Effects of postpartum depression on the behaviour of children born to mothers with epilepsy.

PURPOSE: Postpartum depression (PPD) is a non-psychotic depressive disorder that begins within 4 weeks of childbirth. This study aimed to evaluate the prevalence of PPD by screening mothers with the Edinburgh Postnatal Depression Scale (EPDS), to assess the behavioural outcome of children born to mothers with and without epilepsy and to investigate the relationship between PPD and children's behavioural problems. METHOD: We enrolled 80 pregnancies of women with epilepsy, who filled in EPDS after birth, and afterward we asked them to complete the Child Behavior Checklist (CBCL). RESULTS: 23.8% of patients presented PPD. Children, when the CBCL were completed, had a mean age of 6.05 ±â€¯3.07 years. The CBCL results indicate the occurrence of at least one behavioural issue in 25.0% (20/80) of children. CBCL scores revealed a higher prevalence of behavioural disturbances with regards to the CBCL Total (P = 0.016), internalizing (P = 0.014) and somatic problems (P = 0.048) in patients with PPD vs. patients without PPD. We found an association between mothers' EPDS total score and children's CBCL global score (P = 0.034), internalizing score (P = 0.021), anxiety problems (P = 0.05), affective problems (P = 0.027) and withdrawn/depressed (P = 0.05). We recorded a statistically higher malformation rate in patients with PPD (P = 0.005) compared to the general population. CONCLUSIONS: Children born from mothers with epilepsy have an increased risk for emotional disorders. These findings highlight the importance of screening for emotional distress and providing adequate interventions to children born to women with epilepsy.

Polyclonal immunoglobulin E levels are correlated with hemoglobin values and overall survival in patients with multiple myeloma.

PURPOSE: Polyclonal IgG, IgA, and IgM immunoglobulins are often decreased in sera of patients with multiple myeloma (MM), whereas very few data are available on polyclonal IgE levels. We have determined IgE levels in a large series of MM patients at diagnosis and subjects with monoclonal gammopathy of undetermined significance (MGUS) and correlated IgE levels with survival and prognostic factors in MM. EXPERIMENTAL DESIGN: IgE were determined with a commercially available ELISA kit in 201 MM patients at diagnosis, 144 subjects with MGUS, and 77 age-matched controls. RESULTS: IgE levels progressively decreased from controls to MGUS and from MGUS to MM (P = 0.001). MM patients with IgE levels of >11.5 IU/mL (median) had a better survival than patients with IgE of <11.5 IU/mL (P = 0.048). The difference was even more significant when MM patients were divided according to clinical cutoff values. Patients with elevated IgE levels (>100 IU/mL) had from 2 to 3 years longer survival than those with low (<10 IU/mL) or intermediate values (10-100 IU/mL; P < 0.01). IgE levels were positively and negatively correlated with hemoglobin (P = 0.006) and beta2-microglobulin levels (P = 0.007), respectively. Univariate and multivariate analyses confirmed that high IgE levels are positive predictors of overall survival (P = 0.03 and 0.08, respectively) and strongly correlated with hemoglobin values. CONCLUSIONS: Because IgE levels are dependent on Th(2) responses, these data open new perspectives in the interpretation of antitumor immune responses and pathogenesis of anemia in MM.

Decrease of specific and total IgE levels in allergic patients after BCG vaccination: preliminary report.

BACKGROUND: A systemic reaction to mycobacteria biases the balance of T helper cell types 1 and 2 toward T helper cell type 1. BCG vaccination mimics some characteristics of mycobacterial infection. Children who have undergone tuberculin conversion after BCG vaccination seem to be more likely to lose their atopic symptoms. Inhibition of both allergic response and airway hyperreactivity after vaccination for mycobacteria has been observed in animal experiments. OBJECTIVE: To evaluate the effects that BCG vaccination has on the serological status of allergic people. PARTICIPANTS AND METHODS: This study included 20 volunteers with a history of allergic rhinitis who were required to undergo BCG vaccination by Italian law. Epicutaneous allergy testing with a panel of common seasonal and perennial inhalational allergens and 2 blood withdrawals were performed. The serum total IgE levels and the serum allergen-specific IgE levels of each individual were measured just before BCG vaccination and again 4 months later. Total IgE levels were determined using the paper radioimmunosorbent test, and allergen-specific IgE levels were determined using the radioallergosorbent test. RESULTS: Total IgE and allergen-specific IgE levels were significantly decreased after BCG vaccination (P =.004 and P<.001, respectively). CONCLUSION: BCG, an effective stimulus for cell-mediated immunity, deserves further study to evaluate its ability to modulate the immune response associated with allergic rhinitis.