Background: Vitamin D plays an immunoregulatory role in both the innate and adaptive immune systems. Rickets is a disorder that can develop due to a lack of vitamin D, calcium, or phosphate. Aim: The aim of this study was to assess serum immunoglobulins as one of the aspects of humoral immunity in children with vitamin D resistant rickets. Subjects and Methods: This casecontrol study was performed on 60 patients divided into Group (A):30 cases with vitamin D resistant rickets patients who were presented with rachitic manifestation who did not respond to therapeutic doses of the vitamin. Group (B):30 cases with untreated classic vitamin D deficiency rickets. Group (C): 30 healthy subjects as a control group. All subjects were subjected to detailed history taking including age, sex, weight, dietary history, medication history, and physical examination including vital signs, body weight, and head circumference. Laboratory investigations that included calcium, phosphorus, alkaline phosphatase, electrolytes, ESR, urine analysis, parathyroid hormone, vitamin D, and Immunoglobulin assay. Results: There is a significant decrease of IgA in vitamin D deficiency rickets and vitamin D resistant rickets than in controls (3.74 ± .867, 3.13 ± 1.72, 5.01 ± 1.61, respectively with P =0.012).There is a significant decrease of IgG in vitamin D deficiency rickets and a significant increase in vitamin D resistant rickets than in controls (523.5 ± 136.3, 751.25 ±163.5, 692.0 ± 186.4, respectively with P =0.009). There is no significant difference in IgM in the three studied groups. Conclusion: Patients with vitamin D deficiency have significantly lower IgG levels, while vitamin D resistant patients have significantly higher IgG levels. Whereas, both groups have lower IgA and normal IgM levels.
Background: Children with type 1 diabetes are in risk of developing renal complications as a part of microvascular complications on the long run, early diagnosis of these complications can decrease morbidity and mortality of these complications. Copeptin has shown association with development of chronic kidney disease (CKD) in people with diabetes.Methods: This is a case -control study was conducted at Zagazig University Hospital of pediatrics from June 2017 to January 2018 on 40 cases suffering from T1DM. It also included 40 matched healthy controls who attend outpatient clinics for routine care.All cases were subjected to a complete clinical study (thorough history and physical examination) upon study inclusion, with emphasis on symptoms and signs of diabetes and renal affection.The following investigations were performed: HbA1c, Urine analysis, Albumin/creatinine ratio, renal function test (creatinine, BUN) Renal Ultrasound, Measure serum copeptin level by ELISA (Sandwich technique).Results: Our study showed that there is a significant increase in serum copeptin levels compared to healthy group. There is no significant difference between poorly controlled and well controlled children with T1DM regarding copeptin levels. Serum copeptin has also a positive correlation with albumin/creatinine ratio in children with T1DM. Conclusion: Serum copeptin is a potential prognostic biomarker in childhood diabetic renal affection.
Background: Diabetic peripheral neuropathy (DPN) plays a key role in morbidity and mortality in patients with type 1 and type 2 diabetes mellitus. The study was designed to assess frequency of diabetic peripheral neuropathy among the diabetic children and to evaluate the role of nerve conduction study (NCS) in diagnosis of DPN in children with type 1diabetes mellitus in comparison to neurological examination. Subjects and methods: A cross sectional study was conducted in Pediatrics Department, Zagazig University Hospitals. Forty type-1 diabetic children were subjected to complete history taking, complete general and full neurological examination, Michigan Neuropathy Screening Instrument (MNSI), laboratory investigations and NCS. Results: The estimated frequency of diabetic peripheral neuropathy was 42.5% among the diabetic children. We found a statistically significant moderate agreement between (NCS) and Michigan Neuropathy Screening Instrument, Kappa= 0.564(95% CI, 0.321 to 0.807), (P<.001). The percent of children with microalbuminuria, fairly and poorly controlled diabetes was statistically significantly higher in PN-children than non PN-children (P<.05).Duration of diabetes was the most important factor in prevalence of PNP (odds ratio=2.1 [95% CI 1.3 to 3.4]). Conclusion: NCS are the gold-standard method for the detection of subclinical DN which is frequent in diabetic children .
Background: Epilepsy is a neurological disorder with features of unpredictable epileptic seizures that are periodic and recurrent, caused by variance in inhibitory and excitatory pathways in the central nervous system (CNS).The aim of this study was to investigate the diagnostic value of HMGB1 in children with refractory epilepsy. Method: This case-control study included 42 children with refractory epilepsy who attended the pediatrics neurology unit and pediatric outpatient clinic at Zagazig University Hospitals to investigate the diagnostic value of HMGB1 in children with refractory epilepsy and another healthy children group, who were in the same age range as the patient group, included as a control group. Results: There was a statistically significant higher HMGB1 concentration among our cases than controls. The cut-off point of HMGB1 concentration was >7ng/ml. HMGB1 concentrations had high sensitivity (80.95%), specificity (69.05%), predictive positive value (72.3%), negative predictive value (78.4%) and accuracy (75%). Conclusions: Refractory epilepsy among children remains a great concern and a massive challenge worldwide; despite advances in diagnostics and treatment, refractory epilepsy is still a major medical problem with high morbidity and mortality. Therefore, novel biomarkers for early detection of refractory epilepsy should be used, for example, HMGB1 as a potential biomarker for early detection of refractory epilepsy.
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