ABSTRACT
The wheezing infant is a common but difficult patient to approach diagnostically. The prevalence of IgG subclass antibody deficiency in wheezing infants is still controversial. We studied serum concentration of IgG subclasses in 38 wheezing infants (aged 6-24 months who had not received systemic steroids before investigation) and in 30 healthy age matched control (aged 6-24 months). The prevalence of one or more IgG subclass deficiency was 31.6% in wheezing infants and 26.7% in controls. There was no significant difference in prevalence of IgG subclass deficiency between patients and controls (p > 0.05). The mean concentration of IgG subclasses in patients were compared with controls. There was no significant difference in mean serum concentration of IgG1, G2 and G3 subclasses. But there was a trend towards higher concentrations of IgG4 in wheezing infants and this difference for IgG4 was significant (p < 0.01). However, IgG subclass deficiency was found in 25% and 36.4% of wheezing infants who had experienced from two to four and five or more wheezing episodes in two years, respectively (p > 0.05). These findings suggest that wheezing in infancy is not associated with IgG subclass deficiency and in wheezing infants low IgG subclass levels do not increase the frequency of wheezing.
Subject(s)
Antibodies/blood , Case-Control Studies , Chi-Square Distribution , Child, Preschool , Female , Humans , IgG Deficiency/blood , Immunoglobulin A/blood , Immunoglobulin E/blood , Immunoglobulin G/blood , Immunoglobulin M/blood , Infant , Male , Prevalence , Respiratory Sounds/immunologyABSTRACT
Gastroesophageal reflux (GER) is implicated in the pathogenesis of respiratory symptoms in childhood. It should be taken into account especially in the differential diagnosis of children presenting with wheezing. Although, oesophageal pH monitorization has been reported to be the best technique in the evaluation of GER, radionuclide studies have also been shown to be very sensitive recently. In this study, 82 children presenting with recurrent wheezing (n = 74) and/or vomiting (n = 28) (mean age 17.4 months; range 3-48 months) were evaluated. GER scintigraphy was performed to determine the frequency of GER. GER was determined in 18 of the 82 cases (21.9%). The GER was found in 21.1% of children with recurrent wheezing and in 16.6% of children suffering from recurrent vomiting. GER scintigraphy should be kept in mind in the evaluation of children with the complaint of recurrent wheezing since it is a noninvasive and easily applicable method.
Subject(s)
Age Factors , Child, Preschool , Diagnosis, Differential , Female , Follow-Up Studies , Gastroesophageal Reflux/complications , Humans , Infant , Male , Prevalence , Recurrence , Respiratory Sounds/diagnosis , Vomiting/etiologyABSTRACT
The care of very-low-birth-weight infants has improved over the years with continuing changes in medical and nutritional management. In view of these changes, there is a need to study the pattern of postnatal weight gain. Postnatal weight gain patterns of 32 very-low-birth-weight infants were examined during the first two months of life. Their mean gestational age was 29.5 +/- 2.3 weeks and mean birth weight was 1255 +/- 258 grams. The babies were weighed daily and weight changes were expressed in gram/day. All data were accurately recorded. When mean weight gain profiles were obtained by computing increments at 1, 3, 7 and 14 day intervals, the babies weight gain showed a non-linear pulsatile pattern which did not change even after full enteral nutrition had been established. This study demonstrates that weight velocity profile in very-low-birth-weight infants is not linear as expected from available standard curves and these data might therefore be considered while monitoring the adequacy of the increments of the weight gain of the individual subjects.