Sanaa Shaker Aly

Assessment of serum 25-hydroxyvitamin d levels in children with atopic dermatitis: correlation with SCORAD index.

BackgroundAtopic dermatitis (AD) is a chronic inflammatory skin disorder with an immunologic basis. It may have negative medical and social impacts on a patient and his family. ObjectivesTo assess serum level of vitamin D among children with AD and determine its association with AD severity using the AD Scoring System Index. Study DesignA case-control study. Patients and MethodsTwenty-nine patients with AD in the age group between 2 and 12 years were enrolled in the study. The severity of the disease was determined by the AD scoring system. Thirty controls were recruited. Serum levels of 25-hydroxyvitamin D3 [25(OH)D3] were tested using commercial automated chemiluminescent microparticle immunoassay. ResultsThe mean value of vitamin D in children with AD was much lower than normal value, and there was a significant difference in the mean values of vitamin D between children with AD (5.4±1.9 ng/mL) and the controls (28.9±2.4 ng/mL). Serum 25(OH)D levels were found to be significantly higher in mild AD (14.6±3.5 ng/mL) compared with moderate (5.5±3.1 ng/mL) or severe AD (0.3±0.1 ng/mL); P<0.001. ConclusionPatients with AD have lower serum vitamin D levels than normal. Vitamin D deficiency might be related to the severity of AD.

Dendritic cells in childhood sepsis.

PURPOSE Our aim was to investigate the level and the maturation status of dendritic cells (DCs) in pediatric patients with sepsis and its relation to prognosis. MATERIALS AND METHODS The study included 16 children with sepsis, 24 children with complicated sepsis, and 40 healthy control children. The patients were investigated within 24 hours of intensive care unit admission and after 28 days. Flow cytometric detection of DCs was done. RESULTS Within 24 hours, the levels of both plasmoid DCs and monocytoid DCs and the expression of CD86 and CD83 on DCs were significantly lower in patients than in controls, and the difference was marked in patients with complicated sepsis. The amount of CD86 and CD83 per cell was significantly lower in patients with complicated sepsis. The baseline numbers of monocytoid DCs and plasmoid DCs were higher in the survival patients than in nonsurvival patients. In addition, the expression of CD86 and CD83 on the entire DCs was significantly higher in the survival patients with sepsis. CONCLUSION Sepsis is associated with reduced level of DCs and decreases their maturation. The estimation of DCs number and maturation state may be used as prognostic makers of sepsis.

Glucocorticoid receptors expression and histopathological types in children with nephrotic syndrome.

Abstract Background: Some children with idiopathic nephrotic syndrome (NS) patients fail to respond even when given high dose of steroid. The aim of this study was to assess the GCR expression on the T lymphocytes of children with NS and its relation to the response to steroid and to histopathological type. Methods: Forty-six pediatric patients with idiopathic NS and 20 age and sex matched apparently healthy children as controls were included. Flow cytometry was employed to determine the percentage of CD3+/GCR+ cells which then correlated with pattern of steroid response. Renal biopsy was done for steroid-dependent and steroid-resistant cases for determination of the underlying histopathological type. Results: The mean percentage of T lymphocyte expression of GCRs (CD3+/GCR) was significantly higher in early steroid responders than in late responders and was slightly lower than the controls. There was a significantly lower GCRs expression in steroid-resistant patients in comparison to early responders, late responders and controls. Renal biopsy showed that most cases of late responders were of the focal segmental glomerulosclerosis (FSGS) type. The mean percentage of lymphocyte expression of GCRs was significantly higher in patients with minimal change disease (MCD) compared to patients with FSGS. Conclusion: Evaluation of the expression of intracellular GCRs in T lymphocytes at time of diagnosis of NS can predict the response to steroid therapy and can help in determination of the outcome of NS patients regarding future relapses.

Effects of oral iron (ferrous versus ferric) supplementation on oxidative stress and antioxidant status in pregnant women with iron deficiency: controlled trial

Background Pregnant women are more prone to oxidative stress. Iron deficiency anemia not only affects hematological parameters but also disturbs body oxidative balance, which impairs pregnancy outcome. Besides, iron therapy may generate harmful oxygen species. Objectives The aim of this study was to investigate the effect of the nature of oral iron supplementation (ferrous vs. ferric) in pregnant women with iron deficiency on oxidative stress and its correlation with peripheral systemic inflammatory response markers. Patients and methods A clinical trail study involves study included 30 healthy and 50 anemic pregnant women in their 20th-36th gestational weeks who fulfilled the inclusion criteria. They were randomly distributed to receive either ferrous sulfate or ferric polymaltose complex. Outcome was assessed after 8 weeks of iron supplementation and included hematological parameters, neutrophil : lymphocyte ratio, platelet : lymphocyte ratio, mean platelet volume, serum malondialdehyde (MDA), total antioxidant capacity (TAC), iron, and ferritin. Results Anemic pregnant women have increased oxidative stress with high levels of MDA and TAC, both at baseline and following iron supplementation (P < 0.001). Following 8 weeks of iron supplementation, there were a significant increase (P < 0.001) in hemoglobin and serum ferritin, and a significant decrease (P < 0.001) in the peripheral inflammatory markers neutrophil: lymphocyte ratio, platelet: lymphocyte ratio, mean platelet volume, and absolute lymphocyte counts. Conclusion Iron polymaltose complex was as effective as ferrous sulfate as both were able to correct hematologic parameters in parallel to a decrease in MDA and peripheral inflammatory markers together with an increase in TAC levels to maintain oxidative balance.

Survival outcomes of CD34 + CD38 − LSCs and their expression of CD123 in adult AML patients

Background and aim Acute myeloid leukemia (AML) is one of the most common leukemias in adults. AML is generally regarded as a stem cell disease characterized by an accumulation of undifferentiated and functionally heterogeneous populations of cells, The aim of the present study was to identify leukemia stem cells in patients with AML and their correlations with treatment outcomes namely remission status, disease free survival, and overall survival. Results The mean percentages of CD34+CD38- and CD34+CD38low/−CD123+ LSCs were 2.2± 0.4and 22.3± 2.6, respectively. The percentages of CD34+cells, CD34+CD38- and CD34+CD38low/−CD123+ LSCs were significantly lower in AML patients with complete remission than those without complete response (P<0.001, P<0.004, P<0.001 respectively). The mean OS of all study patients was 20.03±1.2 months while the median OS was 21 months (95% CI=18.32-21.48). The mean DFS was 16.96±1.02 months and the median was 18 months (95% CI=8.9-11.4). DFS and OS were significantly higher among those who achieved CR than those without CR. In addition, there were significant negative effects of WBCs, CD34+cells, CD34+CD38- and CD34+CD38-CD123+LSCs on DFS and OS. Patients and methods We investigated 30 patients with newly diagnosed AML; all patients underwent complete history taking, and thorough physical and clinical examination, complete blood count. Peripheral smears and bone marrow aspirates were also examined. Cytochemistry and immunophenotyping of leukemic cells were performed routinely in bone marrow using monoclonal antibodies. Flow cytometry was used to analyze leukemia stem cells and their expression of CD123. Conclusion Our study elucidated that CD34+CD38-LSCs, with or without CD123+LSCs phenotype was present in a significant proportion of AML patients and it could be responsible for resistance to traditional treatments, and high percentage of MRD that was translated into significantly high number of non CR, poor DFS, and OS.

Vitamin D levels in acne vulgaris patients treated with oral isotretinoin

Acne vulgaris is a common inflammatory skin disease. Vitamin D deficiency plays a role in many inflammatory skin diseases. It may play a role in pathogenesis of acne vulgaris. This study aimed to assess serum levels of 25 hydroxy vitamin D in patients with acne vulgaris before and after treatment with isotretinoin and its relation with acne vulgaris severity.

Diagnostic validity of flow cytometry vs manual counting of polymorphonuclear leukocytes in spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis (SBP) is frequently occurring infection among patients with liver cirrhosis, defined by polymorphonuclear (PMN) leukocytic count ≥250 cell/mm3 with or without a positive ascitic fluid (AF) bacterial culture. So, this study aimed to investigate the diagnostic value of flow cytometry versus manual counting of ascitic fluid PMNL in cirrhotic patients, with clinical suspicion of SBP.

Phenotype analysis of lymphocytes in workers with chronic benzene exposure

Background Automobile service station workers are at high risk of benzene toxicity because they neither take protective measures to prevent inhalation of petroleum products nor undergo regular medical checkup. Objective The aim of this paper was to study the effects of long-term benzene exposure on blood cells and liver function. Patients and methods The study was a controlled trial, which included 30 automobile service station workers investigated for alterations in blood cells, hepatic functions, and lymphocyte phenotype. Results When compared with controls, benzene-exposed workers had significant increase in alanine aminotransferase (47.80±3.19 vs. 28.50±4.35), aspartate aminotransferase (41.20±2.62 vs. 23.60±4.58), and alkaline phosphatase (305.13± 16.39 vs. 174.40±26.69) levels and significant decrease in total proteins (6.39±0.11 vs. 6.79±0.12), albumin (3.57±0.14 vs. 4.5±0.48), hemoglobin (10.77±0.49 vs. 13.97±0.69), platelets count (146.8±4.9 vs. 217.8±37.4), mean platelet volume (7.68±0.4; 8.83±0.8), white blood cells (3459±444 vs. 6171±1482), monocytes (188±64 vs. 338±190), neutrophils (2095±267 vs. 3487±998), lymphocytes (1177±265 vs. 2138±439) and its subsets [CD3 cells (948±217 vs. 1686±337), CD4 cells (321±81 vs. 1101±222), B cells (228±70 vs. 45.1±13.22), and CD4 : CD8 ratio (0.51±0.04 vs. 1.88±0.08)], with significant increase in CD8 cells (627±138 vs. 585±117) and platelet-lymphocyte ratio (PLR) (130.7±26.66 vs. 104.96±22.49). The duration of exposure positively correlated with PLR and negatively correlated with hemoglobin, platelets, mean platelet volume, white blood cells, neutrophil, lymphocyte (B cells, helper cells, and suppressor cells), and serum albumin. PLR had a negative correlation with CD4, CD8, and CD19 absolute counts. Conclusion Benzene exposure is detrimental to the liver and bone marrow and results in the reduction of all blood and lymphocyte series, intiating immune suppression which may predispose to carcinogenesis. PLR is a valuable, inexpensive, and reproducible index that is closely associated with impaired immune system in benzene-exposed workers.

Regulatory and memory B lymphocytes in children with newly diagnosed immune thrombocytopenia

Background Immune (idiopathic) thrombocytopenic purpura (ITP) is a primary autoimmune disease. It is characterized by a diminished peripheral platelet count (< 100 × 109/L) caused by platelet destruction with an increased risk of mucocutaneous bleeding. The diagnosis of ITP depends on clinical characteristics and the laboratory examinations conducted, as well as the ability to exclude other diseases associated with thrombocytopenia. Antiplatelet autoantibodies are responsible for platelet destruction and probably for inhibition of megakaryopoiesis. B lymphocytes participate in immune responses through production of antibodies, antigen presentation to T cells, and cytokine secretion. The aims of this study were to investigate the levels of Bregs and memory B lymphocytes in newly diagnosed pediatric ITP patients and to correlate their levels with the course of the disease. Methods This study was a case-control study. The study included 30 patients with acute ITP. The patients were recruited from Pediatric Clinical Hematology Unit of Children Hospital, Assiut University. In addition, 20 healthy children of comparable age and sex were taken as controls. The institutional review board approved the study and informed consents were obtained. Results There is a significant alteration of B-cell homeostasis in patients with ITP. Conclusion Analysis of Bregs and memory B cells could serve as prognostic markers and might guide therapy in ITP patients in the future.