Relationships between serum immunoglobulin A levels and allergic diseases in Korean children

PURPOSE: IgE is associated with allergic disease. However, insufficient research has been carried out regarding the levels of serum IgA in children with allergic disease. The purpose of this study was to evaluate the levels of serum immunoglobulin in Korean children with allergic disease and to identify significant correlations between such diseases and serum IgA levels. METHODS: We evaluated 338 children who visited the Pediatric Allergy Clinic, CHA Bundang Medical Center from March 2007 to July 2013. We assessed factors, such as sex, age, and family history of allergic diseases. Laboratory tests, including serum IgG, A, and M, total IgE, and specific IgE, were carried out on all patients. In addition, we compared serum IgA levels in allergic Korean children with normal reference ranges. RESULTS: The median (interquartile range) of serum IgA values was 31.1 mg/dL (14.3-50.6 mg/dL) in cases of food allergy and 44.3 mg/dL (25.7-94.2 mg/dL) in cases of atopic dermatitis. The serum IgA levels were lower in allergic Korean children aged 9-12 months and 25-72 months than in the normal mean reference values. Relationships between age and serum IgA levels were statistically significant in allergic children. CONCLUSION: Our study suggests that serum IgA levels might be lower in allergic children than in the normal mean reference values. In order to understand this mechanism, normal levels for IgA in Korean children must be determined.

Active Surveillance of Pertussis in Infants Under 6 Months of Age: A Single Center Experience from 2011 to 2013 / 소아감염

PURPOSE: The objective of this study was to assess and investigate the epidemiology of pertussis in infants under 6 months of age. METHODS: A prospective study was conducted between October 1, 2011 and April 30, 2013 in CHA Bundang Medical Center, Seongnam, South Korea. Polymerase chain reaction (PCR) or culture was used to detect Bordetella pertussis in nasopharyngeal aspirates from case patients who were hospitalized for acute lower respiratory tract infection (LRTI). In addition, multiplex real-time PCR assays were also performed to detect 6 etiologic viruses, including adenovirus, human metapeumovirus, influenza virus, parainfluenza virus, respiratory syncytial virus and rhinovirus. RESULTS: Of the 79 enrolled case patients, whose median age was 2 months of age, the most common diagnoses uncovered in this study were acute bronchiolitis (60%) and pneumonia (28%). B. pertussis infection was found in 13 cases (16%), in which 7 (53%) was coinfected with respiratory syncytial virus and 1 (7%) with influenza A virus. Of the 13 patients with B. pertussis infection, 6 (46%) were not vaccinated with the diphtheria, tetanus toxoid, and acellular pertussis vaccine, while 6 (46%) received 1 dose, and 1 (8%) received 2 doses. CONCLUSION: B. pertussis infection was present in 16% of under 6 month-old infants, who were hospitalized for acute LRTI. Therefore, a nationwide epidemiological surveillance of pertussis, including institutions that cater to infants under 6 months of age is necessary and needed.

The Most Important Factors for Retinopathy of Prematurity in Preterm Infants / 대한주산의학회잡지

PURPOSE: There are many known risk factors for a retinopathy of prematurity (ROP). We analyzed the most important risk factors and predictors of ROP among them. METHODS: We retrospectively reviewed the medical records of all premature infants admitted to the neonatal intensive care unit (NICU), between January 2010 and December 2012 at Gangnam CHA Medical Center, Seoul. . All infants (n=185) were hospitalized for more than 28 days, received eye examination for ROP and showed one of the following criteria: birth weight (BW) below 1,500 g, gestational age (GA) below 32 weeks, or oxygen treatment (> or =40% oxygen for more than 3 days). We divided the infants into the Non-ROP group (n=162) and the ROP group (n=23, more than stage 1) and analyzed group comparisons, risk factors and the importance of each factor of ROP by SPSS 13.0. RESULTS: Risk factors were duration of oxygen uses [Odds ratio (OR): 1.064, 95% confidence interval (CI): 1.007-1.125, P=0.028] and intravenous (IV) steroid (OR: 1.234, 95% CI: 1.000-1.523, P=0.049) by multi-factor adjustment. The most important factor was oxygenation duration. The following factors were time to full enteral feedings, and IV steroid duration. CONCLUSION: The incidence of ROP will be decreased if we can reduce the length of oxygen uses, IV steroid use and advance the full feeding achievement.