Single photon emission computed tomography of the brain in pediatric patients with chronic renal failure

Uremic patients have a high incidence of cerebral atrophy as a result of chronic lowering of cerebral blood flow. A decrease in brain tissue perfusion might be deleterious in combination with a very low hematocrit. The aim of our study is to study the cerebral blood flow abnormalities in patients with chronic renal failure whether on conservative management or on regular hemodialysis. Forty patients with ages ranged from 5 to 18 ys with the mean age 11 +/- 0.03 ys suffering from CRF and attending the Nephrology clinic, Abo-El-Rish Hospital are included in our study. Twenty-four patients of them were treated conservatively whereas the other 16 end-stage renal disease [ESRD] patients are on regular hemodialysis. Another 10 age and sex-matched normal children were also included as control group. All patients and controls were subjected to full medical evaluation and laboratory investigations including intact molecular assay for parathormone [PTH]. We performed Single Photon Emission Computed Tomography [SPECT] scanning of the brain for all patients and Controls. In our study we found hypoperfusion of the frontal area in our patients, compared to controls as detected by low mean values of SPECT of frontal area [p. value <0.01]. Comparing the three studied groups [conservative, dialysis, and control groups] with each other, there are no statistical significance in mean level of SPECT values of frontal area between conservative and control groups, while there is significantly decreased mean level of SPECT values of frontal area in dialysis group compared to both conservative and control groups [p. value <0.01]. So, there is evident hypoperfusion of the frontal area in dialysis group. The decreased hematocrit level in dialysis group has a significant effect on decreased level of SPECT value of the frontal area. Anemia and depression are significantly prevalent in those patients and are to be considered as predisposing factors for frontal hypoperfusion. Therefore special attention should be paid to correction of anemia and periodic assessment of cognitive development and psychosocial adaptation evaluation for ESRD children on hemodialysis

Lymphocytotoxic antibodies in patients with juvenile rheumatoid arthritis

The presence of Iymphocytotoxic antibodies [LCA] in 27 patients with Juvenile Rheumatoid Arthritis [JRA] and 16 normal controls was studied by a Iymphocytotoxicity assay in an attempt to assess their possible role in the immunopathogenesis of the disease. Peripheral blood T-Iymphocyte subpopulations were also investigated using an indirect immunofluorescent test. A significant increase in LCA, together with a significant decrease in T suppressor cell percentage were noted in patients when compared with controls denoting that LCA are possibly an important factor in inibiting generation of suppressor T cells, thus leading to an overactivity of T- helper cells which in turn would result in autoantibodies and immune complex formation and deposition

Diagnostic methods in milk allergy

To assess the value of measuring total I[g]E, milk specific I[g]E and leucocytes migration inhibition [LMI] test in the diagnosis of cow's milk allergy, we selected 83 patients with milk allergy by elimination diet and rechallenge trials. Patients comprised 34 infants with gastrointestinal [GIT] manifestations, 21 with respiratory and 28 with skin manifestations. 32 normal controls were included also in the study. Patient with GIT and skin symptoms showed a significant decrease in migration index [MI] [when using milk extract as antigen in the LMI] as compared to normal controls and a control antigen. Total and specific I[g]E were normal in the GIT group only. On the other hand no significant difference in migration index was noted in patients with respiratory symptoms which showed an increase in total and specific I[g]E. It appears that LMI is useful in the diagnosis of some forms of milk allergy where tests for total and specific I[g]E are not decisive

Mycoplasma pneumoniae [MP] in asthmatic children

To determine the possible role of MP in exacerbations of asthmatic attacks in children,we studied 43 cases during acute attacks by throat swab culture and sera testing for IgMantibodies to MPby ELISA.MPwas isolated in 3 cases and IgM to MP was high in 8 episodes. The study shows that MP although not commonly isolated may be important in exacerbating acute asthmatic attacks in some children