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Zaki MS, Issa MY, Elbendary HM, El-Karaksy H, Hosny H, Ghobrial C, El Safty A, El-Hennawy A, Oraby A, Selim L, Abdel-Hamid MS. Hypermanganesemia with dystonia, polycythemia and cirrhosis in 10 patients: Six novel SLC30A10 mutations and further phenotype delineation. Clin Genet 2018; 93:905-912. [PMID: 29193034 DOI: 10.1111/cge.13184] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 01/15/2023]
Abstract
Biallelic mutations in the SLC30A10 gene cause an inborn error of Mn metabolism characterized by hypermanganesemia, polycythemia, early-onset dystonia, and liver cirrhosis (HMDPC). To date, only 14 families from various ethnic groups have been reported. Here, we describe 10 patients from 7 unrelated Egyptian families with HMDPC. Markedly elevated blood Mn levels, the characteristic basal ganglia hyperintensity on T1-weighted images, and variable degrees of extrapyramidal manifestations with or without liver disease were cardinal features in all patients. Eight patients presented with striking early diseased onset (≤2 years). Unexpectedly, early hepatic involvement before the neurological regression was noted in 3 patients. Mutational analysis of SLC30A10 gene revealed 6 novel homozygous mutations (c.77T > C (p.Leu26Pro), c.90C > G (p.Tyr30*), c.119A > C (p.Asp40Ala), c.122_124delCCT (p.Ser41del), c.780_782delCAT (p.Iso260del) and c.957 + 1G > C). Treatment using 2,3 dimercaptosuccinic acid as a manganese chelating agent showed satisfactory results with improvement of biochemical markers, hepatic manifestations and relative amelioration of the neurological symptoms. Our findings present a large cohort of patients with HMDPC from same ethnic group. The majority of our patients showed severe and early presentation with clear phenotypic variability among sibship. Moreover, we extend the phenotypic and mutational spectrum and emphasize the importance of early diagnosis and treatment of this potentially fatal disorder.
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Affiliation(s)
- M S Zaki
- Human Genetics and Genome Research Division, Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - M Y Issa
- Human Genetics and Genome Research Division, Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - H M Elbendary
- Medical Research Division, Child Health Department, National Research Centre, Cairo, Egypt
| | - H El-Karaksy
- Pediatric Hepatology Department, Kasr Alainy Medical School, Cairo University, Cairo, Egypt
| | - H Hosny
- Pediatric Neurology Department, National Institute of Neuromotor System, Cairo, Egypt
| | - C Ghobrial
- Pediatric Hepatology Department, Kasr Alainy Medical School, Cairo University, Cairo, Egypt
| | - A El Safty
- Department of Occupational and Environmental Medicine, Kasr Alainy Medical School, Cairo University, Egypt
| | - A El-Hennawy
- Pathology Department, Kasr Alainy Medical School, Cairo University, Cairo, Egypt
| | - A Oraby
- Pediatric Neurology Department, Kasr Alainy Medical School, Cairo University, Cairo, Egypt
| | - L Selim
- Pediatric Neurology Department, Kasr Alainy Medical School, Cairo University, Cairo, Egypt
| | - M S Abdel-Hamid
- Human Genetics and Genome Research Division, Medical Molecular Genetics Department, National Research Centre, Cairo, Egypt
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Helmy H, El-Dib N, Mogahed E, Yasin N, El-Karaksy H. A child with rotor syndrome and Capillaria philippinensis: case report and review of literature. J Egypt Soc Parasitol 2011; 41:417-422. [PMID: 21980780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper reported Capillaria philippinensis in an Egyptian child based on clinical and laboratory diagnosis. The patient was successfullly treated with albendazole.
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Affiliation(s)
- H Helmy
- Department of Pediatrics, Kasr Al-Aini Faculty of Medicine, Cairo University, Egypt
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El-Karaksy H, Anwar GH, El-Raziky MS, El-Hawary M, Hashem M, El-Sayed R, El-Shabrawi M, Mohsen N, Fouad H, Esmat G. Anti-HCV prevalence among diabetic and non-diabetic Egyptian children. Curr Diabetes Rev 2010; 6:388-92. [PMID: 20879976 DOI: 10.2174/157339910793499137] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Accepted: 05/14/2010] [Indexed: 12/13/2022]
Abstract
Our aim was to determine the prevalence of the HCV infection among children with type 1 DM as compared to a group of non-diabetic children attending the general outpatient clinics of the same hospital and investigate the possible risk factors. The study was carried out on 692 children with type 1 DM attending the Pediatric Diabetes Unit at Cairo University Pediatric Hospital, Egypt, and 1042 non-diabetic children attending the general outpatient clinics of the same hospital. They were screened for HCV antibodies using third generation ELISA. Anti-HCV antibody prevalence in diabetic children below 9 years of age was comparable to that of non diabetic children (2.5% vs. 1.4%; p=0.25). Diabetic children had higher exposure to medical care (p=0.04); all diabetics were exposed to daily insulin injections and daily blood glucose monitoring. Non-diabetics had higher exposure to razors used by others (p=0.05) and higher rate of traditional hair cutting (p=0.05). To conclude, the prevalence of anti-HCV in diabetic children below 9 years of age was comparable to non diabetic children of the same age group. Application of standard precautions for infection control could successfully limit spread of HCV infection in our Pediatric Diabetes Unit, in a country with high HCV load as Egypt.
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Affiliation(s)
- H El-Karaksy
- Department of Pediatrics, Cairo University, Cairo, Egypt
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El-Karaksy H, El-Sayed R, El-Raziky M, El-Koofy N, Mansour S. Cost-effectiveness of prescreening versus empirical vaccination for hepatitis A in Egyptian children with chronic liver disease. East Mediterr Health J 2008; 14:804-809. [PMID: 19166163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The aim of the study was to determine the prevalence of anti-hepatitis A virus (anti-HAV) antibodies among 172 children with chronic liver disease, and to calculate the cost-effectiveness of prescreening prior to hepatitis A vaccination. Anti-HAV antibodies were positive in 85.1%. However, seroprevalence of anti-HAV antibodies was 62.1% in children < 5 years and 94.4% in children 5+ years. We conclude that while it is cost-effective to do prescreening before hepatitis A vaccination for children with chronic liver disease aged 5+ years, prescreening might not be cost-effective in those aged < 5 years.
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Affiliation(s)
- H El-Karaksy
- Department of Paediatrics, University of Cairo, Cairo, Egypt.
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El-Raziky MS, El-Hawary M, Esmat G, Abouzied AM, El-Koofy N, Mohsen N, Mansour S, Shaheen A, Abdel Hamid M, El-Karaksy H. Prevalence and risk factors of asymptomatic hepatitis C virus infection in Egyptian children. World J Gastroenterol 2007; 13:1828-32. [PMID: 17465475 PMCID: PMC4149961 DOI: 10.3748/wjg.v13.i12.1828] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To identify the prevalence, risk factors and manifestations of asymptomatic hepatitis C virus (HCV) infection in Egyptian children.
METHODS: Children at the age of 1-9 years were screened for HCV antibodies and alanine aminotransferase (ALT) levels. Every child with elevated ALT and/or detectable HCV antibodies was tested for HCV RNA by RT-PCR and compared with two negative controls for risk factors and signs and symptoms of liver disease.
RESULTS: We screened 1042 children, six of them had elevated ALT, negative HCV antibody and positive RNA, likely representing acute hepatitis C cases. Fifteen children were HCV seropositive, 5 of them were HCV RNA positive. Asymptomatic HCV infection was present in 2.02% (positive results for either HCV antibodies or HCV-RNA or both). Symptoms such as diarrhea, abdominal pain, history of fatigue and school absence because of illness and risk factors such as dental care were significantly more common among HCV positive cases than among controls. None of the HCV positive children was diagnosed as having signs of advanced liver disease upon clinical or ultrasonographic examination.
CONCLUSION: Asymptomatic HCV infection is detectable in 2.02% Egyptian children.
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Affiliation(s)
- M S El-Raziky
- Department of Pediatrics, Faculty of Medicine, Cairo University, 8 street No. 25, El-Mokattam, Cairo11585, Egypt.
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El-Raziky MS, El-Hawary M, El-Koofy N, Okasha S, Kotb M, Salama K, Esmat G, El-Raziky M, Abouzied AM, El-Karaksy H. Hepatitis C virus infection in Egyptian children: single centre experience. J Viral Hepat 2004; 11:471-6. [PMID: 15357655 DOI: 10.1111/j.1365-2893.2004.00535.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The outcome of hepatitis C virus (HCV) infection acquired in childhood is uncertain because of the diversity of the epidemiological and clinical features of infection and disease. The aim of this study was to determine the outcome of HCV infection in 105 Egyptian children who tested positive for HCV antibody (anti-HCV). The data of 105 anti-HCV-positive children presenting to the Pediatric Hepatology Unit, Cairo University Children's Hospital, between 1995 and 2002, were retrospectively analysed for risk factors. Seventy-four children with available polymerase chain reaction results were further analysed clinically, serologically and histologically. The age range was 1.3-22 years, with a mean of 11.2 +/- 4.9 years. History of blood transfusion was found in 81 children (77%). HCV RNA was detected in 58.1% of 74 children. Persistently elevated alanine aminotransferase (ALT) levels were present in 40 patients (54.1%). Hepatitis B virus markers (HBsAg and/or anti-HBc) were detected in 18 patients (24.3%). Twenty-six of the 43 HCV RNA-positive children underwent a diagnostic liver biopsy that showed chronic hepatitis in 19 patients (73.1%), cirrhosis in one case only (3.8%), and normal biopsy findings in seven children (26.9%). Blood transfusion remains a major risk of HCV transmission among Egyptian children. HCV infection is not always benign in the childhood period. ALT levels remain elevated in half of the children and histological abnormalities are detected in three quarters of HCV RNA-positive cases.
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Affiliation(s)
- M S El-Raziky
- Department of Pediatrics, Cairo University, Cairo, Egypt.
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