with extensive intracranial calcification. The saccular aneurysm over the left internal carotid artery was resected, and end-to-end anastomosis of the left internal carotid artery was performed. The giant occluded right carotid aneurysm was left unmanaged. The combination of bilateral carotid aneurysms and intracranial calcification has not been reported. The etiologies are discussed and a causal relationship between these two conditions is postulated.

Adolescent↗

PubMedDate not supplied

Whey and casein specific IgE and the cow's milk challenge test for atopic children.

We studied 30 atopic children who suspected of milk allergy by past history (age ranging from 1 yr 4 mo to 9 yr 6 mo, mean age: 5.03 yr.) diagnosed as having asthma, atopic dermatitis and/or allergic rhinitis. These 30 atopic children had been screened from the patients at our outpatient clinic by the Pharmacia CAP system RAST FEIA. All of them showed the presence of at least Class II (greater than 0.7 ku/l) IgE specific to proteins in cow's milk. Further analysis found IgE specific to alpha-lactoalbumin (alpha-LA) elevated in 1 patient (3.3%), 1 patient (3.3%) to beta-lactoglobulin (beta-LG), 4 patients (13.3%) to alpha-LA and beta-LG, 5 patients (16.7%) to casein, 8 patients (26.7%) to casein and alpha-LA, 11 patients (36.7%) to casein, alpha-LA and beta-LG. After 3 weeks' cow-milk-free diet, the patient's milk challenge test was performed at our outpatient clinic. According to the test result, none of these 30 atopic children showed clinical evidence of significant allergic reaction to cow's milk in the skin, the gastrointestinal tract or the respiratory tract either within two hours after the challenge test or within 3 days after they went home. We therefore conclude that: (1) No single major allergen is apparent in cow's milk: casein, alpha-LA and beta-LG all show a high proportion of positive reaction. (2) Many atopic children fully tolerate cow's milk, although they have high titer of IgE antibodies specific to cow's milk. The RAST test is only the first step to screen patients with suspected IgE-mediated allergies. To make sure, any positive reaction must be confirmed by the "golden standard" for diagnosis, i.e., the double-blind placebo-controlled food challenge.

Animals↗

PubMedDate not supplied

Fish induced anaphylactic reaction: report of one case.

In the past 2 years, a 4 year-old boy has had an anaphylactic reaction whenever he contacted food prepared with fish. The symptoms included intense itching in the throat and eyes, which progressed to generalized urticaria and facial angioedema. This was accompanied by cough, wheezing and dyspnea. Many fish preparations caused these episodes including several different kinds of fish (cod, tuna, salmon, trout, eel...), fish soup, chopsticks contaminated with fish preparations and canned fish. Elevated levels of total serum IgE (224 IU/ml) and specific IgE for cod (93.1 IU/ml), tuna (> 100 IU/ml), salmon (> 100 IU/ml), trout (64.4 IU/ml), mackerel (41.2 IU/ml) and eel (28.1 IU/ml) were found by the Pharmacia CAP system RAST FEIA in our allergy clinic. A skin prick test for mixed fish extracts (contain flounder, cod and halibut) was positive. A fish challenge test for cod, tuna, salmon, trout and eel all showed anaphylactic reactions. His allergic symptoms stabilized gradually after strictly avoiding ingestion of fish and using drug treatment. He also had a similar anaphylactic reaction to frogs. The best treatment for fish allergy is avoidance. Avoidance of fish may need to include both ingestion and inhalation of cooking vapors.

Anaphylaxis↗