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A study of hyperimmunoglobulin E syndrome in Damascus University Children’s Hospital

دراسة متلازمة فرط الغلوبولين المناعي E عند الأطفال في مستشفى الأطفال الجامعي

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 Publication date 2011
and research's language is العربية
 Created by Shamra Editor




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Hyperimmunoglobulin E (Job) syndrome is considered to be a relatively rare disease. Its characterized by recurrent infections in skin (eg. boils, abscesses), recurrent upper respiratory tract infections (eg. otitis media, sinusitis and mastoiditis), and lower respiratory infections (eg. recurrent pneumonia, which is often complicated by pneumatoceles and lung abscess), that are usually difficult to treat. The highly increased IgE levels are considered to be the hallmark of the disease. The syndrome has two types: one is inherited as an autosomal recessive, and the other, as an autosomal dominant trait. To highlight the clinical manifestations and laboratory findigs of Job disease, and to compare it with medical literature, to study the bacterial complications and differrent types of antibacterial treatments and treir results, and to increase the level of awareness among physicians.


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Research summary
تتناول هذه الدراسة متلازمة فرط الغلوبولين المناعي E (المعروفة أيضًا بمتلازمة جوب) عند الأطفال، وهي حالة نادرة تتميز بارتفاع مستويات الغلوبولين المناعي E وظهور التهابات جلدية وتنفسية متكررة. هدفت الدراسة إلى تسليط الضوء على التظاهرات السريرية والمخبرية للمتلازمة، ودراسة الاختلاطات الجرثومية والعلاج بالمضادات الحيوية المختلفة، ورفع مستوى الوعي بين الأطباء. أجريت الدراسة في مستشفى الأطفال الجامعي بدمشق على 13 طفلًا تم تشخيصهم بالمتلازمة خلال الفترة من 2006 إلى 2010. أظهرت النتائج أن معظم الحالات كانت من نصيب الذكور، وأن التهابات الجهاز التنفسي العلوي والسفلي كانت من التظاهرات السريرية المهمة. كانت التظاهرات الجلدية من العلامات المميزة، وكانت العنقوديات المذهبة هي الجرثومة الأكثر شيوعًا. خلصت الدراسة إلى أهمية أخذ تاريخ مرضي مفصل والانتباه إلى التشوهات الهيكلية والوجهية المميزة، وإجراء اختبارات متقدمة لتأكيد التشخيص.
Questions related to the research
  1. ما هي الأعراض السريرية المميزة لمتلازمة فرط الغلوبولين المناعي E؟

    تتميز المتلازمة بارتفاع مستويات الغلوبولين المناعي E، وظهور التهابات جلدية مثل الدمامل والخراجات، والتهابات تنفسية علوية وسفلية متكررة مثل التهاب الأذن الوسطى والتهاب الجيوب وذات الرئة المتكررة.

  2. ما هي الجرثومة الأكثر شيوعًا التي تم عزلها في حالات متلازمة فرط الغلوبولين المناعي E؟

    كانت العنقوديات المذهبة هي الجرثومة الأكثر شيوعًا التي تم عزلها في حالات المتلازمة.

  3. ما هي أهمية أخذ تاريخ مرضي مفصل في تشخيص متلازمة فرط الغلوبولين المناعي E؟

    أخذ تاريخ مرضي مفصل يساعد في التعرف على التظاهرات السريرية المميزة للمتلازمة مثل الطفح الوليدي والتشوهات الهيكلية والوجهية، مما يسهم في رفع مستوى الشك السريري وإجراء اختبارات متقدمة لتأكيد التشخيص.

  4. ما هي القيود التي تعاني منها هذه الدراسة؟

    تعاني الدراسة من قيود مثل حجم العينة الصغير، عدم تضمين تحليل جيني لتأكيد التشخيص، عدم التطرق إلى العلاجات الحديثة، وعدم وجود مجموعة مقارنة من الأطفال الأصحاء أو المصابين بأمراض مشابهة.


References used
Rezai N. Primary Immunodeficiency Diseases, Definition, Diagnosis and Management. Tehran: Springer- Verlag Berlin Heidelberg; 2008
LaPine TR, Hill HR, Stiehm ER, TePas E. Hyperimmunoglobulin E syndrome. UpToDate. September 28, 2010. Available at: http://www.uptodate.com/contents/hyperimmunoglobulin-e-syndrome . Accessed April 17, 2011
Heimall J, Freeman A, Holland SM. Pathogenesis of hyper IgE syndrome. Clin Rev Allergy Immunol.. Feb 2010 ;38(1):32-38
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Background& Objective: Selective IgA deficiency is the most common primary immunodeficiency in humans. Its prevalence ranges from 1 in 100 to 1 in 1000 in among Arab populations. The majority of patients with selective IgA deficiency are asymptomat ic. The remaining present with recurrent upper and lower respiratory tract infections, recurrent gastrointestinal infections, otitis media, sinusitis, celiac disease, giardiasis, allergic disorders and some autoimmune diseases. to highlight the clinical manifestations and laboratory findings of Selective IgA deficiency in our study, and to compare it with medical literature. To study the bacterial complications and their prevalence. Materials & Methods: A retrospective study was carried out in Damascus University Children’s Hospital on sixteen child diagnosed as Selective IgA deficiency, in a period of the last ten years (from 2000 till September 2010). Results: most cases in our study were among males, failure to thrive was found in 75%, hepatosplenomegaly in one third, the most prominent infectious complications were: recurrent pneumonia (in 87.5% of cases), recurrent GI infections (in 75% of cases) and UTI’s in (50%)of cases. On the other hand, the celiac disease was found in (25%) of our patients, which is much higher than described in medical literature. In general, the infectious complications had a good response to antibacterial therapy, and the IgA levels became normal in one patient, when he reached the age of eleven years. Conclusion: there is no information in medical literature about the association of selective IgA deficiency with hepatomegaly, splenomegaly, failure to thrive and an increased prevalence of urinary tract infections, therefore, it is necessary to conduct researches about this association.
The hyper immuno-globuline E (IgE) syndrome with recurrent infections or Job syndrome is a rare immunodeficiency characterized by recurrent skin and pulmonary abscesses and extremely elevated levels of IgE in serum with eczematous dermatitis. Asso ciated facial and skeletal features have been recognized but their frequency is unknown. The genetic basis of this syndrome is poorly understood.
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