Histologic and Laboratory Characteristics of Symptomatic and Asymptomatic Castleman Disease in the Pediatric Population

Abstract Objectives Compare the morphologic, laboratory, and clinical features of asymptomatic and symptomatic Castleman disease in the pediatric population. Methods We reviewed clinical records and histopathology of patients with Castleman disease from 2 pediatric institutions. Results Of 39 patients with pediatric Castleman disease, 37 had unicentric disease, all classified with the hyaline vascular variant of Castleman disease, 8 of which were clinically symptomatic. These 8 patients demonstrated abnormal laboratory findings, including microcytic anemia, elevated erythrocyte sedimentation rate and C-reactive protein, and hypoalbuminemia. In addition, histopathologic evaluation showed that the 8 symptomatic cases had more hyperplastic germinal centers, fewer atrophic or regressed germinal centers, fewer mantle zones containing multiple germinal centers, reduced “onion skinning” of mantle zones, and fewer “lollipop” formations compared with the asymptomatic cases. Conclusions This series of pediatric Castleman disease showed that lymph nodes from asymptomatic patients generally demonstrated the more classic hyaline vascular histology, whereas those with symptoms could lack or have only focal classic findings. As such, reactive lymph nodes with subtle Castleman-like features should prompt clinical correlation to ensure proper diagnosis.

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Clinical and Laboratory Characteristics of COVID-19 Infection in Patients Presenting to A Tertiary Care Hospital

BioMedica ◽

10.51441/biomedica/5-497 ◽

2021 ◽

Vol 37 (3) ◽

pp. 1-17

Author(s):

Huma Batool ◽

Asifa Karamat ◽

Khalid Waheed ◽

Sohail Anwar ◽

Syed Arslan Haider ◽

...

Keyword(s):

Medical Records ◽

Clinical Symptoms ◽

Wide Spectrum ◽

Severe Disease ◽

Tertiary Care ◽

Care Hospital ◽

Laboratory Findings ◽

Male Predominance ◽

Reactive Protein ◽

Clinical Records

Background and Objective: COVID-19 disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) having a wide variety of clinical features ranging from asymptomatic carriers to respiratory failure requiring mechanical ventilation. The objective of the study was to analyze the spectrum of different symptoms, laboratory findings and complications in patients who were admitted in either COVID ward or intensive care unit (ICU) of a local hospital. Methods: A retrospective cohort study of the medical records of 100 COVID-19 disease patients with PCR detected SARS-CoV-2 infection were collected. Participant information was retrospectively obtained from the hospital medical records which included clinical records and laboratory findings. All statistical analyses were done using Statistical Package for the Social Sciences (SPSS) version 21. Results: The mean age of the patients was 50.8 ±5.86 with male predominance (79%). Most frequent co-morbidities were diabetes mellitus (42%) and hypertension (36%). Most frequent symptoms were fever (95.9%) and fatigue (95.9%) followed by dry cough (86.5%), myalgia (85.1) and shortness of breath (70%). Amongst the patients admitted, leukocyte count was 10.95 x 103, C-reactive protein (CRP) was 12.8mg/dl, ferritin was 730.8ng/ml and Lactate Dehydrogenase (LDH) was found to be 1254.7 U/l. Hepatic and renal functions were borderline deranged. Conclusion: COVID-19 disease has a wide spectrum of clinical symptoms. Patients with raised inflammatory markers have severe disease and are more likely in need of an ICU care. By carefully observing these markers may help in better management of COVID-19 disease.

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Sex Differences in an Italian Pediatric Population Covid-19 Positive

10.21203/rs.3.rs-44105/v1 ◽

2020 ◽

Author(s):

Elisabetta Straface ◽

Isabella Tarissi De Jacobis ◽

Rosa Vona ◽

Camilla Cittadini ◽

Alessandra Marchesi ◽

...

Keyword(s):

Sex Differences ◽

Pediatric Population ◽

Gastrointestinal Symptoms ◽

Serum Lactate ◽

Serum Lactate Dehydrogenase ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Males And Females ◽

Multiple Drugs

Abstract Background: Since December 2019 coronavirus disease (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children and adolescents are limited. We propose a retrospective study aimed to identify sex differences in a pediatric population with COVI-19.Methods: A pediatric population admitted with COVID-19 to Bambino Gesù Children's Hospital of Rome (Italy) in the period from March to May 2020 has been studied taking into account sex differences. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients' electronic medical records. Results: In 37 patients (19 males and 18 females) we found that: i) fever and cough were the dominant symptoms, while gastrointestinal symptoms were rare; and ii) all ages of childhood were susceptible to COVID-19. Moreover, we found that females with COVID-19 were older than males (p < 0.01); required more days of hospitalization (p < 0.04); needed of treatment with multiple drugs; and had higher serum lactate dehydrogenase values (p < 0.04) than males. Conversely, males had, although not significant, higher values of C reactive protein and erythrocyte sedimentation rate than females.Conclusions: Based on the data listed above sex differences were detected in an Italian pediatric population. Compared to the adults we found that COVID-19 infection in children is a non-severe inflammatory disease in both males and females. In any case, many detailed studies should be conducted.

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Sex differences in an Italian pediatric population COVID-19 positive

10.21203/rs.3.rs-44105/v2 ◽

2020 ◽

Author(s):

Elisabetta Straface ◽

Isabella Tarissi De Jacobis ◽

Rosa Vona ◽

Camilla Cittadini ◽

Alessandra Marchesi ◽

...

Keyword(s):

Sex Differences ◽

Electronic Medical Records ◽

Medical Records ◽

Pediatric Population ◽

Gastrointestinal Symptoms ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Males And Females ◽

Positive Population

Abstract Background: Since December 2019 coronavirus disease (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children and adolescents are limited. We propose a retrospective study aimed to evaluate clinical characteristics of children infected with SARS-CoV-2 in Italy, taking into account gender differences. Methods: A pediatric population admitted with COVID-19 to Bambino Gesù Children's Hospital of Rome (Italy) in the period from the end of February to May 2020 has been studied taking into account sex differences. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients' electronic medical records. Results: In 41 patients (21 males and 20 females) we found that: i) fever and cough were the dominant symptoms, while gastrointestinal symptoms were rare; and ii) all ages of childhood were susceptible to COVID-19. Moreover, we found that females with COVID-19, although not significantly, were older than males and required more days of hospitalization (p = 0.01). Conversely, males had, although not significantly, higher values of C reactive protein and erythrocyte sedimentation rate than females. Conclusions: Based on the data listed above, sex differences were detected in an Italian pediatric COVID-19 positive population. Compared to the adults we found that COVID-19 infection in children is a non-severe inflammatory disease in both males and females. In any case, many detailed studies should be conducted.

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Sex differences in an Italian pediatric population covid-19 positive

10.21203/rs.3.rs-44105/v3 ◽

2021 ◽

Author(s):

Elisabetta Straface ◽

Isabella Tarissi De Jacobis ◽

Rosa Vona ◽

Camilla Cittadini ◽

Alessandra Marchesi ◽

...

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Pediatric Population ◽

Gastrointestinal Symptoms ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Erythrocyte Sedimentation ◽

Males And Females ◽

Number Of Males

Abstract Background: Since December 2019 coronavirus disease (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children and adolescents are limited. We propose a retrospective study aimed to evaluate clinical characteristics of children infected with SARS-CoV-2 in Italy.Methods: A pediatric population admitted with COVID-19 to Bambino Gesù Children's Hospital of Rome (Italy) in the period from the end of February to May 2020 has been studied taking into account gender. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients' electronic medical records. Results: In 41 patients (21 males and 20 females) we found that: i) fever and cough were the dominant symptoms, while gastrointestinal symptoms were rare; and ii) all ages of childhood were susceptible to COVID-19. Moreover, we found that females with COVID-19, were significantly (p = 0.04) older than males and required more days of hospitalization (p = 0.01). Moreover, compared to females, a greater number of males had high values of C reactive protein (3 males vs 1 female) and erythrocyte sedimentation rate (2 males vs 1 female).Conclusions: Compared to the adults we found that COVID-19 infection in children is a non-severe inflammatory disease in both males and females. In any case, many detailed studies should be conducted.

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Analysis of Neurological Clinical Manifestations and Diagnostic Workups in Pediatric COVID-19: A Systematic Review

10.21203/rs.3.rs-535249/v1 ◽

2021 ◽

Author(s):

Gilbert Sterling Octavius ◽

Shally Chandra ◽

Jeremiah Hilkiah Wijaya ◽

Andry Juliansen

Keyword(s):

Systematic Review ◽

Pediatric Population ◽

Clinical Manifestations ◽

Time Correlation ◽

Neurological Manifestations ◽

Laboratory Findings ◽

Reactive Protein ◽

Diagnostic Work ◽

Work Up

Abstract Background While numerous studies report neurological manifestations of COVID-19, there are fewer reviews in the pediatric population, focusing solely on the manifestations.Aim This systematic review aims to describe the clinical manifestations and laboratory findings of pediatric patients with neurological manifestations of COVID-19.Methods We searched Pubmed, Science Direct, Medline, Scielo, Medrxiv, Research Square, SSRN, and Biorxiv with the appropriate keywords. Inclusion criteria include new-onset neurological manifestations with a time correlation to the confirmed COVID-19 with a further diagnostic work-up. We use The Joanna Briggs Institute's (JBI) essential evaluation checklist and Newcastle Ottawa Quality Assessment Scale (NOS) to evaluate the quality of the studies. The protocol for this systematic review has been registered in The international Prospective Register of Systematic Review (PROSPERO) database (CRD42021228671).Results 31 articles were ultimately chosen with 42 patients (26 male) included in this systematic review. The neurological diagnosis was mostly of the CNS classification (38/42) with a predomination of brain disorders (22/38). Most patients had lymphopenia, elevated C-reactive protein, procalcitonin, ferritin, creatinine kinase, blood urea nitrogen, D-dimer, and erythrocyte sedimentation rate. In the CNS group, CSF monocytes (55%; 11–80%), CSF polymorphonuclear (PMN) cells (15%; 0–96%), CSF red blood cells (282 cells/mm3; 2-4000 cells/mm3), and opening pressure (34.5 cm/H2O; 25–100 cm/H2O) were elevated.Conclusions Our systematic review found that neurological manifestations in COVID-19 occurred more often in males, with a majority being CNS disorders. A majority had a favorable outcome. More studies are needed in order to elucidate the viral mechanisms of SARS-CoV-2 in CSF.

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Clinical characteristics of children infected with SARS-CoV-2 in Italy

Italian Journal of Pediatrics ◽

10.1186/s13052-021-01045-0 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Isabella Tarissi De Jacobis ◽

Rosa Vona ◽

Camilla Cittadini ◽

Alessandra Marchesi ◽

Laura Cursi ◽

...

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Clinical Characteristics ◽

Pediatric Population ◽

C Reactive Protein ◽

Normal Range ◽

Laboratory Findings ◽

Reactive Protein ◽

Males And Females ◽

D Dimer

Abstract Background Since December 2019 coronavirus disease (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children and adolescents are limited. We propose a retrospective study aimed to evaluate clinical characteristics of children infected with SARS-CoV-2 in Italy. Methods A pediatric population admitted with COVID-19 to Bambino Gesù Children’s Hospital of Rome (Italy) in the period from the end of February to July 2020 has been studied. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients’ electronic medical records. Results In 66 patients (35 males and 31 females) we found that: i) fever and cough were the dominant symptoms, while vomit and convulsions were rare symptoms; and ii) all ages of childhood were susceptible to COVID-19. Furthermore, we found that, compared to females, males with COVID-19, although not significantly, had higher values of inflammatory markers such as C-reactive protein (CRP) and ESR. Conversely, we found that COVID-19 positive females were older than males and required more days of hospitalization. Both males and females COVID-19 positives had procalcitonin values within the normal range and D-Dimer values slightly higher than the normal range. With regard to this latter marker, the value measured in females, although not significant, was higher than that measured in males. Interestingly, the presence of leukopenia was found in both sexes. Conclusions Compared to the adults we found that COVID-19 infection in children is a non-severe inflammatory disease in both males and females. In any case, many detailed studies should be conducted.

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Association between IgG4-related disease and progressively transformed germinal centers of lymph nodes

Modern Pathology ◽

10.1038/modpathol.2012.54 ◽

2012 ◽

Vol 25 (7) ◽

pp. 956-967 ◽

Cited By ~ 34

Author(s):

Yasuharu Sato ◽

Dai Inoue ◽

Naoko Asano ◽

Katsuyoshi Takata ◽

Hideki Asaoku ◽

...

Keyword(s):

Lymph Nodes ◽

Germinal Centers ◽

Related Disease ◽

Igg4 Related Disease

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MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children

BMC Pediatrics ◽

10.1186/s12887-021-02765-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rafael Peñalver Penedo ◽

Marta Rupérez Lucas ◽

Luis Antonio Álvarez-Sala Walther ◽

Alicia Torregrosa Benavent ◽

María Luisa Casas Losada ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Pediatric Patients ◽

Pediatric Population ◽

Adult Population ◽

Roc Curves ◽

Renal Scintigraphy ◽

Reactive Protein ◽

Sensitivity Specificity

Abstract Background Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early detection of patients with kidney damage, avoiding other invasive tests like renal scintigraphy scans. Our objective is to study the usefulness of MR-proADM as a biomarker of acute and chronic renal parenchymal damage in fUTI within the pediatric population. Methods A prospective cohort study was conducted in pediatric patients with fUTI between January 2015 and December 2018. Plasma and urine MR-proADM levels were measured at admission in addition to other laboratory parameters. After confirmation of fUTI, renal scintigraphy scans were performed during the acute and follow-up stages. A descriptive study has been carried out and sensitivity, specificity and ROC curves for MR-proADM, C-reactive protein, and procalcitonin were calculated. Results 62 pediatric patients (34 female) were enrolled. Scintigraphy showed acute pyelonephritis in 35 patients (56.5%). Of those patients, the median of plasmatic MR-proADM (P-MR-proADM) showed no differences compared to patients without pyelonephritis. 7 patients (11.3%) developed renal scars (RS). Their median P-MR-proADM levels were 1.07 nmol/L (IQR 0.66–1.59), while in patients without RS were 0.48 nmol/L (0.43–0.63) (p < 0.01). The AUC in this case was 0.92 (95% CI 0.77–0.99). We established an optimal cut-off point at 0.66 nmol/L with sensitivity 83.3% and specificity 81.8%. Conclusion MR-ProADM has demonstrated a poor ability to diagnose pyelonephritis in pediatric patients with fUTI. However, P-MR-proADM proved to be a very reliable biomarker for RS prediction.

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False-Positive D-Dimer Result in a Patient With Castleman Disease

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-328-fdriap ◽

2004 ◽

Vol 128 (3) ◽

pp. 328-331

Author(s):

Kimberly Mugler ◽

Jerry B. Lefkowitz

Keyword(s):

Western Blot ◽

Disseminated Intravascular Coagulation ◽

False Positive ◽

Degradation Products ◽

False Negative ◽

Castleman Disease ◽

Laboratory Findings ◽

Intravascular Coagulation ◽

Immunodeficiency Virus ◽

D Dimer

Abstract In suspected cases of disseminated intravascular coagulation, concurrent elevation of both fibrin(ogen) degradation products (FDPs) and D-dimer levels aids in confirming the diagnosis. This pattern of results reflects the action of plasmin proteolysis of cross-linked fibrin polymers as well as fibrinogen. We report the case of a patient with human immunodeficiency virus (HIV) and Castleman disease who presented with a high-positive D-dimer level and a negative FDP level in the course of a workup for disseminated intravascular coagulation. This finding suggested the possibility of either a false-positive D-dimer or a false-negative FDP level. To investigate the former, a Western blot was performed on the patient's serum to determine the presence of the D-dimer. No D-dimer band was visualized on the Western blot, confirming the false-positive nature of the D-dimer result. Insufficient quantity of patient serum, however, prevented further investigation into the etiology of this result. The false-positive D-dimer result is likely attributable to interference caused by the patient's Castleman disease–associated monoclonal gammopathy, a phenomenon that has been reported in other immunoassays. As the development of lymphoproliferative disorders is especially common within the HIV population, and hypergammaglobulinemia in Castleman disease is particularly common, clinicians should be aware of this phenomenon when the laboratory findings do not fit the clinical picture. Although it is rare, recognition of potential paraprotein interference in immunoassays will help avoid undertreatment or overtreatment of patients based on erroneous laboratory results.

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THE EFFECT OF LYMPHOCYTOSIS INDUCED WITH EMBRYONIC EXTRACT ON THE COURSE OF EXPERIMENTAL TUBERCULOSIS IN RABBITS

Journal of Experimental Medicine ◽

10.1084/jem.56.2.173 ◽

1932 ◽

Vol 56 (2) ◽

pp. 173-183 ◽

Cited By ~ 3

Author(s):

Kenneth C. Smithburn

Keyword(s):

Chick Embryo ◽

Lymph Nodes ◽

Blood Cells ◽

Lymphoid Hyperplasia ◽

Germinal Centers ◽

Experimental Tuberculosis ◽

Embryo Extract ◽

Chick Embryo Extract ◽

Tuberculosis In Children ◽

Immature Cells

1. Chick embryo extract given intravenously did not favorably influence the course of experimental tuberculosis in rabbits, although it did cause lymphocytosis and lymphoid hyperplasia. 2. The tuberculous animals treated with chick embryo extract showed lower values for hemoglobin and red blood cells than tuberculous controls inoculated from the same suspension. 3. Under the conditions of these experiments an increase in the number of young, immature cells in the lymph nodes was accompanied by more extensive tuberculous lesions in the lymph nodes and especially in the germinal centers of the nodes. A possible analogy to lymphatic tuberculosis in children is suggested. 4. The observations of previous investigators on the progression and later regression of lesions in experimental tuberculosis have been confirmed. The distribution, character, and extent of lesions have been studied and are presented in tabular form. 5. The presence and significance of tuberculous thrombi in the lungs are discussed.

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