1.Bird-Egg syndrome diagnosed by ImmunoCap ISAC
Jaeeun CHUNG ; David LEE ; Yoonha HWANG
Allergy, Asthma & Respiratory Disease 2023;11(3):161-163
Adult-onset egg allergy is rare compared to child-onset egg allergy, and the component-resolved diagnosis test is effective in evaluating food allergy. We herein report a 24-year-old woman with late-onset egg-yolk allergy diagnosed as bird-egg syndrome. The prolonged exposure to pet parrots' dander or dropping through the respiratory system caused sensitization to the Gal d 5 component and resulted in a cross-reaction to egg yolk. Since the patient was suspected of the syndrome by her history, the skin prick test, ISAC ImmunoCAP, and serum ImmunoCAP test were performed. By confirming Gal d 5 component by ISAC ImmunoCAP, the patient was diagnosed with the syndrome. In patients with newly adult-onset food allergy, the clinician must identify the environmental conditions which can cause cross-sensitization and perform the causative component test.
2.Nontyphoidal Salmonella Meningitis in an Immunocompetent Child
Hye Jeong MOON ; Yoonha LEE ; Mi Seon HAN
Pediatric Infection & Vaccine 2022;29(1):54-60
Salmonella meningitis is rare yet poses causes significant neurological morbidity in children. Infants, especially those under 3 months of age, and those with immunocompromised states, such as malignancy, malaria, and human immunodeficiency virus infection, are at increased risk for developing Salmonella meningitis. Herein, we describe a case of Salmonella meningitis in a previous healthy 8-year-old girl who presented with high fever, vomiting, and altered mental status. Group D Salmonella species were isolated in cerebrospinal fluid culture, and no abnormal findings were noted in brain magnetic resonance imaging. Immunoglobulin levels and lymphocyte subset counts were within the normal ranges, and no genetic mutation responsible for primary immunodeficiency disease was detected by next-generation sequencing. The patient’s condition improved rapidly with third-generation cephalosporin, and no complications or sequalae developed. Nontyphoidal Salmonella can cause meningitis in immunocompetent children and can be successfully treated with early administration of antibiotics.
4.Comparison of Initial Presentation of Pediatric Diabetes Before and During the Coronavirus Disease 2019Pandemic Era
Yoonha LEE ; Minseung KIM ; Kyeongeun OH ; Eungu KANG ; Young-Jun RHIE ; Jieun LEE ; Yong Hee HONG ; Young-Lim SHIN ; Jae Hyun KIM
Journal of Korean Medical Science 2022;37(22):e176-
Background:
Hospital visitation has become challenging during the coronavirus disease 2019 pandemic because of quarantine measures and fear of infection. Consequently, newly diagnosed patients may present with more severe diseases during the pandemic. The present study analyzed the differences in the initial clinical presentations of newly diagnosed patients with type 1 diabetes (T1D) and type 2 diabetes (T2D), comparing pre-pandemic and pandemic periods.
Methods:
Newly diagnosed patients with T1D or T2D and aged < 18 years during 2018–2020 were included in the study. Data were collected retrospectively from four academic centers in Gyeonggi-do, South Korea. Initial clinical data were compared between the pre-pandemic (2018–2019) and pandemic (2020) periods.
Results:
In the pre-pandemic and pandemic periods, 99 patients (41 T1D and 58 T2D patients) and 84 patients (51 T1D and 33 T2D patients) were identified, respectively. During the pandemic, the proportion of diabetic ketoacidosis (DKA) cases increased compared to the pre-pandemic period (21.2% during 2018–2019 vs. 38.1% in 2020; P = 0.012). In the prepandemic and pandemic periods, initial pH was 7.32 ± 0.14 and 7.27 ± 0.15, respectively (P = 0.040), and HbA1c values were 11.18 ± 2.46% and 12.42 ± 2.87%, respectively (P = 0.002). During the pandemic, there was an increased risk of DKA in patients with T1D (odds ratio, 2.42; 95% confidence interval, 1.04–5.62; P = 0.040).
Conclusion
During the pandemic, the proportion of DKA in newly diagnosed patients with T1D increased and clinical parameters showed a deteriorating pattern. Increased awareness of pediatric diabetes, especially DKA, could facilitate visit to the hospital for an early diagnosis; thus, reducing the number of DKA cases during the pandemic era.
5.Longitudinal Intravital Imaging of Tumor-Infiltrating Lymphocyte Motility in Breast Cancer Models
Inwon PARK ; Sujung HONG ; Joon SEOK ; Stephani Edwina LUCIA ; Eunjoo SONG ; Mingyo KIM ; Eunji KONG ; Howon SEO ; Yoonha HWANG ; Soyeon AHN ; Seonghye KIM ; Dong-Hyun JANG ; Jae Hyuk LEE ; Su-Hyung PARK ; Pilhan KIM ; You Hwan JO
Journal of Breast Cancer 2021;24(5):463-473
Immunoreactive dynamics of tumor-infiltrating lymphocytes (TILs) within the tumor microenvironment in breast cancer are not well understood. This study aimed to investigate the spatiotemporal cellular dynamics of TILs in breast cancer models. Breast cancer cells were implanted into the dorsal skinfold chamber of BALB/c nude mice, and T lymphocytes were adoptively transferred. Longitudinal intravital imaging was performed, and the spatiotemporal dynamics of TILs were assessed. In the 4T1 model, TILs progressively exhibited increased motility, and their motility inside the tumor was significantly higher than that outside the tumor. In the MDA-MB-231 model, the motility of TILs progressively decreased after an initial increase. TIL motility in the MDA-MB-231 and MCF-7 models differed significantly, suggesting an association between programmed death-ligand 1 expression levels and TIL motility, which warrants further investigation. Furthermore, intravital imaging of TILs can be a useful method for addressing dynamic interactions between TILs and breast cancer cells.
6.Clinical Characteristics of Atopic Dermatitis in Korean School-Aged Children and Adolescents According to Onset Age and Severity
You Hoon JEON ; Kangmo AHN ; Jihyun KIM ; Meeyong SHIN ; Soo-Jong HONG ; So-Yeon LEE ; Bok Yang PYUN ; Taek Ki MIN ; Minyoung JUNG ; Jeongmin LEE ; Tae Won SONG ; Hye-Young KIM ; Sooyoung LEE ; Kyunguk JEONG ; Yoonha HWANG ; Minji KIM ; Yong Ju LEE ; Min Jung KIM ; Ji Young LEE ; Hye Yung YUM ; Gwang Cheon JANG ; Young A PARK ; Jeong Hee KIM ;
Journal of Korean Medical Science 2022;37(4):e30-
Background:
Atopic dermatitis (AD) is a heterogeneous disease with different age of onset, disease course, clinical symptoms, severity, and risk of comorbidity. The characteristics of children with AD also vary by age or country. However, little is known about the clinical characteristics of AD in Korean school-aged children and adolescents. Furthermore, there are few studies on phenotypic differences according to onset age. This study aimed to explore the clinical characteristics and phenotypes according to onset age and severity of AD in children and adolescents in Korea.
Methods:
AD patients aged 6–18 years who presented to 18 hospitals nationwide were surveyed.The patients were examined for disease severity by pediatric allergy specialists, and data on history of other allergic diseases, familial allergy history, onset age, trigger factors, lesion sites,treatment history and quality of life were collected. The results of the patient’s allergy test were also analyzed. The patients were classified into infancy-onset (< 2 years of age), preschoolonset (2–5 years of age), and childhood-onset (≥ 6 years of age) groups. Study population was analyzed for clinical features according to onset-age groups and severity groups.
Results:
A total of 258 patients with a mean age of 10.62 ± 3.18 years were included in the study. Infancy-onset group accounted for about 60% of all patients and presented significantly more other allergic diseases, such as allergic rhinitis and asthma (P = 0.002 and P = 0.001, respectively). Food allergy symptoms and diagnoses were highly relevant to both earlier onset and more severe group. Inhalant allergen sensitization was significantly associated with both infancy-onset group and severe group (P = 0.012 and P = 0.024, respectively). A family history of food allergies was significantly associated with infancyonset group (P = 0.036). Severe group was significantly associated with a family history of AD, especially a paternal history of AD (P = 0.048 and P = 0.004, respectively). Facial (periorbital, ear, and cheek) lesions, periauricular fissures, hand/foot eczema, and xerosis were associated with infancy-onset group. The earlier the onset of AD, the poorer the quality of life (P = 0.038). Systemic immunosuppressants were used in only 9.6% of the patients in the severe group.
Conclusion
This study analyzed the clinical features of AD in Korean children and adolescents through a multicenter nationwide study and demonstrated the phenotypic differences according to onset age and severity. Considering the findings that the early-onset group is more severe and accompanied by more systemic allergic diseases, early management should be emphasized in young children and infants.