Stromal Derived Factor-1 Gene Polymorphism in Pediatric Immune Thrombocytopenia.

Immune thrombocytopenia (ITP) is a multifactorial disease in which both environmental and genetic factors have been implicated. The study aimed to investigate a possible association of single nucleotide polymorphisms (SNPs rs266085 and rs2839693) in the stromal derived factor-1 (SDF-1) gene and its association to ITP and effect on ITP severity and response to treatment. Genomic DNA was extracted from peripheral blood and polymorphism in SDF-1 gene rs266085 and rs2839693 was analyzed using PCR-restriction fragment length polymorphism technique in DNA extracted from 60 children with ITP together with 90 healthy controls. On analysis of SDF-1 rs266085 polymorphism, there was a high frequency of CC genotype in cases than controls and that difference was significant at codominant, overdominant, and dominant models (P<0.05). Furthermore, carriers of the CC genotype were more susceptible to severe ITP at onset, steroid dependency, and chronicity than carriers of other genotypes (P<0.05). Otherwise, no significant differences between ITP patients and controls as regard SDF-1 rs2839693 genotypes and alleles, and we did not find a relation between this polymorphism and ITP severity, steroid dependency, or duration. SDF-1 gene rs266085 SNP C allele is associated with susceptibility to develop ITP as well as increases the risk for severe ITP at onset, chronic ITP and steroid dependency.

Effect of Blastocystis sp. infection on hematological parameters and trace element status in children with iron-deficiency anemia.

Iron deficiency anemia (IDA), which causes greater morbidity and mortality in children, has multifactorial causes, including many helminthic and protozoal infections. Herein, the study aimed to find out the frequency and associated risk of Blastocystis sp. infection among children with IDA, together with the estimation of the serum levels of iron, zinc, copper, and vitamin A. Both stool and blood samples were obtained from 90 children with a confirmed diagnosis of IDA and 90 non-anemic children. Blastocystis sp. was diagnosed by direct stool examination and Invitro cultivation methods. Different hematological parameters were recorded, and the serum level of iron, zinc, copper, and vitamin A was measured in serum samples. The overall predominance of Blastocystis in children was 36.7%, significantly higher (P < 0.001) in children with IDA (55.6%) compared to non-anemic controls (17.8%). Furthermore, Blastocystis infected children were 5.781 times more prone to be anemic (OR = 5.781). All IDA cases with positive Blastocystis infection had a mean hemoglobin level of 9.55 g/dl (moderate anemia). While in other non-infected IDA cases, it was 9.56 g/dl, showing no statistical difference (P = 0.845). Serum levels of zinc, iron, and vitamin A considerably decreased, whereas serum copper levels significantly increased in IDA children infected with Blastocystis. The current research is the first in Egypt to indicate that Blastocystis infection in children is a high-risk factor for developing IDA. Blastocystis infection significantly alters the metabolic and biochemical processes and interferes with the absorption of micronutrients and vitamin A in IDA children.

Toxocariasis: potential association with bronchial asthma, and pneumonia among pediatric children.

Toxocariasis is an underestimated geohelminthic infection which shows respiratory changes concurrent with larval migration. The purpose of the present study was to detect Toxocara seropositivity in asthmatic and pneumonic children, and in turn to evaluate its association with the children clinical manifestations, laboratory test results, and sociodemographic risk factors. A total of 50 asthmatic, 50 pneumonic children and 50 healthy controls were subjected to stool analysis by direct wet mount and concentration techniques to exclude possible cross reactivity. Blood samples were collected for complete blood count and assessment of eosinophil count. Sera were examined for anti-Toxocara IgG antibodies, and measurement of total IgE level. Anti Toxocara IgG was detected in 27.3% (41/150) of the studied children. It was significantly higher in asthmatic group compared to controls (26%. p value = 0.033) and significantly highest in pneumonia group compared to both bronchial asthma group (46%. p value = 0.030) and control group (10%. p value = 0.001). There was a significant association between anti Toxocara IgG seroprevalence and each of eosinophilia, total IgE and both combined. Anti Toxocara IgG showed significant higher percentage in asthmatic children who recorded history of soil contact and pets contact as compared to control and pneumonic groups. Toxocara IgG seropositivity was highly associated with fever, cough, wheezes and dyspnea with statistical significance. Toxocara seropositivity has to be considered as a vital associated factor for asthmatic and pneumonic children, and eventually better to be considered in differential diagnosis by pediatricians. Further studies are still needed to explore the correlation between toxocariasis and different patient categories.

WITHDRAWN:Randomized controlled trial of effect of N-acetylcysteine as an antioxidant on iron overload in children with thalassemia major.

Ahead of Print article withdrawn by publisher.