The Study of Selective Decreased Serum IgG4 In Acute Phase of Kawasaki Disease

PURPOSE: The study was performed to investigate the IgG subclasses in acute febrile phase of Kawasaki disease(KD) to find correlation between selective IgG4 deficiency and incidence of KD patients. METHODS: The patients group consisted of 64 cases in acute phase of KD hospitalized from Jan. 1996 to Jul. 1999, and control group consisted of age matched 36 cases who admitted without KD. The obtained sera were measured the level of total IgG, IgM, IgA and IgG subclasses(IgG1, IgG2, IgG3, IgG4) by using Enzyme Immuno Assay and Single Radial Immuno-Diffusion method. RESULTS: The sex ratio of male to female was 1.4:1.0, and febrile days before admission was 4.6+/-2.4 days. Total levels of IgG, IgM and IgA were normal range in both groups. The levels of IgG1, IgG2 and IgG3 were not specific changes but significantly decreased the level of IgG4 in patients group as compared with control group(P<0.05). CONCLUSION: Selective decreased the levels of serum IgG4 can be one of factors to increasing the incidence of KD.

Drug-Resistant Tuberculosis in Children

PURPOSE: Initial drug resistance of children with tuberculosis is a useful performance indicator of tuberculosis control programme in the concerned country because it represented infection transmitted from adult patients with either primary or acquired drug resistance. But there have been a few studies available. The present study was made to know the incidence of drug-resistant tuberculosis in hopes of selecting effective treatment regimens for the treatment of childhood tuberculosis. METHODS: Tuberculosis patients were selected from those whose cultures had been submitted to drug susceptibility testing in the Korean National Tuberculosis Association from Jan. 1987 to Jun. 1995. We have investigated the drug resistance and reviewed retrospectively the medical records of children. A total of 48 strains were tested for drug susceptibility. Of these cases medical records were available in one half and 22 patients did not have a history of previous antituberculosis therapy. RESULTS: 1) Of the 48 strains, 18 (37.5%) were resistant to 1 or more antituberculosis drugs. The 14 (29.2%) and 8 (16.7%) strains were resistant to isoniazid and rifampin, respectively. The 7 (14.6%) strains were resistant to both isoniazid and rifampin. 2) Of the 22 strains isolated from patients without previous therapy, 4 (18.2%) were resistant to 1 or more antituberculosis drugs. The 2 (9.1%) strains were resistant to isoniazid. There were no resistant strains to rifampin and to both isoniazid and rifampin. CONCLUSIONS: Primary resistance rate for isoniazid was 9.1%. These limited data suggested that four-drug regimens is indicated in childhood tuberculosis patients.

A case of cyclic neutropenia

Cyclic Neutropenia is a benign, unusual hematologic disorder characterized by regularly recurring episodes of severe neutropenia occurring approximately every 21 days. Beside neutrophils, monocytes, lymphocytes, platelets and reticulocytes all cycle with strict periodicity suggest that this disease should be viewed as cyclic hematopoiesis, not merely as cyclic neutropenia. During neutropenic periods, patients regularly experience aphthous stomatitis, fever, malaise, cervical lymphadenitis, cutaneous infections and occasional pneumonia and otitis media. The exact cause of cyclic neutropenia is unknown. But it is strongly suggested that cyclic neurtopenia is due to an abnormality in the regulation of early hematopoietic precursor cells. We have documented a case of cyclic neutropenia for a period of 2.5 years in a 11 year-old boy who had suffered from recurrent fever, stomatitis, gingival swelling, cervical lymphadenitis and skin infections at 3 weeks intervals since 5 years of age. A brief review of the related literatures is presented.