Serap Ozmen

Erythrocyte zinc levels in children with bronchial asthma

Zinc deficiency may be suspected to play a role in the pathogenesis, control, and severity of asthma because of its antioxidant, antiapoptotic, and anti‐inflammatory effects. We aimed to investigate whether there was any relationship between erythrocyte zinc levels and childhood asthma. The erythrocyte zinc levels of 67 asthmatic and 45 healthy children were analyzed in this case–control study. The mean concentrations of erythrocyte zinc were 1215.8 ± 145.1 µg/dl in asthma patients and 1206.9 ± 119.5 µg/dl in controls with no significant difference (P = 0.472). The erythrocyte zinc level was below 1,000 µg/dl in 6 asthmatic patients (8.9%) and 2 control group patients (4.4%). There was no relationship between erythrocyte zinc levels and duration of follow‐up, severity, and control of the asthma (P > 0.05). On the other hand, patients hospitalized for an asthma attack had significantly lower erythrocyte zinc levels compared with nonhospitalized patients and the control group (P = 0.000 and P = 0.004 respectively). This studys findings indicate that asthmatic children are not a risk group for zinc deficiency. We emphasize that checking zinc levels in children who are hospitalized for an asthma attack may be useful. Pediatr Pulmonol. 2011; 46: 1189–1193.

Symmetrical Drug‐Related Intertriginous and Flexural Exanthema (Baboon Syndrome) Induced by Amoxicillin‐Clavulanate

Abstract:  Systemic drug‐related intertriginous and flexural exanthema (SDRIFE), also known as Baboon syndrome, is an uncommon, cutaneous reaction that occurs after the systemic administration of drug‐related allergens. We report the case of a 5‐year‐old boy with SDRIFE after systemic administration of amoxicillin‐clavulanate.

Serum Sickness–Like Reaction in Children Due to Cefditoren

Abstract:  We describe the case of a 7‐year‐old boy with urticaria, fever, and arthritis that appeared 10 days after starting cefditoren therapy for acute tonsillopharyngitis, which was diagnosed as a serum sickness‐like reaction due to this medication.

Role of laryngoscopy in children with respiratory complaints and suspected reflux.

BACKGROUND In recent years, laryngopharyngeal reflux (LPR) in children has been taken into consideration. OBJECTIVE The aim of this study was to assess the laryngoscopic findings in children diagnosed LPR and/or gastro-oesophageal reflux (GERD). METHODS The findings of 49 patients with at least one or more respiratory complaint such as chronic cough, wheezing, hoarseness, recurrent laryngitis, and throat clearing/postnasal discharge suggesting LPR were evaluated retrospectively. The diagnosis of LPR+GERD or GERD was done by the clinical history and 24 h double-probe pH monitoring and/or scintigraphy. RESULTS Thirty eight out of 49 patients examined by laryngoscopy underwent 24 h double-probe pH monitoring and/or scintigraphy. Thirty of them were diagnosed as LPR+GERD or GERD by any test positivity. Twelve of 30 patients diagnosed with LPR+GERD or GERD had a positive laryngeal finding on the examination of fibre optic laryngoscopy. The most common finding with eight cases was arytenoid erythema A sensitivity of 40% and specificity of 50% for the laryngoscopy in the diagnosis of LPR/GERD were found. CONCLUSION In children with unexplained respiratory symptoms, laryngopharyngeal reflux should be suspected. Therefore, until enough data on this issue in the literature accumulates, the history and the laboratory findings of the patients obtained from various techniques to document paediatric LPR should be evaluated together.

Probable cytarabine-induced acral erythema: report of 2 pediatric cases.

Acral erythema (palmoplantar erythrodysesthesia) is a localized skin side effect that is seen most often in patients receiving cytarabine, liposomal pegylated doxorubicin, capecitabine, and 5-fluorouracil. It is characterized by painful erythema of both palms and soles with symmetrically well-defined borders, which may progress to bullae formation and desquamation. It is frequently occurred in patients with acute myeloid leukemia and lymphoma. Here, we reported 2 cases of acral erythema that developed during cytarabin-etoposide and cytarabine-mitoxantrone combination treatment for acute myeloid leukemia. Although rarely reported in children, pediatricians should especially be aware of this reaction when taking care of children who receive chemotherapy.

Two adolescent patients with high IgE levels and hypereosinophilia are associated with cockroach allergen.

Cockroach is an important indoor allergen especially in hot and moist environments. The main types of cockroaches causing the sensitivity are Blatella germanica, Periplanata americana ve Blatella orientalis. Although cockroach allergens are found throughout the home, including beds, furniture, and carpets, allergen levels are highest in the kitchen. Saliva, faecal material, secretions, cast skins, debris, and dead bodies are cockroach allergens. Sensitivity to cockroach allergen has been shown to be associated with exposure levels and is more prevalent in urban than in suburban areas. For good protection, it is necessary to use insecticides and clear out the indoor environment very well.1 IgE is a combination of two heavy and two light chain immunglobulin in 190 kg Dalton which contains less than 1 mcg/ml in normal monomeric plasma. Serum IgE concentrations are highly age dependent. Since IgE does not cross the placental barrier in a significant amount, cord serum IgE levels are low, usually less than 2 kU/L. Progressive increases in mean serum IgE levels occur up to age 10 to 15 years. After age 14, serum IgE levels greater than 333 Ku/L (800 mcg/L) are strongly associated with atopic disorder. Although high levels of serum IgE are common in allergic disease, total serum IgE has become less frequently used as an indicator for atopy because of the wide overlap in the IgE distributions of the atopic and non-atopic population.2 Eosinophils are generated in the bone marrow and can be found in the peripheral blood, where they represent 1% to 5% of the leukocytes with an upper limit of 0.4x109/L. Eosinophilia and IgE production is driven by allergen-activated Th2 cells that generate large amounts of Th2 cytokines (IL-4, IL-5, IL-13).3 Here we present two adolescent patients admitted to our allergy clinic because of high IgE levels and hypereosinophilia. In evaluation of these two patients we determined cockroach allergy. We stress that cockroach allergy should always be kept in mind in cases of high IgE levels and hypereosinophilia in adolescents.