Mannose-binding lectin deficiency in preterm neonates

Mannose-binding lectin [MBL] is a collagenous protein that plays a role in innate immunity. MBL deficiency is associated with an opsonization defect and has been associated with recurrent infections, especially in immunocompromised individuals. Neonates are considered to be immunocompromised because adaptive immunity has not yet been developed. This study was done to evaluate the levels of MBL in premature neonates and to determine the relation between MBL deficiency and development of sepsis. This case- control study was conducted on 64 neonates classified into 2 groups; 39 preterm neonates with gestational age [G.A] <36 weeks and 25 healthy full term neonates. Measurement of mannose-binding lectin [MBL] serum level was done on the first day of life using ELISA technique. Mean MBL plasma level was found to be lower in preterm than full term neonates, yet this difference did not reach statistical significance. There was a negative correlation albeit an insignificant one, between MBL level and GA. The deficient group [those with MBL level

Protein C and microalbuminuria in insulin dependent diabetic children

The aim of this study was to assess one of the coagulation parameters, protein C, in insulin-dependent diabetic children and to find out its relation to the development of vascular changes manifested by microalbuminuria and to the glycemic control indices in diabetic children. The study was performed on 46 children including 24 diabetic patients with normoalbuminuria [mean age 11.2 +/- 1.9 years], 10 patients with microalbuminuria [mean age 13.5 +/- 1.23 years] and 12 healthy children of comparable age and sex with the patients as a control group. All children were subjected to full history taking, thorough physical examination, anthropometric assessment, fundus examination and laboratory investigations including a measurement of complete blood picture [CBC], fasting blood sugar [FBS], glycosylated hemoglobin [HbA1c], cholesterol [CH], triglycerides [TG], microalbuminuria and protein C [PC] levels. There was a highly significant increase in plasma PC level in diabetic children when compared with the controls and this increase was significantly more in microalbuminuric than in normoalbuminuric children. Moreover, PC level was significantly positively correlated with the duration of the disease and with other parameters and indices of diabetic control including HbA1c, CH, TG and microalbuminuria, which indicated that PC assessment could be used as a predictor of development of vascular complications as atherosclerosis and nephropathy in insulin-dependent diabetes mellitus

Procalcitonin: an early marker of neonatal sepsis after premature rupture of membranes

In order to assess the predictive value of procalcitonin [PCT] in the early diagnosis and management of neonatal sepsis following premature rupture of membranes [PROM], cord blood procalcitonin [PCT] was evaluated by radioimmunoassay in addition to complete blood count, C- reactive protein [CRP] and blood cultures in 80 newborn infants following PROM of >/24 hours and in 20 healthy comparable controls. Then, a clinical follow up of all cases was done during the neonatal period for the diagnosis of any manifestations and outcomes of infection. A highly significant mean cord blood level of PCT was detected in PROM group compared with the controls. PCT levels were positively correlated with the hematologic score for sepsis and with CRP levels. Moreover, newborns with proven infection [positive blood cultures] showed a significant higher mean PCT level than those with negative cultures and the level was markedly increased in non- survivors compared with the survivors indicating its value as both diagnostic and prognostic test. Higher sensitivity [100%] and specificity [75%] of PCT to sepsis were noted when compared with other indicators of infection; namely, hematologic score and CRP

Role of IgG subclasses and allergy in children with recurrent otitis media

In order to evaluate the role of immunoglobulins especially IgG subclasses in the occurrence of recurrent otitis media [OM], serum levels of IgM, IgA, IgE, total IgG and its subclasses were estimated in 60 children aged 1 to 6 years [mean 3.1 +/- 1.3 yrs]. They included 32 patients with recurrent acute otitis media [AOM] and 28 patients with recurrent otitis media with effusion [OME. Another group of 20 healthy comparable controls was also studied. In addition, all children were subjected to full history taking, thorough physical examination with special stress on the systemic manifestations of recurrent infections, immunodeficiency and allergy. Then, complete ENT assessment was done including use of pneumatic ostoscopy and tympanometry. Significant decrease of mean serum level of IgA, total IgG and its subclasses IgG[1], IgG[2] and IgG4 was found in both groups of children with recurrent OM in comparison to the controls and their levels were negatively correlated with the rate of recurrence of OM. This immunodeficiency was attributed to either congenital defect or delayed maturation of the immune system. Moreover, children with recurrent ome showed significant increase of their IgE and decrease of IgG4 serum levels when compared to those with recurrent AOM which points to the role of allergy in occurrence of this disease. In conclusion, assessment of immuoglobulins levels including IgG sublasses was recommended in children with recurrent OM. In addition, taking all prophylactic measures against both infection and allergy in these children and encounragement of trials of immunoglobulin therapy for them were emphasized as an approach for prevention of their recurrent disease