scholarly journals Serology confirms SARS-CoV-2 infection in PCR-negative children presenting with Paediatric Inflammatory Multi-System Syndrome

2020 ◽  
Author(s):  
Marisol Perez-Toledo ◽  
Sian E. Faustini ◽  
Sian E. Jossi ◽  
Adrian M. Shields ◽  
Hari Krishnan Kanthimathinathan ◽  
...  
Keyword(s):  
Late Complication ◽  
Elisa Test ◽  
Case Definition ◽  
Spike Glycoprotein ◽  
Igg Antibody ◽  
Immune Mediated ◽  
Patient Groups ◽  
Igg Isotypes ◽  
Age Range ◽  
Inflammatory Syndrome

BackgroundDuring the COVID-19 outbreak, reports have surfaced of children who present with features of a multisystem inflammatory syndrome with overlapping features of Kawasaki disease and toxic shock syndrome – Paediatric Inflammatory Multisystem Syndrome-temporally associated with SARS-CoV-2 pandemic (PIMS-TS). Initial reports find that many of the children are PCR-negative for SARS-CoV-2, so it is difficult to confirm whether this syndrome is a late complication of viral infection in an age group largely spared the worst consequences of this infection, or if this syndrome reflects enhanced surveillance.MethodsChildren hospitalised for symptoms consistent with PIMS-TS between 28 April and 8 May 2020, and who were PCR-negative for SARS-CoV-2, were tested for antibodies to viral spike glycoprotein using an ELISA test.ResultsEight patients (age range 7–14 years, 63% male) fulfilled case-definition for PIMS-TS during the study period. Six of the eight patients required admission to intensive care. All patients exhibited significant IgG and IgA responses to viral spike glycoprotein. Further assessment showed that the IgG isotypes detected in children with PIMS-TS were of the IgGl and lgG3 subclasses, a distribution similar to that observed in samples from hospitalised adult COVID-19 patients. In contrast, lgG2 and lgG4 were not detected in children or adults. IgM was not detected in children, which contrasts with adult hospitalised adult COVID-19 patients of whom all had positive IgM responses.ConclusionsStrong IgG antibody responses can be detected in PCR-negative children with PIMS-TS. The low detection rate of IgM in these patients is consistent with infection having occurred weeks previously and that the syndrome onset occurs well after the control of SARS-CoV-2 viral load. This implies that the disease is largely immune-mediated. Lastly, this indicates that serology can be an appropriate diagnostic tool in select patient groups.

scholarly journals A 6-Year-Old Boy with COVID-19-Positive Pleural Effusion and Kawasaki-Like Features

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Sedigheh Yousefzadegan ◽  
Ramin Zare Mahmoudabadi ◽  
Golnaz Gharehbaghi
Keyword(s):  
Pleural Fluid ◽  
Signs And Symptoms ◽  
Elisa Test ◽  
The Novel ◽  
Pleural Effusions ◽  
Rt Pcr ◽  
Igg Antibody ◽  
Antibody Elisa ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome

The ongoing outbreak of the novel coronavirus (SARS-CoV-2) has exposed many pediatric patients from around the world to coronavirus disease. Although pleural effusions are classified as atypical features of COVID-19 infection, we report a 6-year-old boy who had a positive IgG antibody ELISA test for COVID-19 and presented with respiratory distress, bilateral pleural effusions, and signs and symptoms of multisystem inflammatory syndrome. The RT-PCR test of the pleural fluid specimen was positive for novel coronavirus. To our knowledge, this is the first pediatric report of a COVID-19-positive pleural fluid.

Clinical case definition and manifestations of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome

AIDS ◽  
2009 ◽  
Vol 23 (18) ◽  
pp. 2467-2471 ◽  
Author(s):  
Weerawat Manosuthi ◽  
Hong Van Tieu ◽  
Wiroj Mankatitham ◽  
Aroon Lueangniyomkul ◽  
Jintanat Ananworanich ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Clinical Case ◽  
Case Definition ◽  
Inflammatory Syndrome ◽  
Clinical Case Definition

Focal myositis

Neurology ◽  
2018 ◽  
Vol 90 (12) ◽  
pp. e1013-e1020 ◽  
Author(s):  
Laure Gallay ◽  
Arnaud Hot ◽  
Philippe Petiot ◽  
Françoise Thivolet-Bejui ◽  
Delphine Maucort-Boulch ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Cohort Study ◽  
Inflammatory Disease ◽  
Immunosuppressive Drugs ◽  
Serum Creatine Kinase ◽  
Immune Mediated ◽  
Pathologic Features ◽  
Antibody Positivity ◽  
Male Patients ◽  
Inflammatory Syndrome

ObjectiveTo better define in a cohort study the clinical and pathologic features of focal myositis (FM).MethodsWith the use of the usual clinicopathologic definition, each confirmed case of FM in the Lyon University Hospital's myopathologic database between 2000 and 2016 was retrieved. Clinical, pathologic, imaging, serologic, and therapeutic data were collected. When data were missing but feasible, appropriate pathologic analyses were performed.ResultsOf the 924 patients included in the database, 37 (4%) had confirmed FM (14 female, 23 male patients). The main symptoms were pain (n = 30, 81%), muscular mass (n = 16, 43%), erythema at the site of FM (n = 12, 32%), and fever (n = 9, 24%). Serum creatine kinase was normal in most patients (81%); serum immune abnormalities were frequent (inflammatory syndrome in sera [39%], dysglobulinemia [52%], and anti-nuclear antibody positivity [29%]). In addition to confirming previously reported findings, pathologic analyses found significant rates of vasculitis (68%) and fasciitis (73%). Here, FM appeared frequently to be associated with other diseases such as immune-mediated inflammatory disease (IMID; 32%), neoplasia (24%), and radiculopathy (11%). Regarding outcomes, 64% of the cases had received immunosuppressive drugs, and the relapse rate was 41%.ConclusionThe present study suggests that FM is not as innocuous as previously believed, particularly considering the associated disorders. Notably, patients with FM should receive careful IMID and neoplasia screening.

scholarly journals Treatment of recalcitrant orbital inflammatory syndrome with plasmapheresis therapy

2020 ◽  
Vol 13 (1) ◽  
pp. e232379
Author(s):  
Yasaira Rodriguez Torres ◽  
Fereshteh Azad ◽  
Xihui Lin
Keyword(s):  
Case Report ◽  
Significant Role ◽  
Therapeutic Response ◽  
Immunosuppressive Agents ◽  
Significant Proportion ◽  
Idiopathic Orbital Inflammation ◽  
Immune Mediated ◽  
Neurological Conditions ◽  
Inflammatory Syndrome ◽  
Management Challenge

Refractory idiopathic orbital inflammation (IOI) represents a management challenge due to its significant proportion of treatment failures. Currently, there are no established guidelines for recalcitrant IOI and majority of immunosuppressive agents have resulted in variable outcomes. Advancements of plasmapheresis therapy can play a significant role in ophthalmological diseases. This treatment has shown to produce a satisfactory therapeutic response in immune-mediated neurological conditions. In this case report, we share our successful experience with the use of plasmapheresis therapy in a patient with recalcitrant IOI.

Vitamin D levels in patients with childhood cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e20000-e20000
Author(s):  
Nurdan Tacyildiz ◽  
Gulsah oktay Tanyildiz ◽  
Deniz Tekin ◽  
Can Ates ◽  
Handan Dincaslan ◽  
...  
Keyword(s):  
Vitamin D ◽  
Inverse Correlation ◽  
Control Group ◽  
Healthy Children ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Patient Groups ◽  
Cell Growth And Differentiation ◽  
Age Range ◽  
Nonparametric Correlation

e20000 Background: There is increasing interest in the possible association between cancer incidence and vitamin D through its role as a regulator of cell growth and differentiation. Although there are several studies related cancer risk and prognosis of cancer, related vit D levels in adult patients there are only few recent studies in pediatric patients. Methods: Between 2010 and 2011, D Vit levels of 45 patients (25 boys, 20 girls; age range: 6 months-17 years, median: 11 years) have been compared to D Vit levels of 22 healthy children with similar age group. Patient groups were leukemias, lymphomas, bone tumors, retinoblastoma (RB), and other tumors. Kruskal-Wallis and Spearman nonparametric correlations test of SPSS has been used for statistics. Results: Although there was no statistically significant difference for vit D levels between control group (range: 7.2-22.8; median: 14.75 ng/ml) and patients (range: 5.5-40.2; median: 16.0 ng/ml),difference between patients groups were significant (Table). Patients with RB have statistically lower level of Vit D than leukemia (p:0.016) and lymphoma groups ( p: 0.047). “Other tumors group” has lower vit D levels than leukemia group (p: 0.024). Since RB and other tumors group have younger age than other patients, Spearsman’s nonparametric correlation has been performed to exclude age effect on the results and no statistically significant correlation between D vit levels and age (p: 0.779) was found, although there was an inverse correlation between age and vit D levels in patient group (p: 0.03). Conclusions: According to our preliminary results, most of the patients and healthy children have low level of Vit D. Especially patients with RB have statistically significant lower level of Vit D than other malignancies which can be subject to future studies for confirmation of our results. In addition, etiologic studies related RB may have a new area. [Table: see text]

scholarly journals Immune complexes can trigger specific, T cell-dependent, autoanti-IgG antibody production in mice.

1985 ◽  
Vol 161 (1) ◽  
pp. 242-256 ◽  
Author(s):  
D A Nemazee
Keyword(s):  
Rheumatoid Factor ◽  
Antibody Production ◽  
Immune Complexes ◽  
B Lymphocyte ◽  
Active Form ◽  
Igg Antibody ◽  
Factor Production ◽  
Igg Isotypes ◽  
Igg2a Response

Immunization of mice with a combination of passively administered syngeneic IgG (anti-p-azophenylarsonate [anti-Ars]) antibody and a soluble, multivalent form of the antibody's corresponding antigen (Limulus polyphemus hemocyanin conjugated with Ars [Lph-Ars]) resulted in specific autoanti-IgG Fc (rheumatoid factor) production. The response was rapid and only anti-IgG of the IgM isotype is found. Because immunization with either the IgG antibody or the antigen alone did not result in rheumatoid antibody production, immune complexes appear to be the active form of the immunogens. Antibody/antigen ratios that resulted in maximal anti-IgG antibody responses were the same as those required for peak in vitro immunoprecipitation, i.e., equivalence. Previous exposure of the mice to the exogenously supplied antigen was not required for the response. The response to immune complexes is specific because mice immunized with IgG2a-containing complexes produced autoanti-IgG2a, while mice immunized with IgG1-containing complexes produced anti-IgG1 with little reactivity to other IgG isotypes. IgG2a blocked in its complement-fixing capacity was more effective in eliciting the anti-IgG2a response than native IgG2a, suggesting a possible role for the complement system in modulating the anti-IgG2a response. Induction of rheumatoid factor production by immune complexes could be induced in xid mice but not in nu/nu mice, indicating T lymphocyte dependence of the response. In contrast, the B lymphocyte activator lipopolysaccharide was able to elicit vigorous rheumatoid factor production in both nu/nu and normal mice, demonstrating that nu/nu mice contain B cells capable of making the response. Rheumatoid antibody produced in the immune complex- or LPS-induced responses is Fc specific and has relatively low affinity for IgG that is not bound to antigen.

scholarly journals Chylous Ascites in a Patient with HIV/AIDS: A Late Complication ofMycobacterium aviumComplex-Immune Reconstitution Inflammatory Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Imam H. Shaik ◽  
Fernando Gonzalez-Ibarra ◽  
Rumana Khan ◽  
Saira Shah ◽  
Amer K. Syed ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Late Complication ◽  
Chylous Ascites ◽  
Rapid Decline ◽  
Hiv Rna ◽  
Late Sequela ◽  
Long Term Prognosis ◽  
Inflammatory Syndrome ◽  
Hiv Aids

Chylous ascites is very rare in HIV/AIDS and its association withMycobacterium aviumcomplex-immune reconstitution inflammatory syndrome (MAC-IRIS) has been rarely reported. Here, we report a case of a young African-American male who developed chylous ascites as a late sequela to immune reconstitution inflammatory syndrome while on treatment for MAC. Antiretroviral drug-naive patients who start HAART in close proximity to the diagnosis of an opportunistic infection and have a rapid decline in HIV RNA level should be monitored for development of IRIS. Although the long term prognosis is poor, early diagnosis and treatment help to improve quality of life.

scholarly journals The burden of parvovirus B19 infection in women of childbearing age in England and Wales

2007 ◽  
Vol 135 (8) ◽  
pp. 1354-1362 ◽  
Author(s):  
A. J. VYSE ◽  
N. J. ANDREWS ◽  
L. M. HESKETH ◽  
R. PEBODY
Keyword(s):  
Parvovirus B19 ◽  
Childbearing Age ◽  
Igg Antibody ◽  
England And Wales ◽  
Force Of Infection ◽  
Previous Infection ◽  
Parvovirus B19 Infection ◽  
Specific Igg ◽  
Age Range ◽  
Made In

SUMMARYA serological survey has been used to investigate the epidemiology of parvovirus B19 infection in England and Wales. A total of 2835 sera representing the complete age range were selected from a convenience collection obtained in 1996 that reflects the general population and screened for parvovirus B19-specific IgG. Antibody prevalence rose nonlinearly with age from 21% in those aged 1–4 years to >75% in adults aged ⩾45 years. Force-of-infection estimates were similar to those previously made in 1991, being highest in those aged <15 years. There was no association between evidence of previous infection and sex or region. Quantitatively strongest antibody responses were found in those aged 15–34 years and IgG levels in females were 28·5% higher than those found in males (P=0·004, 95% CI 8·2–52·6). Applying the upper 95% confidence interval for the force of infection to maternity estimates for England and Wales in 1996, parvovirus infection in pregnancy was estimated to occur on average in up to 1 in every 512 pregnancies each year. This represents 1257 maternal infections, causing up to an estimated 59 fetal deaths and 11 cases of hydrops fetalis annually. An analysis of all available laboratory-confirmed parvovirus infections found a mean of 944 infections per year in women aged 15–44 years highlighting a need for enhanced surveillance of maternal parvovirus B19 infection in England and Wales, including information on both pregnancy and outcome of pregnancy.

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