Introduction: Chronic lymphocytic leukemia (CLL) is a hematologic malignancy characterized by the clonal proliferation and accumulation of mature monoclonal B lymphocytes in the peripheral blood. CLL is relatively common in Europe and North America, with an incidence of approximately 4–6 cases per 100,000 population, whereas it is rare in South Asia, with an incidence of approximately 0.11 cases per 100,000 population. During the course of the disease, neoplastic lymphocytes may infiltrate the bone marrow, lymph nodes, liver, spleen, and, less commonly, other organs and tissues. CLL presenting with marked splenomegaly in the absence of lymphadenopathy is uncommon. Therefore, in patients with unexplained splenomegaly, the differential diagnosis should include CLL and other lymphoproliferative disorders. Case Presentation: We report a case of CLL diagnosed on the basis of clinical findings, laboratory investigations, and additional diagnostic evaluation in a patient who presented to a hematology outpatient clinic with splenomegaly. An 81-year-old man presented with a macular rash involving the thighs, lower legs, chest, and both upper extremities, accompanied by dizziness, unsteadiness, nausea, fatigue, and generalized weakness. Physical examination revealed massive splenomegaly with a smooth surface and blunt edge, palpable approximately 25 cm below the left costal margin. Laboratory investigations demonstrated hyperleukocytosis with lymphocytosis, moderate normocytic normochromic anemia, and severe thrombocytopenia. Contrast-enhanced abdominal computed tomography revealed massive splenomegaly, with the spleen measuring 27.9×20.0×7.9 cm. The patient was treated with cyclophosphamide at a dose of 250 mg/m (400 mg administered) in combination with glucocorticoid therapy. Following treatment, leukocytosis, lymphocytosis, and monocytosis improved, and the spleen decreased substantially in size, becoming palpable approximately 4 cm below the umbilicus on physical examination. Conclusion Hematologic malignancies should be considered in the differential diagnosis of patients presenting with unexplained splenomegaly. In this case, a diagnosis of chronic lymphocytic leukemia was established based on bone marrow examination and the overall clinical and laboratory findings. Following treatment with cyclophosphamide and glucocorticoids, peripheral blood abnormalities improved and splenic enlargement decreased substantially, suggesting a favorable therapeutic response.

Background: The global prevalence of IgE-mediated food allergy (FA) among children has increased significantly over the last few decades, in some cases leading to severe, life-threatening anaphylaxis. While international prevalence rates average 6-10%, contemporary data in Mongolia are limited. Identifying the characteristics of pediatric food allergy and its risk factors is essential for developing appropriate clinical management and preventive strategies. Aim: To identify the primary causative allergens and evaluate the factors influencing food allergy among Mongolian children. Materials and Methods: A cross-sectional analytical study was conducted from June 2025 to December 2025. Data from children screened using a food allergy detection questionnaire were analyzed using Excel and R software. Results: Among 244 children aged 0–5 years, 18.8% were identified as having a potential food allergy. The most common specific allergens were egg (5.4%), cow’s milk (2.6%), peanut (2.3%), and wheat (0.8%). Additionally, 7.7% of participants reported allergies to less common triggers such as yellow fruits, peaches, tomatoes, and pumpkin. Multiple food allergies (to two or more foods) were observed in 1.57% of the cohort. Atopic dermatitis was the strongest independent risk factor for developing a food allergy (OR 15.3, 95% CI 3.73–107.0, p<0.001). A family history of allergy also significantly increased the risk (OR 3.66, p=0.042). Conversely, exclusive breastfeeding for more than 6 months demonstrated a protective effect against food allergy (p=0.041). No statistically significant associations were found regarding antibiotic use, mode of delivery, or maternal vitamin supplementation during pregnancy. Conclusions 1. Based on parent/caregiver-reported questionnaires, the prevalence of food allergy among children is 18.8%. 2. Pediatric skin allergies and genetics (family history) are powerful risk factors for food allergies. Breastfeeding for more than 6 months significantly reduces the risk of a child developing a food allergy.

PURPOSE: Recent data indicate that sensitization to mold contributes to the severity and persistence of asthma. In this study, we investigated the relationships between sensitization to mold and lung function parameters in children with asthma. METHODS: We retrospectively reviewed clinical data from 551 asthmatic subjects. We selected subjects who met clinical diagnostic criteria of asthma. Their spirometry, methacholine challenge tests, and measurements of blood eosinophils, serum IgE, eosinophil cationic protein (ECP) and fractional exhaled nitric oxide (FeNO) results were included. Skin prick testing (SPT) results with 13 common aeroallergens in Korea including house dust mites, animal dander, pollen, cockroach and mold were reviewed. Subjects were divided into 3 groups according to their SPT results. Subjects who showed no positive result to any aeroallergen were designated as group 1 (non-sensitized). Group 2 represented subjects who were sensitized to aeroallergens other than mold (other allergen-sensitized) and group 3 included subjects who were sensitized to mold allergens (mold-sensitized). RESULTS: Among the 551 asthmatic subjects, 67 (12.2%) were sensitized to mold and 366 (66.4%) were sensitized to other aeroallergens. The log mean IgE levels were higher in groups 2 (5.96±1.14 IU/mL) and 3 (5.81±0.97 IU/mL) compared to group 1 (3.88±1.68 IU/mL). Blood eosinophils, ECP and FeNO concentrations were significantly higher in groups 2 and 3, but no significant difference was found between the 2 groups. The mean FEV1 value was significantly lower in group 3 (86.9±12.1%pred) than in groups 2 (92.0±14.8%pred) and 1 (93.4±15.4%pred). The log mean methacholine PC20 was significantly lower in group 3 (0.08±1.91 mg/mL) than in groups 2 (1.31±1.69 mg/mL) and 1 (2.29±1.66 mg/mL). CONCLUSIONS: We observed a differential association between mold and other aeroallergen sensitization, and severity of asthma. Sensitization to mold is associated with lower lung function and increased airway hyper-responsiveness in children with asthma. Mold sensitization could be an important factor determining asthma severity particularly airflow limitation in children.
Allergens ; Animals ; Asthma* ; Child* ; Cockroaches ; Dander ; Eosinophil Cationic Protein ; Eosinophils ; Fungi* ; Humans ; Immunoglobulin E ; Korea ; Lung ; Methacholine Chloride ; Nitric Oxide ; Pollen ; Pyroglyphidae ; Respiratory Hypersensitivity ; Retrospective Studies ; Skin ; Spirometry