scholarly journals Clinico-Epidemiological Profile and Outcome of Children with IgA Vasculitis in Aseer Region, Southwestern Saudi Arabia

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1694
Author(s):  
Samy A. Dawood ◽  
Abdoh M. Abodiah ◽  
Saleh M. Alqahtani ◽  
Ayed A. Shati ◽  
Youssef A. Alqahtani ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Gastrointestinal Tract ◽  
Renal Involvement ◽  
Clinical Profile ◽  
Treatment Modalities ◽  
Iga Vasculitis ◽  
Upper Respiratory Tract ◽  
Female Ratio ◽  
Tract Infections ◽  
Pulse Steroid

Introduction: Immunoglobulin A (IgA) vasculitis is one of the most common forms of primary vasculitis in children; it typically has a benign course but can be aggressive and require intervention. Aim of the work: The aim of this retrospective study was to evaluate the epidemiological and clinical profile and treatment modalities used for children with IgA vasculitis in the southwestern region of Saudi Arabia. Material and Methods: We reviewed the medical records of 89 children admitted to Abha Maternity and Children Hospital in the southwestern region of Saudi Arabia from January 2016 to December 2020 with a confirmed diagnosis of IgA vasculitis according to the European League Against Rheumatism/Paediatric Rheumatology International Trials Organisation/Pediatric Rheumatology European Society criteria. Results: Eighty-nine children had a confirmed diagnosis of IgA vasculitis, with 50 boys (56.2%) and 39 girls (43.8%; male-to-female ratio of 1.28:1) and a mean age at diagnosis of 5.87 ± 2.81 years. The mean hospital stay duration was 5.66 ± 4.72 days. Infections preceded 29.2% of the cases, with upper respiratory tract infections comprising 24.7%. Approximately 31.5% of the cases were diagnosed in summer, followed by autumn in 28% of the cases. Rash was present in 100%, arthritis in 72.2%, gastrointestinal tract involvement in 60.7%, and renal involvement in 23.5% of cases. Thrombocytosis and leukocytosis were found in 35% and 46% of all cases, and 52.3% and 47.6.25% of cases with renal involvement, respectively (OR = 2.035, 95% CI: 0.75–5.52 and OR = 1.393, 95% CI: 0.522–1.716, respectively). Approximately 26% of cases experienced relapses. Treatment was conservative in 23.6%, oral prednisolone in 23.6%, and pulse steroid in 45% of cases. Abdominal pain with lower gastrointestinal tract bleeding was the primary indication for initiating pulse steroid treatment. Conclusions: There were similarities and differences in the epidemiology and frequency of clinical manifestations of patients with IgA vasculitis compared to previous studies. Children presenting with such epidemiological and clinical profile need to be closely monitored and long-term follow-up is recommended to improve the outcomes.

Infection Rates Before and After Diagnosis of IgA Vasculitis in Childhood: A Population-wide Study Using Non-exposed Matched Controls

2019 ◽  
Vol 47 (3) ◽  
pp. 424-430 ◽  
Author(s):  
Johannes C. Nossent ◽  
Warren Raymond ◽  
Helen Keen ◽  
David B. Preen ◽  
Charles A. Inderjeeth
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Iga Vasculitis ◽  
Upper Respiratory Tract ◽  
Serious Infection ◽  
Serious Infections ◽  
Before And After ◽  
Upper Respiratory ◽  
Tract Infections

Objective.Clinical data suggest that infections can trigger IgA vasculitis (IgAV), but longterm observations are lacking. We compared rates, types, and microorganisms for serious infection before and after diagnosis for children with IgAV and non-exposed controls.Methods.Using population-based administrative linked health datasets we estimated incidence rates (IR) for serious infection per 1000 person-months for patients with IgAV (n = 504, age 5 yrs, 59.1% males) and controls matched for age, sex, and year of presentation (n = 1281, age 6 yrs, 66% males). Time zero (T0) was the date of IgAV diagnosis or equivalent date in controls, lookback (median 38 mos) was the period prior to T0, and followup (median 239 mos) was the period after T0.Results.During lookback, prevalence of serious infection was similar in patients with IgAV and controls (11.5% vs 9.5%, respectively), but patients with IgAV had a higher rate of upper respiratory tract infections [incidence rate ratio (IRR) 1.79; 95% CI 1.39–2.31] with shorter time between first serious infection and T0 (27 vs 43 mos; p = 0.02). During followup, patients were at a constant increased risk for serious infections (IRR 1.46, 95% CI 1.35–1.58). These rates were higher during followup: sepsis (IRR 12.6), pneumonia (IRR 6.19), upper respiratory tract infections (IRR 2.36), and skin infections (IRR 1.85). There was little overlap between patients with serious infections in the lookback and followup periods.Conclusion.In patients with childhood IgAV there is an increased longterm risk for a broader spectrum of infections, which is unrelated to serious infections prior to diagnosis or treatment. This suggests disease-specific factors may have a lasting effect on immune competence in childhood IgAV.

scholarly journals PC3 - 128 Clinical Profile and Treatment Outcomes of Patients with Primary CNS Lymphoma in a Tertiary Hospital in the Philippines: An Eight-Year Retrospective Review

2016 ◽  
Vol 43 (S4) ◽  
pp. S20-S20
Author(s):  
M.C. Concepcion Sales
Keyword(s):  
Survival Rate ◽  
Combination Chemotherapy ◽  
Single Agent ◽  
Primary Cns Lymphoma ◽  
B Cell Lymphoma ◽  
The Philippines ◽  
Clinical Profile ◽  
Treatment Modalities ◽  
Cns Lymphoma ◽  
Female Ratio

Primary CNS Lymphoma (PCNSL) is an unusual extranodal form of Non-Hodgkin’s lymphoma with a locally aggressive course but a rare tendency to disseminate systemically. It has been documented in that the clinical characteristics and response to treatment among Asians is comparable to the Western population yet no studies done locally are available. Objectives: This study aims to determine the clinico-pathologic profile of patients diagnosed with PCNSL seen at Philippine General Hospital (PGH) from January 2006 to September, 2014 and to evaluate the patients’ response to the following treatment modalities: 1) Combination chemotherapy 2) Chemo-RT 3) Single agent chemotherapy and 4) no specific anti-lymphoma treatment. Methodology: This is a descriptive and retrospective study that included all cases of histologically-proven PCNSL seen at the PGH from January 2006 to September, 2014. The clinical profile, imaging studies and biopsy findings were obtained from the patient records. The survival rates at the end of one and two years of diagnosis were computed. Results and Conclusion. Among patients diagnosed with PCNSL at PGH, there is a higher incidence of PCNSL among males with a male to female ratio of 1.4:1 and have a younger onset with a median age of 50.2 years. Most patients presented with signs of increase ICP and majority had solitary cortical lesions with histopathologic diagnosis of diffuse large B cell lymphoma. Patients who did not undergo any form of treatment had a mean survival of 10 months. Immunocompromised patients had a shorter life-span with a mean survival of 7.5 months. Treatment of combination chemotherapy with HD-MTX and Rituximab had the most favorable outcome followed by HD-MTX only with a 2 year survival rate of 100% and 66% respectively while patients who underwent chemo-RT had a 2 year survival rate of 33% with a high incidence of neurocognitive delay.

Place of phytotherapy in the treatment of acute infections of upper respiratory tract and upper gastrointestinal tract

2018 ◽  
Vol 72 (4) ◽  
pp. 42-50 ◽  
Author(s):  
Wioletta Pietruszewska ◽  
Magda Barańska ◽  
Jakub Wielgat
Keyword(s):  
Gastrointestinal Tract ◽  
Respiratory Tract ◽  
Upper Gastrointestinal Tract ◽  
Upper Respiratory Tract ◽  
Persistent Symptoms ◽  
Acute Infections ◽  
Intranasal Steroids ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Upper Gastrointestinal

Acute infections of the upper respiratory tract and upper gastrointestinal tract (mouth and throat) are still the most common reason for reporting to the general practitioner or ENT specialist. Despite the fact that the most common causative agent of these diseases are virurs, antibiotics are still flavored in about 60-80% of patients who report to the doctor. In consensus such as EPOS, WHO reports and other local / national reports, there is a need to limit antibacterial treatment for symptomatic and anti-inflammatory drugs. In addition to intranasal steroids and mucocutaneous decongestants, supplementary treatment should be considered which resolves persistent symptoms. Plant preparations are used here. The growing role of rational phytotherapy is emphasized, especially due to the most frequent etiological factor of these infections, i.e. viruses. Modern phytotherapy is part of pharmacology, and all preparations based on plants meet the standards for medicines and are subject to standard registration procedures. The article discusses the use and mechanism of action of selected herbs, among others: sorrel, elderberry, yarrow and horsetail in the treatment of upper respiratory tract infections and upper gastrointestinal tract. The phytotherapy show good efficacy and tolerance, and can be used both in children and adults in recurrent infections of the upper respiratory tract. It is worth paying attention to the combined preparations, the components of which have the effect confirmed by randomized trials and long-term registration for use in treatment, both during the first signs of cold and its further duration, and supportive in chronic inflammation especially of the paranasal sinuses.

scholarly journals Diagnosis and Management of Hoarseness in Developing Country

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Shuaib Kayode Aremu ◽  
Waheed Atilade Adegbiji ◽  
Clement Nwawolo ◽  
Oyebanji Anthony Olajuyin ◽  
Fatai Olatoke
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Care Center ◽  
Predisposing Factors ◽  
Common Symptom ◽  
Upper Respiratory Tract ◽  
Specialist Care ◽  
Tertiary Institution ◽  
Female Ratio ◽  
Health Care Center ◽  
Tract Infections

Background: Hoarseness/dysphonia of voice is the most common symptom of laryngeal disorder regardless of its pathology.This study aimed at determining the sociodemographic profile, aetiology, predisposing factors, clinical profile and management of hoarseness.Materials and Methods: This study was a prospective study carried out on all patients who presented hoarseness of voice via the Ear, Nose, and the Throat at the department of a tertiary institution in Nigeria.The study was carried out between October 2015 to September 2017. Data were obtained from patients who gave consent by using pre tested interviewer assisted questionnaire. All the data obtained were analyzed using SPSS version 16.0.Results: Prevalence of hoarseness was 2.4%. There were 58.4% males with male to female ratio being 1.5:1. Housewives were involved 27.6%, Singers 21.5%, Teachers 17.3%, and Clergy 13.1%.  Main causes were 96.3% organic causes and 2.8% neurological causes. Common organic causes were 36.4% acute laryngitis, 30.8% chronic laryngitis, and 15.0% vocal nodules.Main predisposing factors were Upper respiratory tract infections 50.5%, Voice abuse 33.6%, and Laryngopharyngeal reflux 29.4%. Commonest duration of the hoarseness prior to presentation were >12 months in 29.4% and 6–9 months in 27.1%.  Main clinical features were hoarseness 78.5%, catarrh/cold 73.4%, sensation of lump in the throat 62.6%, and cough 55.6%. Prior medications before presentation to otorhinolaryngologist were local herb 84.6%, over the counter medication 48.6%, and health care center 38.3%. Specialist care was conservative/medical treatment 77.6%, surgical intervention 20.1%, and referral 2.3%.Conclusion: Prevalence of hoarseness of voice was high with associated presentation to the specialist. Organic causes are the commonest with predominant inflammatory origin. Laryngeal neoplasm with associated malignancy was significant in a numbers of patients.

Clinical profile and outcome of Henoch Schonlein purpura in a tertiary care hospital in South India

2017 ◽  
Vol 4 (3) ◽  
pp. 822 ◽  
Author(s):  
Shanavas Abbas ◽  
Geetha S. ◽  
Deepthi R.V. ◽  
Jubin Kamar ◽  
Susan Uthup
Keyword(s):  
Clinical Features ◽  
Renal Involvement ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Treatment Modalities ◽  
Joint Involvement ◽  
Care Hospital ◽  
Henoch Schonlein Purpura ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Background: Henoch Schonlein purpura (HSP) is the most common systemic vasculitis in children. It is an immunoglobulin A (IgA) mediated systemic small-vessel vasculitis, with IgA deposition in vessel walls leading to symptoms involving the skin, joints, intestines, and kidneys. The objective of present study was to identify and describe the clinical profile, pattern of joint involvement, histopathological features, treatment modalities and complications of Henoch Schonlein purpura.Methods: 52 children less than 12 years diagnosed to have Henoch Schonlein Purpura according to the European League against Rheumatism criteria were included in the study. All patients were subjected to detailed history taking and thorough examination. The clinical features, investigations, management and complications of the disease were studied. Descriptive statistics was used to analyse the results.Results: The common clinical features were palpable purpura (100%) followed by arthritis (66%) and abdominal pain (50%). Renal manifestations were in the form of hematuria in 12% of the patients. Skin biopsy was done in 25 patients of which 19 had findings suggestive of Henoch Schonlein purpura. Steroids were used in 42% of patients. The severity of illness was associated with lower mean age, arthritis, leg edema and stool occult blood.Conclusions: The clinical features of Henoch Schonlein purpura in the population were different from the previously published studies. Renal involvement was less common. The short-term outcome of the patients were satisfactory. 

scholarly journals Patterns of Human Respiratory Viruses and Lack of MERS-Coronavirus in Patients with Acute Upper Respiratory Tract Infections in Southwestern Province of Saudi Arabia

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed A. Abdulhaq ◽  
Vinod Kumar Basode ◽  
Anwar M. Hashem ◽  
Ahmed S. Alshrari ◽  
Nassrin A. Badroon ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Respiratory Viruses ◽  
Surveillance Systems ◽  
Upper Respiratory Tract ◽  
Nasal Swabs ◽  
Syncytial Virus ◽  
Human Coronaviruses ◽  
Winter Time ◽  
Tract Infections ◽  
Dual Infections

We undertook enhanced surveillance of those presenting with respiratory symptoms at five healthcare centers by testing all symptomatic outpatients between November 2013 and January 2014 (winter time). Nasal swabs were collected from 182 patients and screened for MERS-CoV as well as other respiratory viruses using RT-PCR and multiplex microarray. A total of 75 (41.2%) of these patients had positive viral infection. MERS-CoV was not detected in any of the samples. Human rhinovirus (hRV) was the most detected pathogen (40.9%) followed by non-MERS-CoV human coronaviruses (19.3%), influenza (Flu) viruses (15.9%), and human respiratory syncytial virus (hRSV) (13.6%). Viruses differed markedly depending on age in which hRV, Flu A, and hCoV-OC43 were more prevalent in adults and RSV, hCoV-HKU1, and hCoV-NL63 were mostly restricted to children under the age of 15. Moreover, coinfection was not uncommon in this study, in which 17.3% of the infected patients had dual infections due to several combinations of viruses. Dual infections decreased with age and completely disappeared in people older than 45 years. Our study confirms that MERS-CoV is not common in the southwestern region of Saudi Arabia and shows high diversity and prevalence of other common respiratory viruses. This study also highlights the importance and contribution of enhanced surveillance systems for better infection control.

scholarly journals Predictors for Multiple Hospital Admissions in Children with Asthma

2000 ◽  
Vol 7 (2) ◽  
pp. 163-166 ◽  
Author(s):  
Fuat Gürkan ◽  
Aydin Ece ◽  
Kenan Haspolat ◽  
Orhan Derman ◽  
Mehmet Bosnak
Keyword(s):  
Hospital Admission ◽  
Maternal Smoking ◽  
Hospital Admissions ◽  
Immunoglobulin E ◽  
Multivariate Logistic Regression Analysis ◽  
Upper Respiratory Tract ◽  
Female Ratio ◽  
Children With Asthma ◽  
Tract Infections

BACKGROUND:Asthma is one of the most frequent causes of preventable hospital admissions among children.OBJECTIVES:To identify preventable risk factors for future hospital admissions. Some of the environmental and patient characteristics of children who were hospitalized more than once with an acute asthma attack were investigated.DESIGN, SETTING AND PATIENTS:An analysis was performed of 140 children with asthma, aged three to 15 years, admitted to the Department of Pediatrics at Dicle University Hospital, Diyarbakir, Turkey, over three years, followed for a maximum of 48 months. Associations between hospital admissions and probable predictors (clinical findings, laboratory studies and a detailed case history) were analyzed.RESULTS:The asthma admissions were higher in boys than in girls (male to female ratio 1.86). Of 140 children, 30 (21.4%) had multiple admissions, defined as a mean of more than one admission per year during the follow-up period. The following factors were associated significantly with the frequency of hospital admission for asthma attacks when analyzed using aX2test: indoor cigarette smoking (odds ratio [OR] 2.55), maternal smoking (OR 4.05), symptoms of dermal atopy (OR 2.96), symptoms of allergic conjunctivitis (OR 2.68), age less than five years (OR 5.12) and use of inhaled corticosteroids during the follow-up (OR 0.37). With multivariate logistic regression analysis, among other factors, only maternal smoking (r=0.29, P=0.017) and age less than five years (r=-0.32, P=0.012) were significant effective factors for the multiple hospital admissions. No significant association with the frequency of hospital admission was found for sex, serum total immunoglobulin E, history of frequent upper respiratory tract infections or number of family members.CONCLUSIONS:Prevention of indoor smoking, especially maternal smoking, may be effective in decreasing hospital admissions in children with asthma. Children less than five years of age are more likely to be hospitalized than are children five years of age or greater.

scholarly journals POS0823 ARTHRITIS IN ADULT IGA VASCULITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 664.2-665
Author(s):  
A. Hočevar ◽  
V. Jurčić ◽  
M. Tomsic ◽  
Z. Rotar
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Characteristics ◽  
Renal Involvement ◽  
Elevated Serum ◽  
Joint Involvement ◽  
P Value ◽  
Iga Vasculitis ◽  
Upper And Lower Extremities ◽  
Tract Involvement ◽  
Metatarsophalangeal Joints

Background:Arthritis is one of the main clinical features of IgA vasculitis (IgAV). Joint involvement represents the second most common manifestation in childhood IgAV with the predilection for the knees and ankles.Objectives:We aimed to describe the characteristics of arthritis in adult IgAV cohort.Methods:We analysed medical records of histologically proven adult IgAV cases, diagnosed between January 2010 and December 2020 at our secondary/tertiary rheumatology centre. The frequency, temporal occurrence and the localization of arthritis was recorded. In addition, we searched for potential differences in other IgAV features between patients with and without arthritis.Results:During the 132-month observation period we identified 328 new IgAV cases (59.5% males, median (IQR) age 64.3 (45.1; 76.1) years). Forty-eight (14.6%) patients developed arthritis. Arthritis was the first IgAV manifestation in 16 (4.9%) patients. Arthritis was mono-, oligo- and poly- articular (involving up to 15 joints) in 13 (4.0%), 25 (7.6%) and 10 (3.0%) patients, respectively. Arthritis was most common in wrists and ankles (each in 18 (37.5%) patients); metacarpophalangeal joints and knees (each in 11 (22.9%)); proximal interphalangeal joints (9 (18.8%)); elbows (8 (16.7%)) and metatarsophalangeal joints (4 (8.3%)). Clinical differences between IgAV patients with and without arthritis are presented in table 1. Patients with arthritis were significantly younger, more commonly developed gastrointestinal tract involvement compared to those without arthritis. Arthritis remitted in all with immunomodulatory treatment (given predominantly for necrotic skin purpura or visceral involvement). Follow up (FU) data accessible for 42/48 (87.5%) patients with arthritis showed that IgAV relapsed in 10 (23.8%) patients during a median (IQR) 24.5 (12.9; 40.7) month FU. Relapses were limited to skin and/or kidneys, there were no relapses of arthritis.Table 1.Clinical characteristics of IgA vasculitis patients with and without arthritisClinical characteristicsArthritis IgAV(48)Non-arthritis IgAV(280)P valueMale gender (%)56.360.00.636Age (years)*49.9 (36.1-66.9)65.4 (48.4;77.5)<0.001Ever smoker (%)50.043.60.435Prior infection (%)43.830.40.094Generalized purpura50.050.01.0Skin necroses (%)35.449.60.085GI involvement (%)47.925.00.002Renal involvement (%)47.946.81.0Elevated serum IgA (%)33.3 (11/33)52.0 (115/221)0.061Legend: * median and IQR; GI gastrointestinal;Conclusion:Arthritis in adult IgAV was frequently oligoarticular, involved large and small joints of both upper and lower extremities, and was not prone to chronic course and recurrence. In addition, we found an association between arthritis and gastrointestinal tract involvement.Disclosure of Interests:None declared

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