Normal antistreptolysin O titers of children by age group in the Gyeonggi-Incheon region / 소아과

PURPOSE: Measurement of antistreptolysin O (ASO) is often necessary to confirm a clinical diagnosis of recent streptococcal infection, especially in patients suspected of rheumatic fever and acute glomerulonephritis. Standard normal ranges for ASO should be established locally for each age group. We analyzed ASO to determine the upper limit of normal (ULN) ASO in children in the Gyeonggi-Incheon area. METHODS: ASO in normal individual concentrations were measured quantitatively by nephelometry on sera from 753 children (Male:381, Female:372). ULN were determined by separating the upper 20% from the lower 80% of the group (80 percentile). RESULTS: The mean ASO concentration calculated in a total cases was 149.9+/-7.2 IU/mL. The ASO concentration in neonates was 83.4+/-10.7 IU/mL, and lowest in the 1 year of age group, 26.7+/-6.6 IU/ mL, and increased to 318.0+/-33.2 IU/mL gradually in the 9 years of age group. Thereafter, ASO concentration decreased. The ULN for neonates was 122 IU/mL, for 0-3 years, 40 IU/mL; for 4-6 years, 113 IU/ mL; for 7-9 years, 489 IU/mL; for 10-19 years, 433 IU/mL; for 20-29 years, 122 IU/mL. CONCLUSION: The age-specific ULN for children in the Gyeonggi-Incheon area were determined. The distribution of ASO concentration according to age groups was different from previous reports. These results should be of clinical value to physicians to interprete the ASO results of their patients.

The alteration of the positive rate of cytomegalovirus IgG antibody among preschool period children / 소아과

PURPOSE: In order to evaluate the time of disappearance of cytomegalovirus(CMV) IgG antibodies from mothers, and the alteration of the positive rate of CMV IgG antibodies among preschool period children, we investigated the positive rate of CMV antibodies among preschool children. METHODS: We studied 391 children who visited the Department of Pediatrics from March, 2001 to February, 2004. We measured the serum CMV IgG of 217 children and the serum CMV IgM of 358 children. RESULTS: The positive rate of CMV IgG antibodies is 83.9 percent(the number of positive IgG children is 182 out of 217). The alteration of the positive rate is 92.9 percent in 0-3 months, 75.0 percent in 4-6 months and the nadir was 20.0 percent in 7-9 months. Then, the positive rate increased to 83.9 percent in 22-24 months. After 22 months, the positive rate was 92.1 percent(the number of positive IgG children was 105 out of 114). The positive rate of CMV IgM antibody by age is 3.3 percent in 0-1 months, 3.6 percent in 1-2 months, 10.5 percent in 2-3 months, 14.3 percent in 3-4 months, 14.3 percent in 4-5 months, and then the results of five children among 148 children were positive. The distribution was one in 22-23 months, one in 25-26 months, one in 27-28 months, one in 28-29 months, one in 40-41 months. We discovered IgM positive children succesively from birth to 5 months, but sporadically after 5 months. CONCLUSION: The CMV IgG from mothers has decreased since birth and the time of nadir is 7-9 months. But it increases to a mean value of 83.9 percent at 22-24 months because of perinatal or postnatal infections.

A Case of Young-Simpson Syndrome / 소아과

Young Simpson syndrome is a rare malformation syndrome characterized by congenital hypothyroidism, dysmorphic face, mental retardation, severe postnatal growth retardation, hypotonia and congenital heart abnormalities. In the present study, we report a case of 4-year-old girl with Young Simpson syndrome for the first case in Korea.

Detection of Cytokeratin-19 caused by Intestinal Epithelial Cell Damage in Childhood Diarrhea / 소아과

PURPOSE: Acute gastroenteritis in infancy is a very common disease with a frequency of a billion diarrhea per year, leading to 3 to 5 million deaths. Since the etiology is not always clear, the treatment plan can be quite difficult to make. The laboratory examinations of stool culture, along with complete blood counts may sometimes be helpful to find bacterial etiology, while occult blood in stool merely means the presence of gastrointestinal tract bleeding. We evaluated the presence of cytokeratin-19 in stools in differentiating bacterial and non-bacterial causes of childhood diarrhea to establish appropriate treatment plans. METHODS: Among 201(male 124 patients, female 77 patients) patients with diarrhea, cytokeratin-19 examined by ELISA was positive in 40 patients. Laboratory findings including peripheral blood leukocytes count with differential count, ESR, CRP were compared between the cytokeratin-19 positive and negative groups. We also investigated the correlation between cytokeratin-19 and stool culture, leukocytes, rotavirus antegen test, and occult blood in stool. RESULTS: The leukocytes count, neutrophil count in peripheral blood and ESR were higher in cytokeratin-19 positive group(P=0.030). There was significant correlation between serum CRP and cytokeratin-19(P=0.007). Sensitivity of cytokeratin-19 was 0.30 and specificity was 0.86 in serum CRP positive group and negative group. CONCLUSION: Cytokeratin-19 in stool was significantly increased in correlation with leukocytes and neutrophil count in peripheral blood, ESR, serum CRP and the specificity of cytokeratin-19 was 0.86 in the serum CRP positive group and the negative group. Therefore, the quantitification of cytokeratin-19 in stool was considered as indicator of differential diagnosis between clinically bacterial and non-bacterial infection groups.