ABSTRACT
BACKGROUND: Transfusion of granulocytes obtained by apheresis is beneficial in febrile neutropenia (FN) but expensive and time-consuming. Buffy-coat-derived granulocytes could be an alternative. We studied the efficacy and safety of the administration of irradiated buffy-coat-derived granulocytes along with the standard of care in pediatric high-risk (HR) FN. METHODS: Sixty children ≤18 years with malignancy and chemotherapy-induced HR FN were randomized to either the granulocyte transfusion (GT) arm which received irradiated buffy-coat derived granulocyte transfusion along with the standard treatment or the standard treatment (ST) arm. RESULTS: Baseline characteristics, day-to-defervescence, antibiotic duration, hospital stay, and mortality were comparable between the groups. A significant difference was seen in days to achieve absolute neutrophil count (ANC) >500/mm3 in the 2 groups: 4.5 days (3-6.5) in the GT arm v/s 8 days (4-11) in the ST arm (P=0.01). CONCLUSION: Buffy-coat-derived granulocyte transfusion was safe and led to early hematological recovery but was not associated with survival benefits. Future studies with earlier initiation in the intended dose could be undertaken to generate more evidence.
ABSTRACT
OBJECTIVE: To determine the diagnostic accuracy of polymerase chain reaction-based detection of sof gene compared to throat swab culture for S. pyogenes infection in patients with acute rheumatic fever and those with recurrence of rheumatic activity. METHODS: 40 patients between 3 to 18 years of age, with clinical diagnosis of acute rheumatic fever or new activity in established rheumatic heart disease were included. The amplicon of 228bp of sof gene was detected using a polymerase chain reaction-based technique and the results were compared with throat swab culture for Streptococcus pyogenes. RESULTS: 10 patients had a positive throat swab culture and 11 had sof gene detected. The sensitivity and specificity of the test was 100% and 96.7%, respectively compared to throat swab culture (P=0.001). The positive predictive value and the negative predictive value was 90.9% and 100% respectively. CONCLUSION: Polymerase chain reaction-based detection of sof gene provides an alternative to throat swab culture in diagnosing activity in Acute Rheumatic Fever or established Rheumatic heart disease.
Subject(s)
Bacterial Typing Techniques/methods , Peptide Hydrolases/genetics , Rheumatic Fever/diagnosis , Streptococcal Infections/diagnosis , Streptococcus pyogenes , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , DNA, Bacterial/analysis , DNA, Bacterial/genetics , Humans , India , Pharynx/microbiology , Polymerase Chain Reaction , Rheumatic Fever/microbiology , Sensitivity and Specificity , Streptococcal Infections/microbiology , Streptococcus pyogenes/genetics , Streptococcus pyogenes/isolation & purificationSubject(s)
Infections/complications , Infections/diagnosis , Phagocytes , Primary Immunodeficiency Diseases/complications , Primary Immunodeficiency Diseases/diagnosis , CD18 Antigens/metabolism , Child, Preschool , Female , Genetic Predisposition to Disease/genetics , Humans , Infant , Male , Membrane Proteins/genetics , Monosaccharide Transport Proteins/genetics , Mutation , Neoplasm Proteins/genetics , Neutrophils , Periodontitis , Primary Immunodeficiency Diseases/classification , Primary Immunodeficiency Diseases/geneticsABSTRACT
Down syndrome is the most common chromosomal abnormality and is frequently associated with transient myeloproliferative disorder (TMD) and leukaemias. The coinheritance of this syndrome with beta-thalassemia major is uncommon. Only two cases of coinheritance of Down syndrome with beta-thalassemia major have been published in literature. We report an infant suffering from Down syndrome who presented with severe anemia which was later attributed to beta-thalassemia major and TMD. The infant improved after blood transfusion and other supportive management. The blasts disappeared from marrow during hospital stay. In areas of high prevalence of beta-thalassemia heterozygotes, the presence of coinheritance of the mentioned condition with another congenital disorder may be common.