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Hsu TC, Wang JD, Chen CH, Chang TK, Wang TM, Chou CM, Lin HK. Treatment with propranolol for infantile hemangioma in 13 Taiwanese newborns and young infants. Pediatr Neonatol 2012; 53:125-32. [PMID: 22503260 DOI: 10.1016/j.pedneo.2012.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 06/22/2011] [Accepted: 08/19/2011] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Hemangioma in infants has a benign self-limited course, but the 10% of cases with complications need further treatment. Successful treatment with propranolol in western countries has been reported over the past few years. We evaluated the efficacy of propranolol for treating infantile hemangioma in Taiwanese newborns and young infants. METHODS Patients below 1 year of age treated with propanolol between November 2009 and March 2011 were enrolled. Demographic data, clinical features, imaging findings, treatment regimens of propranolol, and outcome were investigated. RESULTS Thirteen patients were treated with propranolol at a dose of 2-3 mg/kg/day. Seven (53.8%) patients had solitary hemangioma and six had multiple ones. The indications for treatment were risk of local event in nine patients, functional risk in four, local complication in one, and life-threatening complication in one. The median age for starting propranolol was 4 months (range: 1-11 months). Responses to propranolol, such as decolorization, regression in tumor size, or improvement of hemangioma-associated complications were observed in all patients within 1-2 weeks after treatment. Propranolol-associated adverse effects occurred in two patients. One infant had occasional tachypnea, and the other had occasional pale-looking appearance. The symptoms resolved after dosage tapering. CONCLUSION Propranolol may be a promising therapeutic modality for infantile hemangioma. Therapeutic strategies are needed to evaluate the optimal treatment protocol and long-term adverse effects.
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Huang LW, Wang JD, Huang JA, Hu SY, Wang LM, Tsan YT. Wound infections secondary to snakebite in central Taiwan. J Venom Anim Toxins Incl Trop Dis 2012. [DOI: 10.1590/s1678-91992012000300004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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78
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Wang JD, Chang TK, Lin HK, Huang FL, Wang CJ, Lee HJ. Reduced expression of transforming growth factor-β1 and correlated elevation of interleukin-17 and interferon-γ in pediatric patients with chronic primary immune thrombocytopenia (ITP). Pediatr Blood Cancer 2011; 57:636-40. [PMID: 21721104 DOI: 10.1002/pbc.22984] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Accepted: 11/23/2010] [Indexed: 11/06/2022]
Abstract
BACKGROUND Dysregulated T helper (Th) cells are considered important in the pathophysiology of chronic primary immune thrombocytopenia (ITP). The present study investigated whether levels of Th cytokines in pediatric patients with chronic ITP were different compared with healthy controls. PROCEDURES Fifty-seven pediatric patients with chronic ITP and 28 healthy controls were enrolled. Patients were divided into three groups based on their platelet counts at the time of the study: (i) active disease <50 × 10(9) /l (n = 23), (ii) stable disease 50-150 × 10(9) /l (n = 23), and (iii) in remission >150 × 10(9) /l (n = 11). Plasma concentration of Th1 [interferon gamma (INF-γ), interleukin 2 (IL-2)], Th2 (IL-4, IL-10), Th3 [transforming growth factor-β1 (TGF-β1)], and Th17 (IL-17) cytokines were investigated by enzyme-linked immunosorbent assay. RESULTS IFN-γ was increased in patients with active (P < 0.001) and stable disease (P = 0.026) when compared with controls. The IL-17 level was significantly higher in all of the 3 patient groups. In addition, there was a positive correlation between IL-17 and IFN-γ levels in chronic ITP patients (r = 0.640, P < 0.001). Reduced TGF-β1 expression was observed in patients with active (P < 0.001) and stable disease (P = 0.001) in comparison with controls. Moreover, TGF-β1 level in patients was positively correlated with the platelet count (r = 0.355, P = 0.007). CONCLUSIONS Elevation of IL-17 and IFN-γ may be an important dysregulation of cellular immunity in pediatric patients with chronic ITP. The disease activity is associated with reduced production of TGF-β1.
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Lin HK, Wang JD, Fu LS. Juvenile diffuse systemic sclerosis/systemic lupus erythematosus overlap syndrome—a case report. Rheumatol Int 2011; 32:1809-11. [DOI: 10.1007/s00296-011-1937-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 03/13/2011] [Indexed: 12/01/2022]
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Mao YC, Wang JD, Hung DZ, Deng JF, Yang CC. Hyperammonemia following glufosinate-containing herbicide poisoning: A potential marker of severe neurotoxicity. Clin Toxicol (Phila) 2011; 49:48-52. [DOI: 10.3109/15563650.2010.539184] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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81
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Wang JD, Chang TK, Shu SG. Lymphoblastic lymphoma arising at the insulin injection sites in a child with type 1 diabetes mellitus. J Pediatr 2010; 157:1043-1043.e1. [PMID: 20547397 DOI: 10.1016/j.jpeds.2010.04.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 04/26/2010] [Indexed: 10/19/2022]
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Wang JD, Ou TT, Wang CJ, Chang TK, Lee HJ. Platelet apoptosis resistance and increased CXCR4 expression in pediatric patients with chronic immune thrombocytopenic purpura. Thromb Res 2010; 126:311-8. [DOI: 10.1016/j.thromres.2010.06.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 06/16/2010] [Accepted: 06/29/2010] [Indexed: 11/16/2022]
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Wang LC, Wang JD, Tsai CR, Cheng SB, Lin CC. Clinical features and therapeutic response in Taiwanese children with Wilson's disease: 12 years of experience in a single center. Pediatr Neonatol 2010; 51:124-9. [PMID: 20417464 DOI: 10.1016/s1875-9572(10)60022-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 08/20/2009] [Accepted: 08/28/2009] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Wilson's disease (WD) is an autosomal recessive defect of cellular copper export. Early diagnosis in children is difficult due to its obscure clinical presentations. The efficacy of zinc salts is well documented, although there are limited data concerning zinc use in pediatric patients with WD. METHODS We performed a retrospective analysis of clinical features, laboratory results and treatment responses in children with WD diagnosed at Taichung Veterans General Hospital between 1996 and 2008. Diagnosis was established by low serum ceruloplasmin, high 24-hour urinary copper excretion, presence of Kayser-Fleischer rings, and mutation analysis. RESULTS Eleven children were included in this study. The main initial presentations were impaired liver function tests (6/11) and hemolytic anemia (2/11). Gene studies in seven children showed six different mutations (G934D, R778Q, C490X, 304insC, IVS4-1 G > C, P992I) and one possible novel mutation (L1181P). All patients had improved liver function tests and hemoglobin levels after treatment with D-penicillamine, trientine and zinc supplement therapy. During a mean period of 3.4 +/- 2.1 years with zinc therapy, six patients had serum zinc levels above the normal limit, and seven patients had serum copper levels below the normal range. CONCLUSION Serum ceruloplasmin and 24-hour urinary copper examinations could be used to rule out WD in children with chronic hepatitis and hemolytic anemia. Gene analysis is helpful for prompt diagnosis of asymptomatic siblings and patients with atypical features. Zinc treatment is generally safe in pediatric patients with WD. However, its adverse effects should be monitored.
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Mao YC, Hung DZ, Yang CC, Wang JD. Full recovery from a potentially lethal dose of orphenadrine ingestion using conservative treatment: A case report. Hum Exp Toxicol 2010; 29:961-3. [DOI: 10.1177/0960327110364642] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Intoxication by orphenadrine is uncommon. The clinical features consist of both central and peripheral anticholinergic effects. Ingestion of 2 to 3 g orphenadrine in an adult has been associated with fatality. A 46-year-old female was brought to our emergency department 1.5 hours after ingesting 40 tablets of 100 mg orphenadrine. She became stuporous 3 hours post-ingestion and developed generalized convulsions 1 hour later. Fifty-five hours post-ingestion, she had recovered and was found to have anterior shoulder dislocation. In addition, severe rhabdomyolysis and persistent nausea were observed. All of the above-noted toxic effects resolved with conservative treatment. Although orphenadrine intoxication can cause convulsions and hemodynamic instability, there is no available antidote and treatment remains supportive.
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Nie YL, Jan SL, Fu LS, Chang TK, Wang JD. Congestive heart failure as presentation of acute lymphoblastic leukaemia with eosinophilia. Br J Haematol 2010; 149:633. [PMID: 20148889 DOI: 10.1111/j.1365-2141.2010.08103.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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86
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Mao YC, Wang JD, Wang LM. Hepatic portal venous gas caused by emphysematous pyelonephritis. Clin Gastroenterol Hepatol 2009; 7:A25. [PMID: 19558985 DOI: 10.1016/j.cgh.2009.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Revised: 02/02/2009] [Accepted: 02/04/2009] [Indexed: 02/07/2023]
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Wang JD, Chou G, Yang CS, Shu SG, Chen HC, Chi CS, Chang TK. A child with primary germ cell tumor of the liver. Acta Oncol 2009; 46:1198-9. [PMID: 17978933 DOI: 10.1080/02841860701291706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
A 14-year-old boy with neurofibromatosis type 1 presented with two ill-demarcated, grayish-white, and atrophic patches on his left back, which were confirmed as neurofibroma by histopathologic examinations. This clinical presentation of neurofibroma has rarely been reported in patients with neurofibromatosis.
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Li YJ, Chen HS, Chen DR, Wang JD. Effect of micro/nano-particles in cavitation erosion. JOURNAL OF NANOSCIENCE AND NANOTECHNOLOGY 2009; 9:783-787. [PMID: 19441392 DOI: 10.1166/jnn.2009.c024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The tests in de-ionized water with micro/nano CeO2 particles are carried out to study the effect of the micro/nano particles in inception of cavitation erosion. The existence of micro/nano particles is found to be the requisite factor and the degree of cavitation erosion is related to the sizes of the particles. Particles in the micro/nano scale may act as the transporters of micro bubbles to keep or get close to the solid surface together and the pressure fluctuation induced by the surface roughness causes the collapse of bubbles and erosion of the surface. Discrete phase models are employed to simulation the moving tracks of the particles. The sizes of the particles affect their capabilities of keeping and getting close to the surface. The effect of the particles of a certain size in cavitation erosion is determined by the combinational action of the two.
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Wang JD, Tsan YT, Yan-Chiao M, Wang LM. Venomous snakebites and antivenom treatment according to a protocol for pediatric patients in taiwan. J Venom Anim Toxins Incl Trop Dis 2009. [DOI: 10.1590/s1678-91992009000400006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Wang JD, Deng XC, Jin XJ, Zhang C, Zhou JQ, Zhou QY, Liu J, Qian MF. [Surgical exploration of the sentinel lymph nodes in the papillary thyroid carcinoma]. REVUE DE LARYNGOLOGIE - OTOLOGIE - RHINOLOGIE 2008; 129:285-287. [PMID: 19408511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To study the technique of sentinel lymph node mapping in the papillary thyroid carcinoma and its evaluation in the search for cervical metastases. METHOD Exploration of the sentinel lymph nodes of the papillary thyroid carcinoma by injection of methylene blue around the tumour among 25 patients during surgery. The nodes which stained blue and the other nodes removed by functional neck dissection were examined histologically after staining with hematoxylin-eosin-saffron (HES). We have evaluated the predictive value of the technique in mapping the cervical metastases in the sentinel lymph node. RESULTS Among the 25 patients, 22 patients presented sentinel lymph nodes (blue-stained), that is to say a rate of identification of 88%. At histological examination, 19 of the 22 patients had positive sentinel lymph nodes, of which 13 had also positive nodes not coloured with blue. The histological examination of patients without sentinel lymph node was negative. CONCLUSION The technique of the sentinel lymph node has a strong positive predictive value in the search for cervical node metastases in the papillary thyroid carcinoma.
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Wang JD, Shu SG, Chi CS, Lin CC. Successful treatment of acute pancreatitis with hydrocortisone in a patient postadrenalectomy. Dig Dis Sci 2007; 52:3355-7. [PMID: 17805969 DOI: 10.1007/s10620-007-8103-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2004] [Accepted: 03/17/2005] [Indexed: 12/09/2022]
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Xu XB, He B, Wang JD. Menstrual-like changes in mice are provoked through the pharmacologic withdrawal of progesterone using mifepristone following induction of decidualization. Hum Reprod 2007; 22:3184-91. [PMID: 17921135 DOI: 10.1093/humrep/dem312] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cyclic shedding of the endometrium is unique to menstruating species, and mouse menstruation models by physiologic progesterone withdrawal have been previously reported. Since progesterone action ablated pharmacologically may provide more insight into the mechanism of action, a mouse menstruation model using mifepristone was established. METHODS Mifepristone was administered following oil-induced decidualization in ovarectomized mice primed with hormones. Morphology, hormone levels, leukocytes and apoptosis were evaluated over a period of 48 h after treatment. Vaginal smears were used to monitor bleedings. RESULTS Mifepristone induced menstrual-like changes. Tissue breakdown was drastic by 16 h, and the decidual zone was shed by 24 h while the mice bled. The endometrium regenerated from 24 h onwards and became completely restored by 48 h. These results are consistent with previous reports. However, although progesterone levels remained constant, estradiol levels increased after the treatment. The CD45(+) cells showed two peaks of increase at 16 h (breakdown phase) and 32 h (regeneration phase) (Leukocyte levels also increased in the unstimulated horns, but no breakdown changes occurred there). Moreover, apoptosis drastically increased by 16 h concurrent with tissue destruction. These results differed from those of the physiologic withdrawal models. CONCLUSIONS The pharmacologic withdrawal of progesterone by mifepristone successfully provoked a menstrual-like process in mice after artificial decidualization.
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Wu SJ, Zhang LL, Wang JD, Chen JM. Bacillus circulans WZ-12—a newly discovered aerobic dichloromethane-degrading methylotrophic bacterium. Appl Microbiol Biotechnol 2007; 76:1289-96. [PMID: 17687552 DOI: 10.1007/s00253-007-1100-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Revised: 06/21/2007] [Accepted: 06/25/2007] [Indexed: 10/23/2022]
Abstract
A novel dichloromethane (DCM)-degrading bacterial strain named WZ-12 (GenBank accession no. EF100968) was isolated and identified as Bacillus circulans based on standard morphological and physiological properties and nucleotide sequence analysis of enzymatically amplified 16S ribosomal deoxyribonucleic acid. DCM dehalogenase from B. circulans WZ-12 was purified to 8.27-fold with a yield of 34.83%. The electrophoretically homogeneous-purified enzyme exhibited a specific activity of 118.82 U/mg. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of purified DCM dehalogenase gave a distinct band with an estimated molecular mass of 20,000 +/- 1,000.
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Wang JD, Chang TK, Chen HC, Jan SL, Huang FL, Chi CS, Lin CC. Pediatric liver tumors: initial presentation, image finding and outcome. Pediatr Int 2007; 49:491-6. [PMID: 17587274 DOI: 10.1111/j.1442-200x.2007.02384.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Few reports have been carried out on the characteristics of pediatric liver tumors. METHODS A retrospective study of 57 patients diagnosed with liver tumors from 1989 through 2004 was conducted. They were classified into groups; 10 benign, 33 primary malignant and 14 metastatic liver tumors. Their demographics, initial presentations, laboratory data, image findings and outcomes were investigated and compared. RESULTS Hepatocellular carcinoma (HCC) with 91% hepatitis B virus-related, constituted 23 of 33 primary malignant liver tumors and had the poorest survival rate. Initially, 70% of patients with primary malignant liver tumors were at disseminated stages. All of HCC and 88% of hepatoblastoma had elevated serum levels of aphal-fetoprotein. However, abnormal liver function tests as alanine aminotransferase, total bilirubin, albumin and alkaline phosphatase were uncommon in patients with pediatric liver tumors. Metastatic liver tumors compared with primary malignant liver tumors showed hypo-echogenicity in abdominal ultrasound (US) exam and a lesser presence of vessel invasion and contrast enhancement in computed tomography studies (P < 0.01). CONCLUSIONS It is important to diagnose primary malignant liver tumors before their clinical symptoms and signs develop. Children with chronic hepatitis B virus infection must be followed every 6 months by serum aphal-fetoprotein and abdominal US even when their liver function tests are normal. Image studies with abdominal US and computed tomography scan can differentiate between primary and metastatic liver tumors.
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Wang JD, Chang TK, Cheng YY, Huang FL, Chen HC, Chou CM, Chi CS. A child with dyspnea and unstable gait. Pediatr Hematol Oncol 2007; 24:321-4. [PMID: 17613876 DOI: 10.1080/08880010701364256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fang CT, Chang YY, Hsu HM, Twu SJ, Chen KT, Lin CC, Huang LYL, Chen MY, Hwang JS, Wang JD, Chuang CY. Life expectancy of patients with newly-diagnosed HIV infection in the era of highly active antiretroviral therapy. QJM 2007; 100:97-105. [PMID: 17277317 DOI: 10.1093/qjmed/hcl141] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Limited data are available on the life expectancy of patients with newly-diagnosed HIV infection in the era of highly active antiretroviral therapy (HAART). AIM To provide such an estimate using a semi-parametric projection. DESIGN Statistical analysis. METHODS Follow-up data for patients newly diagnosed with HIV infection in Taiwan (HIV/AIDS Cohort) from 1 May 1997 to 30 April 2003 (n = 3351, only 1% are injecting drug users) were analysed using the Kaplan-Meier method. The survival function for an age- and gender-matched reference population was generated by the Monte Carlo method from the life-table of the general population. A constant excess hazard model was used to project long-term survival of HIV-infected patients, with linear extrapolation of a logit-transformed curve of survival ratio between HIV-infected patients and the reference population. RESULTS The 5-year survival rate was 58% in patients who had already developed AIDS at diagnosis (AIDS group), and 89% in those who had not (non-AIDS group). Extrapolation yielded an expected mean survival time of 10.6 years after diagnosis for the AIDS group, and 21.5 years after diagnosis for the non-AIDS group. DISCUSSION Our results support the expansion of HIV screening programs to minimize delay in diagnosis. With continuing advances in HAART, this estimate of survival in initially asymptomatic patients may be conservative. Their long life expectancy raises questions about what kind of preventive heath services should be offered. These should be addressed through further analysis of overall benefit and cost-effectiveness.
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Ren HM, Wang JD, Zhang XL. Assessment of soil lead exposure in children in Shenyang, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2006; 144:327-35. [PMID: 16824656 DOI: 10.1016/j.envpol.2005.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Revised: 10/25/2005] [Accepted: 11/08/2005] [Indexed: 05/10/2023]
Abstract
Soil lead pollution is serious in Shenyang, China. The paper brings together the soil work, the bioaccessibility, and the blood lead data to assess the soil lead exposure in children in Shenyang, China. Approximately 15.25% of the samples were above China Environment Protection Agency guideline concentration for soil Pb to protect human from health risk (350 mgkg(-1)). Pb concentrations varied among use scenarios. The main lead contamination sources are industry emission and automobile exhaust. Bioaccessibility also varied among use scenarios. Children, who ingested soil from industrial area, public parks, kindergarten playground, and commercial area, are more susceptible to soil lead toxicity. The industrial area soil samples presented higher bioaccessibility compared to the other use scenario soil samples contaminated by automobile exhaust. The result also suggested a most significant linear relationship between the level of Pb contamination and the amount of Pb mobilized from soil into ingestion juice. Soil pH seemed to have insignificant influence on bioaccessibility in the present study. Bioaccessibility was mainly controlled by other factors that are not investigated in this study. A linear relationship between children blood lead and soil intestinal bioaccessibility was present in the study. Children who are 4-5 years old are more likely to demonstrate the significant relationship between soil lead bioaccessibility and blood lead as their behaviors place them at greatest risk of soil lead toxicity, and their blood lead levels are more likely to represent recent exposure.
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Wang JD, Huang FL, Chen PY, Wang TM, Chi CS, Chang TK. Acute immune thrombocytopenic purpura in infants: associated factors, clinical features, treatment and long-term outcome. Eur J Haematol 2006; 77:334-7. [PMID: 16856929 DOI: 10.1111/j.1600-0609.2006.00714.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The natural course of acute immune thrombocytopenic purpura (ITP) in infants is poorly described in the literature. A retrospective study of 17 consecutive patients <1 yr of age admitted and treated for acute ITP between 1996 and 2005 was conducted. We investigated their demographics, vaccination history, clinical features, laboratory examinations, response to treatment and long-term outcome. There were 11 male and six female infants. Their ages ranged from 24 d to 12 months with a median of 3 months. All infants presented with petechiae and/or ecchymoses. Fourteen cases had platelet counts below 20 x 10(9)/L at the time of admission. They all had good response to a single course of treatment (14/17) or multiple courses of treatment (3/17). None had progressed into chronic ITP. Seven infants had a causal relationship with immunization, five associated with hepatitis B, one diphtheria-pertussis-tetanus, one diphtheria-tetanus-acellular pertussis-inactivated poliovirus vaccine-conjugated Haemophilus influenza vaccines. These seven infants responded to treatment within 3-9 d after therapy with intravenous immunoglobulin, high-dose methylprednisolone or oral steroids. Re-boosters with vaccines revealed no recurrence of the disease in all of these seven patients. The study suggests that further immunization is not contraindicated in infants experiencing acute ITP associated with vaccines.
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