The Egyptian Society of Pediatric Allergy and Immunology (ESPAI)The Egyptian Journal of Pediatric Allergy and Immunology1687-164217120190401Eczema the hidden face of primary immunodefeciency diseases3114153110.21608/ejpa.2019.41531ENNesrineRadwanPediatric allergy and immunology unit, Ain Shams UniversityJournal Article20190401The Egyptian Society of Pediatric Allergy and Immunology (ESPAI)The Egyptian Journal of Pediatric Allergy and Immunology1687-164217120190401Double negative alpha beta T cells in pediatric hemophagocytic syndromes13194153310.21608/ejpa.2019.41533ENElhamHossnyPediatric allergy and immunology unit, Ain Shams University, Cairo, EgyptRashaEl-OwaidyMD, PhD. Lecturer of Pediatrics and Pediatric Allergy and Immunology, Ain-Shams University, Egypt. Member, ESPAI, WAO, EAACI, ESID, ASID0000-0002-5609-4160HanaaAfifiClinical pathology department, faculty of medicine, ain sham universityHadeerAhmadMinistry of health public hospitals, Cairo, EgyptJournal Article20190401Introduction: Autoimmune lymphoproliferative syndrome (ALPS) and<br />hemophagocytic lymphohistiocytosis (HLH) share clinical and laboratory<br />features including lymphadenopathy, splenomegaly, and pancytopenia. We<br />sought to measure αβ double negative T cells (αβ DNT) in a group of<br />patients with established diagnosis of HLH in relation to disease activity and<br />severity. Methods: We conducted a follow-up, controlled study that<br />comprised 25 patients with HLH and 25 healthy matched controls. Patients<br />were subjected to clinical evaluation and flowcytometric measurement of αβ<br />DNT Cells at presentation and 9 weeks after start of HLH induction<br />treatment. Results: In 17 (68%) patients, infection was the trigger of HLH<br />while the cause was malignancy in three (12%), and rheumatological<br />disorders in two patients (8%). At enrollment, 15 patients (60%) had αβ<br />DNT cells levels [median (IQR): 1.71 (1.25-2.12)] that were significantly<br />higher than the control values [median (IQR): 0.7 (0.4-0.8)] (p<0.001). The<br />αβ DNT counts of patients were also higher at enrollment as compared to<br />values at the end of week 9 [median (IQR): 0.76 (0.45-1.17)]; p=0.018.<br />Survivors (n=8) and non-survivors (n=17) had comparable levels of αβ DNT<br />cells at enrollment (p=0.861). αβ DNT cell count correlated positively with<br />ALT (p=0.019) and negatively with CD4/CD8 ratios (p=0.023).<br />Conclusion: Elevated αβ DNT cell counts might be related to the HLH<br />process and this implies that mild elevation can exist in HLH and are not<br />specific to ALPS. Wider scale studies with longer periods of follow up are<br />needed to validate the results and properly outline the correlation between<br />both medical conditions.The Egyptian Society of Pediatric Allergy and Immunology (ESPAI)The Egyptian Journal of Pediatric Allergy and Immunology1687-164217120190401Vitamin D level in preschool children with recurrent wheezy chest, and its relation to the severity of the wheezing episodes21294153410.21608/ejpa.2019.41534ENNaglaaOsmanDepartment of Pediatrics, Faculty of Medicine, Assiut University, Assiut,
Egypt.HanaaMohammadDepartment of Pediatrics, Faculty of Medicine, Assiut University, Assiut,
Egypt.KotbMetwalleyDepartment of Pediatrics Faculty of Medicine, Assiut University, Assiut,
Egypt.MostafaEmbabyDepartment of Pediatrics, Faculty of Medicine, Assiut University, Assiut,
Egypt.TarekElmelegyDepartment of Clinical Pathology,
Faculty of Medicine, Assiut University, Assiut,
Egypt.Journal Article20190419Background: Recurrent wheezy chest is a common complaint in pediatric<br />practice. Vitamin D is a potent immunomodulator in allergic diseases as wheezy<br />chest and asthma. The prevalence of vitamin D deficiency has been increasing<br />in Egypt leading to significant morbidities. Objectives: This study aimed to<br />assess serum 25 hydroxy (OH) Vitamin D level in preschool children with<br />recurrent wheezy chest, and to assess its relation to the recurrence, severity,<br />and level of control of the wheezing episodes. Methods: The study included 100<br />preschool children (aged 2 to 5 years), of both sexes, recruited from the<br />Emergency department, Allergy and Pulmonology units at Assiut University<br />Children Hospital, Egypt. They should have at least 3 documented episodes of<br />wheeze, cough, and difficulty breathing in the last year with clinical<br />improvement on inhaled short-acting beta 2 agonists. Patients were subjected to<br />questionnaire-based history, clinical examination, and laboratory investigations<br />(complete blood count (CBC) with the absolute eosinophil count, serum total<br />IgE level, and serum 25 hydroxy (OH) Vitamin D level). Pediatric Respiratory<br />Assessment Measure (PRAM score) for assessment of the severity of the<br />wheezing episodes and Global Initiative for Asthma (GINA) based level of<br />asthma control for children 5 years and younger were applied. The patients<br />were grouped according to PRAM score to mild, moderate and severe episodes<br />and according to vitamin D level as sufficient and below-sufficient groups<br />(including deficient and insufficient patients). Results: 25(OH) Vitamin D level<br />was below-sufficient in 53% of the studied patients (deficient in 32% and<br />insufficient in 21%). PRAM score was significantly lower in patients with<br />sufficient 25(OH) Vitamin D level versus those with below-sufficient level (p <<br />0.025). There was a significant negative correlation between PRAM score and<br />25 (OH) Vitamin D level (r = -0.334, p = 0.001). Conclusion: There is an<br />inverse relationship between 25(OH)vitamin D level and parameters of asthma<br />severity, as well as with the level of asthma control in preschool children with<br />recurrent wheezy chest.The Egyptian Society of Pediatric Allergy and Immunology (ESPAI)The Egyptian Journal of Pediatric Allergy and Immunology1687-164217120190401FOXO3a gene polymorphism and bronchial asthma in Egyptian children31364153510.21608/ejpa.2019.41535ENNihaElrifaiDepartment of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.HananAl-WakeelDepartment of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.HananOsmanDepartment of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.RaniaEl TaweelDepartment of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.Journal Article20190401Background: FOXO3a proteins play multiple crucial roles in immune<br />response. FOXO3 inhibits T cell proliferation, induces T cell apoptosis via<br />upregulation of proapoptotic proteins and it suppresses T cell activation<br />preventing autoimmunity. The role of FOXO3a gene in the pathogenesis of<br />bronchial asthma has been studied in few ethnic groups and revealed its<br />implication in asthma pathogenesis. Objectives: The aim of the current study is<br />to detect the association between single nucleotide polymorphism of the<br />FOXO3a gene (rs13217795) and bronchial asthma, atopy and asthma severity<br />in Egyptian children. Methods: The current cross-sectional case-control study<br />was performed on 75 asthmatic children aged 2 to 12 years following up in the<br />pulmonology outpatient clinic in Children's hospital, Cairo University and 75<br />age and sex matched healthy controls. Candidates were subjected to clinical<br />evaluation in addition to genotyping for the FOXO3a gene polymorphism using<br />PCR-RFLP technique. Results: The highest frequency was for the heterozygous<br />type CT in both cases and controls groups. The genotype frequencies of mutant<br />type TT for cases and controls were 12 % and 16% respectively, and the T allele<br />frequencies were 37.2% in cases and 46.7% in the control group while CC<br />genotype was present in 37.3% of asthmatic patients and 22.6% in the controls<br />and the C allele was detected in 62.8% and 53.3% for cases and controls<br />respectively. No statistically significant differences were observed between<br />asthmatic patients and controls regarding the different genotypes of the<br />FOXO3a gene polymorphism (p=0.161). No significant association was<br />detected between the different genotypes of the FOXO3a gene polymorphism<br />and the atopic status (p=0.536) or the different grades of asthma severity (p=<br />0.545). Conclusions: The study of FOXO3a gene polymorphism (rs13217795)<br />in asthmatic Egyptian children revealed low frequency of the mutant TT<br />genotype among cases and controls. In the current study, FOXO3a<br />polymorphism has no role in the pathogenesis of asthma or atopy. Moreover, it<br />has no relation to degree of disease severity.The Egyptian Society of Pediatric Allergy and Immunology (ESPAI)The Egyptian Journal of Pediatric Allergy and Immunology1687-164217120190401Membrane endothelial protein C receptor expression in renal tissue of pediatric lupus nephritis patients37444153710.21608/ejpa.2019.41537ENMagidIbrahimDepartment of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo,
Egypt.ShereenElsayedDepartment of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo,
Egypt.RagiaSaidDepartment of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo,
Egypt.MonaIsmailDepartment of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo,
Egypt.NaglaaAhmedDepartment of Pathology, Faculty of Medicine, Ain Shams University, Cairo,
Egypt.NesrineRadwanDepartment of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo,
Egypt.Journal Article20190401Background: Lupus nephritis (LN) is more common and more severe is<br />pediatric systemic lupus erythematosus (pSLE). Endothelial protein C<br />receptor (EPCR) is an inducer of anti-apoptotic pathways in endothelial<br />cells. Recent studies have taken elevated anti-injury biomarkers as EPCR<br />into consideration regarding their roles to antagonize LN. Objectives: to<br />evaluate the membrane expression of endothelial protein C receptor<br />(mEPCR) in the renal microvasculature in pediatric patients with LN.<br />Methods This study was conducted on 25 patients with pSLE following up at<br />the Allergy and Immunology Clinic, Children’s Hospital, Ain Shams<br />University. The 25 patients have LN proved by a previous renal biopsy.<br />Medical history, clinical examination and routine laboratory investigations<br />for assessment of disease activity were done for all patients. Paraffin blocks<br />of patients’ renal biopsies were subjected to immunohistochemistry staining<br />for the frequency of mEPCR. Results: mEPCR was mainly expressed in the<br />endothelium of the peritubular capillaries. Our results showed that an equal<br />number of patients had nil and mild marker expression (8 patients each,<br />32%) while 9 patients (36%) showed moderate/strong marker expression.<br />We found that 9 out of 10 (90%) of patients with class II had nil/mild<br />marker expression, 5 patients out of 9 (55.5%) with class III had<br />mild/moderate marker expression, while 5 patients 0ut of 6 (83.3%) with<br />class IV and V had moderate/strong marker expression. We only found a<br />significant statistical difference between the different degrees of mEPCR<br />expression regarding 24 hours urinary proteins. No statistical significance<br />was found between the different degrees of mEPCR expression and different<br />immuno-suppressive therapy dose/kg or renal outcome using the renal<br />British Isles Lupus Assessment Group (BILAG) score; in spite that most of<br />the patients who got improved had nil/mild marker expression. Conclusion:<br />mEPCR -bearing a statistically significant difference in relation to different<br />LN classes- showed more expression in the more aggressive classes; a<br />finding which might suggest a contribution of the endothelium of the renal<br />parenchyma to the pathophysiology of more progressive LN. Hence the<br />tissue marker might emerge as a potential new therapeutic target in the<br />search for more selective treatment for SLE.The Egyptian Society of Pediatric Allergy and Immunology (ESPAI)The Egyptian Journal of Pediatric Allergy and Immunology1687-164217120190401Test yourself in eczema in primary immunodeficiency45454153810.21608/ejpa.2019.41538ENNesrineRadwanDepartment of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, EgyptJournal Article20190401The Egyptian Society of Pediatric Allergy and Immunology (ESPAI)The Egyptian Journal of Pediatric Allergy and Immunology1687-164217120190401Allergy-immunology glossary46464153910.21608/ejpa.2019.41539ENZeinabEl-SayedDepartment of Pediatrics, Faculty of medicine, Ain Shams University, Cairo, EgyptRashaEl-OwaidyMD, PhD. Lecturer of Pediatrics and Pediatric Allergy and Immunology, Ain-Shams University, Egypt. Member, ESPAI, WAO, EAACI, ESID, ASID0000-0002-5609-4160Journal Article20190401The Egyptian Society of Pediatric Allergy and Immunology (ESPAI)The Egyptian Journal of Pediatric Allergy and Immunology1687-164217120190401Selections from international journals47484154010.21608/ejpa.2019.41540ENNahlaHeshmatDepartment of Pediatrics, Ain Shams UniversityJournal Article20190401The Egyptian Society of Pediatric Allergy and Immunology (ESPAI)The Egyptian Journal of Pediatric Allergy and Immunology1687-164217120190401Calendar of events49494154210.21608/ejpa.2019.41542ENRashaEl-OwaidyMD, PhD. Lecturer of Pediatrics and Pediatric Allergy and Immunology, Ain-Shams University, Egypt. Member, ESPAI, WAO, EAACI, ESID, ASID0000-0002-5609-4160Journal Article20190401