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Unlabelled: Common variable immunodeficiency (CVID) is a heterogeneous primary immunodeficiency associated with an increased risk of malignancy in adulthood, with lymphoma as one of the major causes of death. The aim of this study is to describe those malignancies detected in our cohort of pediatric CVID patients. We reviewed the clinical and laboratory data and the treatments and their outcomes in all pediatric CVID patients from our institution that developed a neoplasia. Four malignancies were diagnosed in three out of 27 pediatric CVID patients. Three malignancies were non-Hodgkin lymphoma (NHL) of B cell origin (mean age at diagnosis: 8 years old), and the remaining was a low-grade astrocytoma. Among NHL, two were mucosa-associated lymphoid tissue (MALT) lymphomas and one was associated with Epstein-Barr virus infection. NHL developed before CVID diagnosis in two patients. CVID patients showed different clinical phenotypes and belonged to different groups according Euroclass and Pediatric classification criteria., Conclusions: Malignancies, especially lymphoma, may develop in pediatric CVID patients with no previous signs of lymphoid hyperplasia and even before CVID diagnosis. Consequently, strategies for cancer prevention and/or early diagnosis are required in pediatric CVID patients.

Objective: The prevalence of unknown impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or type 2 diabetes mellitus (T2DM) is high. Numerous studies demonstrated that IFG, IGT, or T2DM are associated with increased cardiovascular risk, therefore an improved identification strategy would be desirable. The objective of this study was to create a simple and reliable tool to identify individuals with impaired glucose metabolism (IGM)., Design and Methods: A cohort of 1737 individuals (1055 controls, 682 with previously unknown IGM) was screened by 75 g oral glucose tolerance test (OGTT). Supervised machine learning was used to automatically generate decision trees to identify individuals with IGM. To evaluate the accuracy of identification, a tenfold cross-validation was performed. Resulting trees were subsequently re-evaluated in a second, independent cohort of 1998 individuals (1253 controls, 745 unknown IGM)., Results: A clinical decision tree included age and systolic blood pressure (sensitivity 89.3%, specificity 37.4%, and positive predictive value (PPV) 48.0%), while a tree based on clinical and laboratory data included fasting glucose and systolic blood pressure (sensitivity 89.7%, specificity 54.6%, and PPV 56.2%). The inclusion of additional parameters did not improve test quality. The external validation approach confirmed the presented decision trees., Conclusion: We proposed a simple tool to identify individuals with existing IGM. From a practical perspective, fasting blood glucose and blood pressure measurements should be regularly measured in all individuals presenting in outpatient clinics. An OGTT appears to be useful only if the subjects are older than 48 years or show abnormalities in fasting glucose or blood pressure.

We describe the clinical characteristics of 209 children younger than 15 years of age with positive pharyngeal cultures for adenovirus. The mean age of the children was 37 +/- 33 months, and the mean peak temperature was 39.2 +/- 0.76 degrees C. On physical examination, tonsillitis was found for 88% of children; 52% of them had exudative tonsillitis. Forty-eight percent of the patients who had a white blood cell count performed had >15,000 leukocytes per mm, and 25% had >20,000 leukocytes per mm. C-reactive protein concentrations were >7 mg/dL for 22.5% of the patients. Adenovirus pharyngeal infections in young children mimic severe bacterial infections.