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Background: Immunological tolerance is compromised in children with immunological thrombocytopenic purpura (ITP), an autoimmune disease. The purpose of this study was to measure the levels of lymphocyte subsets in children with ITP and to assess how these subsets are related to the patient's chronic illness and responsiveness to treatment. Methods: The pediatric hematology outpatient clinic at Zagazig University Hospitals served as the site of this case-control study. Sixty-four patients (16 with newly diagnosed ITP, 16 with persistent ITP, 16 with chronic ITP, and 16 healthy children as a control group) participated in the study. Using flow cytometry, all of the study's patients and controls had their lymphocyte subsets evaluated. Results: CD3+, CD4+, and CD56+ lymphocytes were significantly lower in patients with ITP compared to controls while CD8+ and CD19+ lymphocytes were significantly higher in patients with ITP compared to controls. Apart from CD8+ lymphocytes which were significantly higher in patients with chronic ITP compared to other patients' groups, there was no significant difference among different patients' groups in relation to different lymphocyte subsets. Patients with newly diagnosed ITP who responded to 1st line therapy had lower CD4+ and higher CD8+ and CD19+ lymphocytes compared to those who did not respond to 1st line therapy. Conclusion: We concluded that lymphocyte subsets play a significant role in the pathogenesis, chronicity, and response to treatment in childhood ITP. [ABSTRACT FROM AUTHOR]

Background: Autoantibodies are the hallmark of autoimmune diseases. For Rheumatoid arthritis (RA), they represent equipment for prognosis, detection and analysis of the disease. Several serological markers have recently emerged. For instance, serum Anti-PADI4 that is the enzyme that causes citrullination of proteins leading to autoantibodies production. The goal of this work was to assess the role of peptidyl arginine deiminase type 4 (PADI4) in diagnosis of rheumatoid arthritis and association of its serum level with disease activity. Methods: A case-control study involving 58 subjects, 29 patients with RA and 29 healthy controls matched in age and sex, was carried out at Department of Rheumatology and Rehabilitation, Zagazig University Hospitals. Detailed history taking, clinical examination and assessment of disease activity using: - DAS-28, modified HAQ, CRP, ESR and PGA. Serum Anti-PADI4 was measured in RA patients and healthy controls using quantitative ELISA technique. Results: Statistical analysis of the obtained clinical and laboratory data showed a significant elevation of serum Anti-PADI4 in RA patients 15.39±8.89 ng/ml when compared to controls 6.32±10.3* ng/ml (P<0.001). In our study there were no correlations between serum Anti-PADI4, NTJ, NSJ, MHAQ score, ESR, CRP or DAS28. Our study highlighted that Anti-PADI4 sensitivity was 89.5% and specificity was 78.3%. Conclusions: Serum Anti-PADI4 Abs had a diagnostic value, with no correlation with disease activity. [ABSTRACT FROM AUTHOR]

Background: Chitinase-Like protein YKL-40 is secreted from neutrophils, macrophages and airway epithelial cells of the respiratory tract mucosa. Therefore, it can act as a specific biomarker of granulocyte function and macrophage activation in patients with asthma. This study aimed to investigate the association between serum levels of YKL-40 and asthma in Sharkia Governorate. Methods: This case-control study was carried on 60 children; 30 asthmatic child with confirmed reversible, expiratory airway obstruction with clinically and Spirometric-based diagnosis of asthma and were further classified into 3 subdivide group according to Levels of asthma control in children adopted from the Global Initiative for Asthma GINA 2015 and 30 healthy age and sex matched child as control group who were admitted to paediatrics pulmonology department and outpatient clinic at zagazig university hospital during the period from October (2018) to April (2019). Results: There was a high statistical significant difference between asthmatic and non-asthmatic groups in YKL40 level which was higher in asthmatic group than non-asthmatic group and there was a significant correlation between the levels of serum YKL-40 with the ratio of peripheral blood eosinophils. Conclusion: The high levels of serum YKL-40 correlated with the diagnosis of asthma in children. [ABSTRACT FROM AUTHOR]

Background:Although the exact pathogenesis of primary immune thrombocytopenia (ITP) is still unclear, there are many research efforts directed toward the role of T helper 17 and interleukin 17 (IL -17) in the pathogenesis of this disease. The Th17 cell, which produces IL -17, is a subset of T helper cells. Interleukin 17 is a proinflammatory cytokine that has recently been shown to play a critical role in the development of autoimmune diseases. Our aim was to investigate the role of T helper cells 17 and interleukin-17 in the development of ITP in Egyptian children. Methods and results:This study was performed on 100 children with ITP and 100 healthy children as a control group. Patients underwent a complete history, a thorough physical examination, and routine investigations according to our local standards. The percentage of Th17 cells was measured in the study groups by flow cytometry. Serum IL -17 was also measured by ELISA in the study groups. Th17 cells were significantly higher in patients compared with controls. In addition, serum levels of IL -17 were observed to be 3.1-fold higher in patients with ITP compared to controls. Newly diagnosed patients had a significantly higher percentage of Th-17 cells as well as higher IL -17 levels than patients with persistent or chronic ITP. conclusion: We concluded that Th-17 cells and IL -17 contribute to the pathogenesis of ITP in Egyptian children. [ABSTRACT FROM AUTHOR]

Background: Febrile seizures (FS) are the single most common seizure type and occur in 2 to 5% of children younger than age 5 years with a peak incidence in the second year of life. Evidence that iron might be important for neurological functioning has generated considerable optimism that this element might also play a role in initiation of febrile convulsions. This study aimed to determine the relation between iron deficiency anemia and febrile seizures in infant and children aged 6 months to 6 years. Methods: A case-control study was done in Pediatrics Department, Faculty of Medicine, Zagazig University during the period from September 2018 to March 2019. It included 90 infants and children (45 infant and children presented with febrile convulsions and 45 age and sex matched healthy infants and children between 6 months and 6 years as a control group). All children with febrile convulsion were investigated for iron deficiency to find if there is any association between Anemia and febrile convulsion. Results: The current study showed that cases were significantly higher regarding Total Iron-Binding Capacity (TIBC) than control group with no significant difference between groups regarding ferritin or iron. But, cases were significantly lower regar ding Mean Corpuscular Hemoglobin (MCH) and Hemoglobin (Hb). Therefore, cases were significantly associated with anemia. Conclusion: the study concluded that iron deficiency anemia is a risk factor for febrile seizures in infants and children aged 6 months to 6 years. [ABSTRACT FROM AUTHOR]

Background: Zinc (Zn) is an essential element in the nutrition of human beings. It is needed in all DNA and RNA syntheses and is required at every step of the cell cycle. Zinc deficiency in children can cause stunted growth and increased incidence of infections. Zinc deficiency has been suggested as a major risk factor for developing pneumonia. The aim of this study was to assess the serum Zn levels in children with lower respiratory tract infe ctions (LRTI) and study the association between low Zn levels and other known risk factors of LRTI. Methods: A cross-sectional study, which was conducted on ninety patients with acute LRTI. They aged between two months and five years. The patients were admitted to pediatric department at Zagazig University Hospitals during the period from February 2017 to February 2018. All patients were subjected to general and chest examinations. Also, complete blood picture, serum Zn level measurement and chest X ray were done. Results: Mean serum Zn level among the studied patients was 200.75 ± 37.44 µg/dl, which is considered normal or even slightly elevated than normal values There was no association between serum Zn levels and any of the other risk factors of LRTI. Conclusion: There was no significant difference in serum zinc level among different lower respiratory infections and there was no significant difference in serum zinc level and other risk factors of the disease. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by various immunological abnormalities. Regulatory T cells (Tregs) CD4+CD25+ play an important role in maintaining tolerance to self-antigens controlling occurrence of autoimmune diseases. It has been shown that the transcription factor forkhead box P3 (FoxP3) is specifically expressed on CD4+CD25+T cells. FoxP3 has been described as the master control gene for the development and function of Tregs. A decrease in the number of CD4+CD25highFoxP3+ regulatory T cells can play a key role in the loss of tolerance to self antigens. The study was designed to assess expression levels of FoxP3 in peripheral CD4+CD25+ regulatory T cells in patients with SLE and to evaluate the level of some cytokines that are implicated in the extent of the disease activity. The study was carried out on 30 SLE patients, they were 27 females and 3 males, 10 age and sex matched healthy volunteers were studied as a control group. They were divided into two groups: group I: had active disease (12 patients) and group II: had inactive disease (18 patients) according to Systemic Lupus Erythematosus Disease Activity Index. All individual were subjected to CBC, ESR, s.creatinine, RF, CRP, C3, ANA, anti ds-DNA and flowcytometeric assay of CD4+CD25+ (Tregs) and FoxP3 for patients and controls. Quantitative determination of serum interleukin 10 (IL-10) and transforming growth factor-beta1 (TGF-beta1) concentrations in serum samples by ELISA technique. The results revealed a significant decrease of CD4+CD25high cells in peripheral blood in active lupus patients when compared with patients with inactive lupus and those in healthy controls. Intriguingly, the percentage level of FoxP3 on CD4+CD25high cells was significantly decreased in SLE patients with active disease (2.9 +/- 1.05) when compared with those with inactive SLE (3.5 +/- 0.8) and control groups (4.7 +/- 1.2) (P < 0.05). As regard cytokines levels; the level of IL-10 was significantly increased in patients with active and inactive disease (158.8 +/- 50.8, 82.8 +/- 14.08 respectively) when compared with the control group (P < 0.001). While, the level of TGF-beta1 was significantly decreased in patients with active and inactive disease (22.5 +/- 7.03, 29.07 +/- 10.14 respectively), when compared with the control group (P < 0.05). Our data revealed impaired production of Tregs in SLE patients, which may play a reciprocal role with some cytokines to affect the activity of the disease. Tregs cells should be the target to determine the clinical effectiveness of novel therapy to modulate Tregs in vivo besides the conventional treatments.