Browsing by Author "Škorić, Dejan (6602687814)"

Background/Aim. The cause of eosinophilia often remains unelucidated. The aim of the study was to analyze causes and treatment approaches in children with eosinophilia in pediatric tertiary care hospital. Methods. The medical records of children investigated for eosinophilia (based on the International Classification of Diseases code D72.1) were retrospectively reviewed in the University Children’s Hospital, Belgrade, Serbia, from December 2011 to December 2022. A total of 105 children (62 boys; male:female ratio was 1:4) aged one month to 16.5 years (median 7.7 years) were diagnosed with eosinophilia. After excluding 15 of them due to incorrectly assigned diagnosis based on relative eosinophil number only, the remaining 90 children were grouped according to the severity of eosinophilia (mild, moderate or severe). Results. Serological analysis confirmed toxocariasis in six (6.7%) patients, while two (2.2%) had a confirmed nematode infestation (Ascaris lumbricoides and Enterobius vermicularis, respectively). Thirty-two (35.6%) children with eosinophilia and three with no true eosinophilia were diagnosed with helminthiasis ex juvantibus. Eosinophilia was ultimately explained by allergic/atopic conditions [19 (21.1%)], drug reactions [four (4.4%)], bacterial infections [nine (8.9%)], hematological problems [five (5.5%)], Apstrakt Uvod/Cilj. Uzrok eozinofilije često ostaje nerasvetlјen. Cilj rada bio je da se analiziraju uzrok i terapijski pristup kod dece sa eozinofilijom u pedijatrijskoj bolnici tercijarnog stepena zbrinjavanja. Metode. Retrospektivno je analizirana medicinska dokumentacija dece koja su ispitivana zbog eozinofilije (naznačene šifrom D72.1 na osnovu Međunarodne klasifikacije bolesti) u Univerzitetskoj dečjoj klinici u Beogradu, Srbija, u periodu od decembra 2011. do decembra 2022. Dijagnozu eozinofilije imalo je ukupno 105 dece (62 dečaka; odnos autoimmune disorders [three (3.3%)], unrelated congenital disorders (one), or as an isolated finding [seven (7.8%)]. In addition, one of the children without an increased absolute eosinophil number was diagnosed with eosinophilic esophagitis. A total of 56 (53.3%) children received anthelminthic treatment: 9 (90.0%) with severe eosinophilia, 19 (51.4%) with moderate, 23 (53.5%) with mild, and 5 (33.3%) children with no true eosinophilia. Most (42) of the children were given mebendazole only, while the remaining 14 (eight with severe, three with moderate, and three with mild) were also initially treated with mebendazole but subsequently shifted to albendazole due to the persistence of eosinophilia. In all treated children, eosinophilia and other relevant findings (if any) subsided in a matter of a few days to a few weeks after initializing treatment. Conclusion. Our results support the recommendation that unexplained eosinophilia of all levels of severity requires a standardized diagnostic approach. The results also provide some support for a potential rational basis for ex juvantibus administration of anthelminthic drugs in a fraction of children with eosinophilia without an obvious etiological explanation. © 2024 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background: Antiepileptic drugs (AEDs) can cause hypersensitivity reactions in children. These reactions are mainly cutaneous, self-limiting, and benign, but life-threatening severe cutaneous adverse reactions can occur. Infections can lead to skin eruptions and mimic drug hypersensitivity reactions, if a drug is taken at the same time. The aims of our study were to confirm or rule out the diagnosis of hypersensitivity reactions to AEDs in children and to detect an infection which mimics these reactions. Methods: A prospective survey was conducted in a group of 100 children with histories of hypersensitivity reactions to AEDs by performing patch tests, delayed-reading intradermal test, and, in case of negative results, challenge test. In all children, a study was performed to detect infections by viruses or Mycoplasma pneumoniae. Results: Maculopapular exanthema and delayed-appearing urticaria were the most reported hypersensitivity reactions to AEDs. Sixty-six (66%) of 100 children had confirmed hypersensitivity reactions to AEDs. Fifty-nine children had positive patch test. No children had positive challenge tests. The most common AEDs causing hypersensitivity reactions were carbamazepine (45.4%) and lamotrigine (43.6%). Thirty-two children had positive tests for viruses or M pneumoniae, and nine of them had also a positive allergy work-up. Conclusion: Considering that there are no specific tests to distinguish between a viral infection and hypersensitivity reactions to AEDs in the acute phase, a diagnostic work-up should be performed in all children with suspected hypersensitivity reactions to AEDs, as well as infectious agent study, to remove a false label of hypersensitivity. © 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Background: Antiepileptic drugs (AEDs) can cause hypersensitivity reactions in children. These reactions are mainly cutaneous, self-limiting, and benign, but life-threatening severe cutaneous adverse reactions can occur. Infections can lead to skin eruptions and mimic drug hypersensitivity reactions, if a drug is taken at the same time. The aims of our study were to confirm or rule out the diagnosis of hypersensitivity reactions to AEDs in children and to detect an infection which mimics these reactions. Methods: A prospective survey was conducted in a group of 100 children with histories of hypersensitivity reactions to AEDs by performing patch tests, delayed-reading intradermal test, and, in case of negative results, challenge test. In all children, a study was performed to detect infections by viruses or Mycoplasma pneumoniae. Results: Maculopapular exanthema and delayed-appearing urticaria were the most reported hypersensitivity reactions to AEDs. Sixty-six (66%) of 100 children had confirmed hypersensitivity reactions to AEDs. Fifty-nine children had positive patch test. No children had positive challenge tests. The most common AEDs causing hypersensitivity reactions were carbamazepine (45.4%) and lamotrigine (43.6%). Thirty-two children had positive tests for viruses or M pneumoniae, and nine of them had also a positive allergy work-up. Conclusion: Considering that there are no specific tests to distinguish between a viral infection and hypersensitivity reactions to AEDs in the acute phase, a diagnostic work-up should be performed in all children with suspected hypersensitivity reactions to AEDs, as well as infectious agent study, to remove a false label of hypersensitivity. © 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

TEL-AML1 (ETV6-RUNX1) fusion gene which is formed prenatally in 1% of the newborns, is a common genetic abnormality in childhood Bcell precursor acute lymphoblastic leukemia. But only one child out of a hundred children born with this fusion gene develops leukemia (bottleneck phenomenon) later in its life, if contracts the second mutation. In other words, out of a hundred children born with TEL-AML1 only one child is at risk for leukemia development, which means that TEL-AML1 fusion gene is not sufficient for overt leukemia. There is a stringent requirement for a second genetic abnormality for leukemia development and this is the real or the ultimate cause of the leukemia bottleneck phenomenon. In most cases of TEL-AML1+ leukemia, the translocation t(12;21) is complemented with the loss of the normal TEL gene, not involved in the translocation, on the contralateral 12p. The loss of the normal TEL gene, i.e. loss of heterozygosity at 12p, occurs postnatally during the mitotic proliferation of TEL-AML1+ cell in the mitotic crossing over process. Mitotic crossing over is a very rare event with a frequency rate of 10-6 in a 10 kb region. The exploration and identification of the environmental exposure(s) that cause(s) proliferation of the TELAML1+ cell in which approximately 106 mitoses are generated to cause 12p loss of heterozygosity, i.e. TEL gene deletion, may contribute to the introduction of preventive measures for leukemia. © I. Ivanovski et al., 2015.

Introduction Spinal muscular atrophy (SMA) and acute lymphoblastic leukemia (ALL) are rare diseases, with usual onset in childhood. To date, no cases have been reported where these conditions co-exist in one patient. Nusinersen has not been used concurrently with chemotherapy for ALL in children. The aim of the paper is to present two patients with two rare diseases and the results of their therapy. Outlines of cases We describe two patients diagnosed with SMA and ALL. The first patient received nusinersen, while the second did not receive SMA treatment. ALL in both patients was successfully cured by the appropriate treatment protocol. In the first patient, nusinersen was temporarily discontinued but restarted during the maintenance phase of chemotherapy. The chemotherapy regimen in the first patient was modified during the maintenance of ALL treatment. Conclusion The concomitant use of nusinersen and chemotherapy for ALL in our first case was safe, demonstrating good efficacy and tolerance without significant interactions or adverse events. We consider the occurrence of ALL and SMA in our both patients to be just coincidental; however, further research is needed to clarify many dilemmas about potential connections between these two rare diseases. © 2024, Serbia Medical Society. All rights reserved.

Background/Aim. The umbilical cord blood (UCB) volume and hematopoietic stem cells count are used as indicators for hematopoietic potential of UBC units. These indicators are affected by a collection method and obstetric factors. It was established that birth weight and placental weight affect the volume and hematopoietic stem cells count in UCB units. The influence of other obstetric factors is less clear. The aim of this study was to investigate the impact of obstetric factors on hematopoietic potential of UCB units. Methods. The study involved 103 consecutive UCB units collected during 2013. Relationship of UCB volume, total nucleated cells, CD34+ cells and Colony Forming Unit-Granulocyte Monocyte count with maternal and neonatal characteristics was retrospectively analyzed. Results. It was shown that birth weight, placental weight and umbilical cord length ≥ 31 cm significantly increased the volume of collected samples, total nucleated cells, CD34+ cells and Colony Forming Unit-Granulocyte Monocyte count. Gestational age between 38−40 weeks increased significantly all umbilical factors (volume, total nucleated cells, CD34+ cells, and Colony Forming Unit-Granulocyte Monocyte count). Gender did not have an influence on quality of UCB units except on total nucleated cells and CD34+ cells count. Other obstetric factors did not affect significantly the quality of UCB units. Conclusion. Our study confirmed that birth weight, placenta weight, length of the umbilical cord and gestational age independently influenced the UCB unit volume, and absolute count of nuclear cells and hematopoietic stem cells. Due to a positive correlation between birth weight and placental weight, only birth weight, umbilical cord length and gestational age should be standard parameters in procedure of donor selection. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.