scholarly journals COVID-19 and Children With Down Syndrome: is There Any Real Reason to Worry? Case Report

2020 ◽  
Author(s):  
Ahmad Kantar ◽  
Angelo Mazza ◽  
Ezio Bonanomi ◽  
Marta Odoni ◽  
Manuela Seminara ◽  
...  

Abstract Background: Down syndrome (DS) is characterised by a series of immune dysregulations, of which interferon hyperreactivity is a key one as it is responsible for surging antiviral responses and probable initiation of an amplified cytokine storm. This biological condition is attributed to immune regulators encoded in chromosome 21. Moreover, DS is characterised by the coexistence of cardiovascular and respiratory anomalies as well as obesity, which constitutes a risk factor for SARS-CoV-2 respiratory disease (COVID-19).Case presentation: Of the total number of children 55 admitted to paediatric wards in Bergamo in the period between February to May 2020 for COVID-19 infection, we present 2 children with DS and confirmed COVID-19 diagnosis that had a severe course. In addition, both cases had one or more comorbidities, being cardiovascular anomalies, obesity, and/or OSA.Conclusions: Our observations indicate the need to consider children with DS a population at a risk of severe COVID-19.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ahmad Kantar ◽  
Angelo Mazza ◽  
Ezio Bonanomi ◽  
Marta Odoni ◽  
Manuela Seminara ◽  
...  

Abstract Background Down syndrome (DS) is characterized by a series of immune dysregulations, of which interferon hyperreactivity is important, as it is responsible for surging antiviral responses and the possible initiation of an amplified cytokine storm. This biological condition is attributed to immune regulators encoded in chromosome 21. Moreover, DS is also characterized by the coexistence of obesity and cardiovascular and respiratory anomalies, which are risk factors for coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Case presentation A total of 55 children were admitted to the pediatric ward in Bergamo, between February and May 2020 for COVID-19. Here, we describe the cases of two children with DS and a confirmed COVID-19 diagnosis who had a severe course. In addition, both cases involved one or more comorbidities, including cardiovascular anomalies, obesity, and/or obstructive sleep apnea. Conclusions Our observations indicate that children with DS are at risk for severe COVID-19 disease course.


Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2721-2721
Author(s):  
Paul Lee ◽  
Rahul Bhansali ◽  
Malini Rammohan ◽  
Nobuko Hijiya ◽  
Shai Izraeli ◽  
...  

Abstract Children with Down syndrome have a spectrum of associated disorders including a 20-fold increased incidence of B-cell acute lymphoblastic leukemia (DS-ALL). Although a number of genetic alterations have been found in this ALL subtype, such as activating mutations in JAK2 and overexpression of CRLF2, the mechanisms by which trisomy 21 promotes the leukemia are largely unknown. Previous studies have implicated chromosome 21 genes HMGN1 and DYRK1A in both malignant and normal lymphopoiesis. DYRK1A is a member of the dual-specificity tyrosine phosphorylation-regulated kinase family that has been well studied in non-hematopoietic tissues. Its targets include proteins that regulate multiple pathways including cell signaling, cell cycle, and brain development. We have previously shown that DYRK1A is a megakaryoblastic leukemia-promoting gene through its negative regulation of NFAT transcription factors. Furthermore, in studies with a conditional Dyrk1a knock-out mouse, we found that the kinase is required for lymphoid, but not myeloid cell development. In developing lymphocytes, Dyrk1a regulates the cell cycle by destabilizing cyclin D3. Consequently, loss of Dyrk1a resulted in the failure of these cells to switch from a proliferative to quiescent phase for subsequent maturation (Thompson et al. J. Exp. Med. 2015 212:953-70). Despite this deficiency in exiting the cell cycle, Dyrk1a-deficient lymphocytes also exhibit impaired proliferation before undergoing apoptosis. These data reveal a critical role for DYRK1A in lymphopoiesis and suggest that it may be a target for therapeutic intervention. We assayed the activity of the highly selective and potent DYRK1 inhibitor, EHT 1610, in multiple ALL cell lines. EHT 1610 inhibited the growth of Jurkat and MHH-CALL-4 cells with EC50s of 0.83mM and 0.49mM, respectively. Next, we treated primary human ALL blasts with EHT 1610 and the less selective DYRK1A inhibitor harmine. Growth of 16 out of 30 specimens, which included DS-ALL, pre-B ALL, and T-ALL, was sensitive to DYRK1A inhibition at doses between 0.5 and 10mM. Of note, growth of 9 of the 11 of the DS-ALL samples was inhibited by EHT 1610. This result indicates that the increased dosage of DYRK1A in DS samples sensitizes the cells to DYRK1A inhibition. To further study the contributions of DYRK1A to normal and malignant lymphopoiesis, we performed phosphoproteomic analysis on primary murine pre-B cells treated with EHT 1610. After 2 hours of EHT 1610 treatment, the cells were collected and analyzed for changes in the phosphoproteome. Phosphorylation of 36 proteins was significantly altered. Bioinformatics analysis led to the identification of a number of notable pathways that appear to be regulated by DYRK1A including cell cycle, cell division and mitosis, RNA metabolism, and JAK-STAT signaling. Differentially phosphorylated proteins included geminin, which is important in cell division and whose loss enhances megakaryopoiesis, and POLR2M, which is intriguing because DYRK1A phosphorylates the CTD of RNA Pol II and binds chromatin at specific sites in glioblastoma cells. Another interesting target is STAT3, which is phosphorylated by DYRK1A on Ser727, a residue whose phosphorylation is required for maximal STAT3 activation. Treatment of murine pre-B cells with EHT 1610 significantly reduced the level of phosphorylation of Ser727 and Tyr705, suggesting that DYRK1A may provide a priming event for STAT3 activation similar to its priming effect on GSK3b phosphorylation. Consistent with a role for JAK/STAT signaling and STAT3 activity, B-ALL cells were highly sensitive to ruxolitinib therapy. Taken together, our study suggests that DYRK1A is a therapeutic target in DS-ALL and likely functions in part by enhancing JAK/STAT signaling. Disclosures No relevant conflicts of interest to declare.


2018 ◽  
Vol 48 (1) ◽  
pp. 102
Author(s):  
Susyana Tamin ◽  
Elvie Zulka ◽  
Iman Pradana Maryadi ◽  
Rahmanofa Yunizaf

Latar Belakang: Sindrom Down merupakan kelainan kromosom autosomal yang terjadi akibat trisomi seluruh atau sebagian dari kromosom 21, yang terjadi kurang lebih 1 dari 700 kelahiran hidup. Berbagai studi mendapatkan bahwa gangguan makan (feeding difficulty) dan disfagia merupakan masalah yang umum terjadi dan terkadang persisten pada anak sindrom Down. Tujuan: Memaparkan karakteristik kelainan disfagia fase oral dan fase faring yang dapat timbul pada anak dengan sindrom Down menggunakan instrument pemeriksaan Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Laporan kasus: Dilaporkan 8 pasien anak dengan sindrom Down yang didapatkan dari rekam medis pasien sejak Oktober 2016 hingga September 2017, yang dilakukan pemeriksaan FEES di Poli Endoskopi Bronkoesofagologi Departemen Telinga Hidung Tenggorok-Bedah Kepala Leher (THT-KL) Rumah Sakit Dr. Cipto Mangunkusumo. Metode: Pencarian literatur secara terstruktur dilakukan dengan menggunakan Pubmed, ClinicalKey, Cochrane, dan Google scholar, sesuai dengan pertanyaan klinis berupa bagaimana karakteristik disfagia pada pasien anak dengan sindrom Down melalui pemeriksaan FEES. Pemilihan artikel dilakukan berdasarkan kriteria inklusi dan eksklusi. Hasil didapatkan 1 artikel yang relevan. Hasil: Artikel yang didapat merupakan suatu studi retrospektif yang melaporkan gambaran deskriptif karakteristik disfagia pada anak dengan sindrom Down. Kesimpulan: Kelainan anatomis pada sindrom Down berperan pada terjadinya gangguan makan dan disfagia. ABSTRACTBackground: Down syndrome is an autosomal chromosomal disorder caused by entire or partial trisomy of chromosome 21, which occurs in approximately 1 out of 700 live births. Several studies had found that feeding difficulty and swallowing disorder (dysphagia) are common and persistent problems in children with Down syndrome. Purpose: to describe characteristics of abnormalities that can occur in children with Down syndrome using the Fiberoptic Endoscopic Evaluation of Swallowing (FEES) examination. Case report: 8 Pediatric patients with Down syndrome, obtained from medical record of FEES examination in Endoscopic Bronchoesophagology Clinic of Otorhinolaryngology-Head and Neck Surgery Department (ENT-HNS) Cipto Mangunkusumo Hospital, from October 2016 up to September 2017. Method: A structured literature search was performed using Pubmed, ClinicalKey, Cochrane, and Google scholar, according to clinical question of how the characteristics of dysphagia in pediatric patients with Down syndrome through FEES examination? The selection of articles is based on inclusion and exclusion criteria which resulted in 1 relevant paper. Results: The article obtained was a retrospective study reporting descriptive characteristics of dysphagia in children with Down syndrome. Conclusion: Anatomical abnormalities in children with Down syndrome play a role in eating disorders and dysphagia. Keywords:


2019 ◽  
Vol 08 (04) ◽  
pp. 187-192
Author(s):  
Kanokporn Chukua ◽  
Chayanont Netsawang ◽  
Kittipoom Padungthai ◽  
Thanitchet Khetkham ◽  
Piyaporn Chokevittaya ◽  
...  

AbstractChildren with Down syndrome (DS) are 150 times more likely to develop acute myeloid leukemia (ML-DS), compared with those without. One risk factor is transient abnormal myelopoiesis (TAM). Somatic truncating GATA1 mutations are found in most TAM patients and are markers for future ML-DS. We identified two novel frameshift mutations in our seven newborns with DS and TAM: a heterozygous mutation of 17 nucleotide duplication (c.154_170 dup) and a heterozygous 9-nucleotide deletion combined with a 2-nucleotide insertion (c.150_158delins CT). Both mutations introduced a truncated GATA1 protein. Thus, neonates with DS and TAM require frequent ML-DS monitoring.


2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Nadiya Mujaheda Alwafa ◽  
Yetty Herdiyati ◽  
Inne Suherna Sasmita ◽  
Williyanti Suwondo

Pendahuluan: Missing teeth adalah suatu keadaan berupa hilangnya gigi karena adanya kegagalan perkembangan gigi yang dapat menyebabkan berkurangnya fungsi pengunyahan, fonetik, estetika, serta munculnya masalah pada jaringan keras dan lunak di sekitarnya. Gejala missing teeth ditemukan pada anak Sindroma Down yaitu anak yang memiliki kromosom berlebih (trisomi 21) mengakibatkan kelainan dan keterlambatan pertumbuhan dan perkembangan baik fisik dan mental. Tujuan penelitian adalah untuk mengetahui distribusi frekuensi missing teeth pada anak Sindroma Down di Yayasan POTADS. Metode: Jenis penelitian deskriptif dengan teknik survei. Teknik pengambilan sampel yang digunakan adalah total sampling yaitu seluruh anak Sindroma Down di Yayasan POTADS yang datang ke RSGM FKG Unpad pada bulan Oktober 2017 dan Februari 2018. Hasil: Sebanyak 48,07% anak Sindroma Down yang diperiksa mengalami missing teeth dengan tipe hipodonsia sebesar 88%. Simpulan: Distribusi frekuensi missing teeth terjadi pada hampir setengah populasi anak Sindroma Down di Yayasan POTADS.Kata kunci: Missing teeth, hipodonsia, sindroma Down. ABSTRACTIntroduction: Missing teeth is a condition when tooth loss caused by failure development of dental which can lead to decreased function of mastication, phonetics, aesthetics, and become problems in the surrounding hard and soft tissues. Missing teeth founded in children with Down Syndrome which had extra copied of chromosome 21 (trisomy 21) resulting an abnormalities and delays in both physical and mental growth and development.  The purpose of this research was to find out the frequency distribution of missing teeth in Down Syndrome children at POTADS Foundation. Methods: Research method was conducted using descriptive survey technique. The samples were using total sampling approach all children with Down Syndrome at POTADS foundation that came to RSGM FKG Unpad in October 2017 and February 2018. Result: 48,07% of pupolation had missing teeth and 88% of them were hypodontia type of missing teeth Conclusion: Frequency distribution of  missing teeth almost half population of Down Syndrome Children at POTADS Foundation.Keywords: Missing teeth, hypodontia, Down Syndrome.


2017 ◽  
Vol 4 (1) ◽  
pp. 27
Author(s):  
Riezqia Ayu Wulandari ◽  
Sandy Christiono ◽  
Niluh Ringga

Background: Down syndrome (DS) is a congenital disorder caused by abnormalities of chromosome 21, resulting in migration defect of neutrophils, specifically in GCF as a marker of increasing periodontal infection. This study aimed to analyze the difference in neutrophil numbers between down syndrome and healthy children.Method: This research was an analytic observational with cross sectional design, and divided into two groups. The control group is consisted of healthy children and the other is consisted of down syndrome children. GCF was taken using paper point number 45-50 for 30 seconds, then it smeared into object glass and painted with giemsa staining. Observations was done by light microscopy with 1000 times magnification.Result: The result of studies with p<0.05 was indicating a significant difference of neutrophil numbers between children with down syndrome and the healthy group.Conclusion: This study concluded that there was a difference in neutrophil numbers due to the migration defect of neutrophils in children with down syndrome, that can cause proneness to periodontal infections.


Author(s):  
Iryna Melnyk ◽  
◽  
Svitlana Kost ◽  

The article outlines the importance of interaction between teachers and parents in order to provide effective adaptation of a child with Down syndrome to the inclusive groups of a preschool education institution. Every year the number of children with genetic pathologies is increasing. Their adaptation in society is available through educational activities known as inclusive education. Among the common pathologies, occurring in newborns the most widespread is the one, known as “Down syndrome”. This pathology occurs with the frequency of one case per 500-800 newborn babies. The process of adaptation of a child with Down syndrome to the conditions of a preschool institution has three levels. This adaptation to the surrounding reality can be light (easy process of adaptation), middle (adaptation with some difficulties) and heavy (difficult). At each stage, the interaction between teachers and a child’s parents is very important. Cooperation of teachers and parents helps to find better educational forms and methods to be used, encourage children with Down syndrome to use and improve the skills and knowledge gained in educational institutions at home. Keywords: social adaptation, inclusive education, children with Down syndrome, preschool institution, teachers, parents, inclusive groups.


2021 ◽  
Vol 55 (8) ◽  
Author(s):  
Tania Saskianti ◽  
Ardianti Maartrina Dewi ◽  
Nur Masyitah Iskandar Putri ◽  
Andi Octafianto

Background. Down syndrome (DS) is a chromosome disorder due to the presence of all or part of a third copy of chromosome 21 (trisomy 21) caused by a failure in chromosome segregation. Following Riset Kesehatan Dasar (RISKESDAS) in 2013, the number of people with DS in Indonesia increased compared to 2010, with an estimated 924 children with DS in Surabaya. Data regarding caries status in children with DS in Surabaya is limited. Objective. To evaluate parents’ behavior (predisposing, enabling, and reinforcing factors) related to the caries status of children with DS. Methods. This observational analytic cross-sectional study included children aged ≤18 years with DS and parents who were members of the Parents' Association of Children with Down Syndrome (POTADS). Caries status were measured using the DMF-T/def-t score, and parents were asked to fill out a questionnaire. Data were analyzed using Spearman’s correlation test. Result. We included 46 children with DS in this study. The DMF-t / def-t index of children with DS (7.2) was categorized as very high according to WHO. There was a significant relationship between lack of knowledge of parents and caries status in children with DS. Enabling factors and reinforcing factors were not significantly correlated with caries status. Conclusion. Parents' behavior is correlated with the caries status of children with DS. All combination of three factors behavior, including predisposing, enabling and reinforcing, are needed to reduce the number of caries in children with DS.


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