Increased subsequent risk of myasthenia gravis in children with allergic diseases.

Myasthenia gravis (MG) is an autoimmune disorder that affects the neuromuscular junction. The initiating factors of MG remain unclear. However, allergy has been regarded as a potential risk factor. We included 410 children with MG diagnosed between 2000 and 2008, as well as 1640 randomly selected controls. The odds ratios of MG were calculated to determine the association between MG and preexisting allergic diseases. The children with allergic diseases were at increased subsequent risk of MG, which was associated with the cumulative effect of the concurrent allergic diseases and the frequency of seeking medical care.

[Psychoneuroimmunology of the life span: impact of childhood stress on immune dysregulation and inflammatory disease in later life]. / Psychoneuroimmunologie des Lebenslaufs: Einfluss von Stress in der Kindheit auf Immunfunktionsstörung und entzündliche Erkrankung im weiteren Leben.

Studies have shown clearly that childhood mistreatment, abuse and neglect are associated with severe inflammatory disease in adulthood (e. g. cancer, heart disease, autoimmune disorder) and shortened life span. This review deals with the psychoneuroimmunological pathways of this connection. It shows that chronic stressors interfere very early in life with those protective mechanisms of the biological stress system that normally down-regulate potentially harmful inflammation. In the long term, serious inflammatory diseases, such as allergic asthma, can result. In this review, the pathogenetic connections between allergic asthma and early stress and stress system dysfunction are discussed. As our understanding of the dysfunctional psychophysiological mechanisms of inflammatory disease increases, psychodiagnostic and psychotherapeutic intervention in the treatment of physical disease will become more specific.

Vitamin D deficiency in children with a chronic illness-seasonal and age-related variations in serum 25-hydroxy Vitamin D concentrations.

INTRODUCTION: Children and adolescents with a chronic illness have potential risk factors for vitamin D deficiency. An optimal vitamin D status might have multiple health effects. This study evaluated vitamin D status and its association with age, gender, and season in a large cohort of chronically ill Finnish patients at a tertiary pediatric outpatient clinic. A cross-sectional register-based study was carried out, involving altogether 1351 children (51% boys, age range 0.2-18 years), who visited the outpatient clinic during 2007-2010 and had their vitamin D status (S-25-OHD) determined. A post-doc analysis was conducted to identify predisposing and preventing factors for vitamin D deficiency. RESULTS: Almost half (47%) of the S-25-OHD values were consistent with subnormal vitamin D status (S-25-OHD <50 nmol/L) while only 12% were >80 nmol/L. Age and season were the most important determinants for S-25-OHD concentration. Mean S-25-OHD concentration differed between age groups (Kruskal-Wallis; p<0.001), adolescents being at highest risk for vitamin D insufficiency. Young age and vitamin D supplementation were preventive factors for deficiency, while non-Finnish ethnic background was a predisposing factor. S-25-OHD showed significant seasonal variation in children older than 6 years. In the whole cohort, S-25-OHD was on average 13 nmol/L higher in summer than in winter, and the prevalence of vitamin D deficiency ( =  S-25-OHD <37.5 nmol/l) varied from 11% in summer to 29% in winter. CONCLUSIONS: The finding that almost half of the studied Finnish children with a chronic illness had suboptimal vitamin D status is alarming. Inferior vitamin D status was noted in adolescents compared with younger children, suggesting that imbalance between intake and requirement evolves with age. Although less common during summer, subnormal vitamin D status was still observed in 28% of those evaluated in summer. Clinicians should identify individuals at risk and actively recommend vitamin D supplementation.