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Novel marker fever in children

Megan E Mignemi, Michael A Benvenuti, Thomas J An, Jeffrey E Martus, Gregory A Mencio, Stephen A Lovejoy, Lawson A Copley, Derek J Williams, Isaac P Thomsen, Jonathan G Schoenecker
BACKGROUND: Musculoskeletal infections (MSKIs) are a common cause of pediatric hospitalization. Children affected by MSKI have highly variable hospital courses, which seem to depend on infection severity. Early stratification of infection severity would therefore help to maximize resource utilization and improve patient care. Currently, MSKIs are classified according to primary diagnoses such as osteomyelitis, pyomyositis, etc. These diagnoses, however, do not often occur in isolation and may differ widely in severity...
June 13, 2016: Journal of Pediatric Orthopedics
Cyril Badaut, Léa Guyonnet, Jacqueline Milet, Emmanuelle Renard, Rémy Durand, Firmine Viwami, Gratien Sagbo, Francis Layla, Philippe Deloron, Serge Bonnefoy, Florence Migot-Nabias
BACKGROUND: The three members of the ring-infected erythrocyte surface antigen (RESA) proteins family share high sequence homologies, which impair the detection and assignment to one or another protein of some pathogenic processes inherent to Plasmodium falciparum malaria. The present study was intended to determine if the antibody and inflammatory responses of children living in a malaria-endemic area varied depending on the RESA-1, RESA-2 or RESA-3 proteins and the severity of the disease, two groups of severe and uncomplicated malaria cases being considered...
2015: Malaria Journal
Sarra Benmiloud, Sana Chaouki, Samir Atmani, Moustapha Hida
Multicentric Castleman's disease is a rare benign and unexplained lymphoproliferative disorder that is extremely uncommon in children. It presents with fever, systemic symptoms, generalized lymphadenopathy, and laboratory markers of inflammation. Its treatment is not standardized and its prognosis is poor. We report a novel case of multicentric Castleman's disease in a 13-year-old girl who had presented with chronic diarrhea as the only initial presenting symptom. The diagnosis of celiac or inflammatory bowel diseases was suspected, but two and a half years later, the diagnosis of multicentric Castleman's disease was brought following the appearance of abdominal mass whose biopsy revealed Castleman's disease in the plasma cell form...
2015: Case Reports in Pediatrics
Ying-Ju Lin, Jeng-Sheng Chang, Xiang Liu, Hsinyi Tsang, Ting-Hsu Lin, Chiu-Chu Liao, Shao-Mei Huang, Wen-Kuei Chien, Jin-Hua Chen, Jer-Yuarn Wu, Chien-Hsiun Chen, Li-Ching Chang, Cheng-Wen Lin, Tsung-Jung Ho, Fuu-Jen Tsai
BACKGROUND: Patients with Kawasaki disease (KD), a pediatric systemic vasculitis, may develop coronary artery aneurysm (CAA) as a complication. To investigate the role of glutamate receptors in KD and its CAA development, we performed genetic association studies. METHODS AND RESULTS: We examined the whole family of glutamate receptors by genetic association studies in a Taiwanese cohort of 262 KD patients. We identified glutamate receptor ionotropic, kainate 1 (GRIK1) as a novel susceptibility locus associated with CAA formation in KD...
2014: Cell & Bioscience
A Wrotek, T Jackowska, K Pawlik
Enhanced level of soluble urokinase plasminogen activator receptor (suPAR) level has been associated with activation of the immune system. It may be a novel biomarker for pneumonia severity, yet data on this subject are limited. In the present study we seek to determine the suPAR level in hospitalized children with community-acquired pneumonia (CAP), its correlation with pneumonia severity, and to compare the suPAR level between pneumonia and healthy conditions. The study encompassed a total of 596 children: 447 with pneumonia and 119 healthy...
2015: Advances in Experimental Medicine and Biology
Yujie Liu, Liping Zou, Yan Meng, Ying Zhang, Xiuyu Shi, Jun Ju, Guang Yang, Linyan Hu, Xiaoqiao Chen
OBJECTIVE: The authors sought to investigate the clinical features and characteristics of genetic mutation in patients with aspartylglucosaminuria. METHOD: Clinical data of two pediatric siblings in a family were analyzed retrospectively and relative literature was reviewed in order to study the clinical features, imaging and enzymatic characteristics and genetic mutations. RESULT: Case 1, the proband, male, he was hospitalized at 20 months of age because of fever and hepatosplenomegaly for nine days...
June 2014: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Y Itoh, T Imai, O Fujino, T Igarashi, Y Fukunaga
Abstract Although Sjögren's syndrome (SS) is quite rare among children, subclinical conditions without any sicca symptoms have been reported. This condition is characterized by nonspecific rheumatic symptoms and histopathological findings in salivary glands which are equivalent to SS. Many children with subclinical SS are positive for anti-Ro/SSA. On the other hand, autoimmune fatigue syndrome (AIFS) is characterized by chronic nonspecific complaints and positive antinuclear antibodies, with or without fulfilling the criteria for chronic fatigue syndrome...
September 2002: Modern Rheumatology
Travis J Menge, Heather A Cole, Megan E Mignemi, William C Corn, Jeffrey E Martus, Steven A Lovejoy, Christopher M Stutz, Gregory A Mencio, Jonathan G Schoenecker
BACKGROUND: In a recent study designed to determine the anatomic location of infection in children presenting with acute hip pain, fever, and elevated inflammatory markers, we demonstrated the incidence of infection of the musculature surrounding the hip to be greater than twice that of septic arthritis. Importantly, the obturator musculature was infected in >60% of cases. Situated deep in the pelvis, surrounding the obturator foramen, debridement of these muscles and placement of a drain traditionally requires an extensive ilioinguinal or Pfannenstiel approach, placing significant risk to the surrounding neurovascular structures...
April 2014: Journal of Pediatric Orthopedics
Xiang-Shi Wang, Jie-Hao Cai, Wei-Lei Yao, Yan-Ling Ge, Qi-Rong Zhu, Mei Zeng
OBJECTIVE: To investigate the epidemiological features, genetic drift in the epitopes of hemagglutinin (HA) of the novel influenza A (H1N1) virus and oseltamivir-resistant variants characterized by H275Y and N295S mutations in children in Shanghai since the outbreak. METHOD: Between June 2009 and May 2012, a prospective surveillance study was carried out in Shanghainese children who attended the outpatient clinic of Children's Hospital of Fudan University for influenza-like illness...
May 2013: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Zehra Karataş, Tamer Baysal, Fatih Şap, Hayrullah Alp, Idris Mehmetoğlu
INTRODUCTION: Ischaemia-modified albumin, a novel biochemical marker for tissue ischaemia, was found to be associated with oxidative stress. The purpose of this study was to assess the role of ischaemia-modified albumin in the diagnosis of acute rheumatic fever and also to evaluate the ischaemia-modified albumin levels in children with heart valve disease. METHODS: The study groups, aged 5-18 years, consisted of 128 individuals - 40 with acute rheumatic fever, 35 with congenital heart valve disease, 33 with chronic rheumatic heart disease, and 20 healthy control subjects...
June 2014: Cardiology in the Young
Hector R Wong, Natalie Z Cvijanovich, Mark Hall, Geoffrey L Allen, Neal J Thomas, Robert J Freishtat, Nick Anas, Keith Meyer, Paul A Checchia, Richard Lin, Michael T Bigham, Anita Sen, Jeffrey Nowak, Michael Quasney, Jared W Henricksen, Arun Chopra, Sharon Banschbach, Eileen Beckman, Kelli Harmon, Patrick Lahni, Thomas P Shanley
INTRODUCTION: Differentiating between sterile inflammation and bacterial infection in critically ill patients with fever and other signs of the systemic inflammatory response syndrome (SIRS) remains a clinical challenge. The objective of our study was to mine an existing genome-wide expression database for the discovery of candidate diagnostic biomarkers to predict the presence of bacterial infection in critically ill children. METHODS: Genome-wide expression data were compared between patients with SIRS having negative bacterial cultures (n = 21) and patients with sepsis having positive bacterial cultures (n = 60)...
2012: Critical Care: the Official Journal of the Critical Care Forum
Aspasia Katragkou, Emmanuel Roilides
PURPOSE OF REVIEW: Invasive fungal infections are an escalating problem in paediatrics. The purpose of this review is to update the recent evidence on antifungal treatment options as well as to provide an outline of best practices in treating children. RECENT FINDINGS: Candida and Aspergillus species are the leading causes of invasive fungal infections in paediatric patients. Invasive fungal infections are associated with significant morbidity and mortality and preemptive antifungal therapy has been found to improve survival...
June 2011: Current Opinion in Infectious Diseases
Jasmin B Kuemmerle-Deschner, Pascal N Tyrrell, Ina Koetter, Helmut Wittkowski, Anja Bialkowski, Nicolai Tzaribachev, Peter Lohse, Assen Koitchev, Christoph Deuter, Dirk Foell, Susanne M Benseler
OBJECTIVE: Muckle-Wells syndrome (MWS) is an inherited autoinflammatory disease caused by mutations in the NLRP3 gene that result in excessive interleukin-1 (IL-1) release. It is characterized by severe fevers, rashes, arthralgia, and conjunctivitis, leading to sensorineural deafness and amyloidosis. The recombinant IL-1 receptor antagonist anakinra blocks the biologic activity of IL-1. The aim of this study was to determine the short- and long-term efficacy and safety of anakinra therapy in children and adults with severe MWS...
March 2011: Arthritis and Rheumatism
Tilmann Kallinich, Helmut Wittkowski, Rolf Keitzer, Johannes Roth, Dirk Foell
OBJECTIVE: Familial Mediterranean fever (FMF) is characterised by recurrent periodic febrile attacks and persistent subclinical inflammation. The damage-associated molecular pattern (DAMP) protein S100A12 has proven to be a sensitive marker for disease activity and inflammation in numerous inflammatory disorders. The aim of this study was to analyse the role of S100A12 in the detection of inflammation in patients with FMF. METHODS: 52 children and adolescents with a clinical and/or genetic diagnosis of FMF were prospectively followed-up over 18 months (in total 196 visits)...
April 2010: Annals of the Rheumatic Diseases
L J Schlapbach, C Aebi, A G Hansen, A Hirt, J C Jensenius, R A Ammann
H-ficolin (Hakata antigen, ficolin-3) activates the lectin pathway of complement similar to mannose-binding lectin. However, its impact on susceptibility to infection is currently unknown. This study investigated whether the serum concentration of H-ficolin at diagnosis is associated with fever and neutropenia (FN) in paediatric cancer patients. H-ficolin was measured by time-resolved immunofluorometric assay in serum taken at cancer diagnosis from 94 children treated with chemotherapy. The association of FN episodes with H-ficolin serum concentration was analysed by multivariate Poisson regression...
July 2009: Clinical and Experimental Immunology
Michael Frosch, Martina Ahlmann, Thomas Vogl, Helmut Wittkowski, Nico Wulffraat, Dirk Foell, Johannes Roth
OBJECTIVE: Fever of unknown origin is a diagnostic challenge in children, especially for differentiation of systemic-onset juvenile idiopathic arthritis (systemic-onset JIA) and infectious diseases. We undertook this study to analyze the relevance of myeloid-related proteins (MRPs) 8 and 14, endogenous activators of Toll-like receptor 4, in diagnosis and pathogenesis of systemic-onset JIA. METHODS: Serum concentrations of MRP-8/MRP-14 were analyzed in 60 patients with systemic-onset JIA, 85 patients with systemic infections, 40 patients with acute lymphoblastic leukemia, 5 patients with acute myeloblastic leukemia, 18 patients with neonatal-onset multisystem inflammatory disease (NOMID), and 50 healthy controls...
March 2009: Arthritis and Rheumatism
Helmut Wittkowski, Michael Frosch, Nico Wulffraat, Raphaela Goldbach-Mansky, Tilmann Kallinich, Jasmin Kuemmerle-Deschner, Michael C Frühwald, Sandra Dassmann, Tuyet-Hang Pham, Johannes Roth, Dirk Foell
OBJECTIVE: Fever of unknown origin (FUO) in children presents a diagnostic challenge. The differential diagnosis includes systemic-onset juvenile idiopathic arthritis (JIA), an autoinflammatory syndrome associated with activation of phagocytic cells that, at presentation, is difficult to differentiate from severe systemic infections. The aim of this study was to investigate whether serum concentrations of the phagocytic proinflammatory protein S100A12 may help in deciding whether to treat patients with FUO with antibiotics or immunosuppressive agents...
December 2008: Arthritis and Rheumatism
Brahm Goldstein, Brett Giroir, Adrienne Randolph
OBJECTIVE: Although general definitions of the sepsis continuum have been published for adults, no such work has been done for the pediatric population. Physiologic and laboratory variables used to define the systemic inflammatory response syndrome (SIRS) and organ dysfunction require modification for the developmental stages of children. An international panel of 20 experts in sepsis and clinical research from five countries (Canada, France, Netherlands, United Kingdom, and United States) was convened to modify the published adult consensus definitions of infection, sepsis, severe sepsis, septic shock, and organ dysfunction for children...
January 2005: Pediatric Critical Care Medicine
B J Bloom, L B Tucker, L C Miller, J G Schaller
OBJECTIVE: To study the prevalence of coagulation abnormalities in children with systemic juvenile rheumatoid arthritis (JRA) using a sensitive marker of fibrin degradation, and to determine whether serial levels of this variable parallel disease activity or predict response to medications in this disease. METHODS: Levels of d-dimer were determined in 24 consecutive patients with systemic JRA in conjunction with complete blood counts, erythrocyte sedimentation rate, maximum fever, duration of morning stiffness, and swollen joint count...
August 1998: Journal of Rheumatology
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