Sensitization profile in differential diagnosis: allergic asthma vs. chronic (nonspecific) cough syndrome

Diagnostic value of Der p 1 and Der p 2 specific IgE in Dermatophagoides pteronyssinus IgE sensitization

OBJECTIVE

To assess the diagnostic performance of Der p 1 and Der p 2 specific IgE (sIgE).

DATA SOURCES

Studies were systematic computerized searches of the PubMed, EMBASE, and Cochrane libraries (published 1966 to September 5, 2015).

STUDY SELECTION

Records were screened by title and abstract and then by full-text articles of relevant studies. Eligible studies were selected according to inclusion criteria: (1) all house dust mite allergy diagnosed on the basis of clinical symptoms in combination with a dust mite extract skin prick test result; (2) the inclusion of controls in the study; and (3) enough data to construct the diagnostic 2 × 2 table. True-positive, false-positive, false-negative, and true-negative values were extracted from or calculated for each study. Then the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were calculated. A summary receiver operating characteristic curve and area under the curve were used to evaluate the overall diagnostic performance.

RESULTS

Seven eligible studies that involved 1040 cases were included in this meta-analysis. The meta-analysis found that detection of Der p 1 or Der p 2 sIgE is of sufficient diagnostic accuracy for use in the diagnosis of Dermatophagoides pteronyssinus IgE sensitization.

CONCLUSION

Detection of Der p 1 or Der p 2 sIgE is a promising diagnostic tool in the diagnosis of D pteronyssinus IgE sensitization.

Pulmonary Sequestration: A 29 Patient Case Series and Review

INTRODUCTION

Pulmonary sequestration also known as bronchopulmonary sequestration is a rare disease, with very few case series reviewed in literature. In this study, we review the demographics, presentation, imaging and treatment of pulmonary sequestration in 29 patients from our institution, and provide comparison data from previously published series with an overview of the disease history.

MATERIALS AND METHODS

Records reviewed for all patients evaluated and treated in our institution with a pathological proven diagnosis of pulmonary sequestration from January 2004 through December 2013. Collected data included demographics, clinical presentation, diagnostic imaging, location of the lesion, type of sequestration, and subsequent treatment.

RESULTS

Of the 29 patients reviewed 8 (28%) were children 0-2 years, 1 adolescent age 17, and 20 (69%) adults 21-70 years with a mean age of 42 among adults. Systemic arterial supply to the sequestered segment was demonstrated with computed tomographic angiography (CTA) in 25 patients (86%). In 19 patients (66%), the sequestered segment was located in the left lower lobe, and 16 (55%) were intralobar.

CONCLUSION

Diagnostic delays of pulmonary sequestration were common among the adult population as the presenting symptoms often mimicked other common pulmonary diseases, such as pneumonia and asthma. These findings were consistent among previously published series. CTA was the preferred imaging modality for preoperative planning with high sensitivity and specificity in identifying the lesion.

Pulmonary sequestration in children: a clinical analysis of 48 cases

BACKGROUND

This study aimed to explore clinical features, diagnosis, treatment, and outcomes of children's pulmonary sequestration (PS) to reduce misdiagnosis.

METHODS

Clinical records of 48 children with PS in Children's Hospital of Chongqing Medical University between April 1994 and April 2013 were retrieved, and the literature was reviewed.

RESULTS

48 cases were collected, 30 cases confirmed (Group A) and 18 suspicious cases (Group B). In Group A, 16 cases were confirmed before operation by 64-row enhanced CT (4 cases), enhanced CT combined with three-dimensional reconstruction (9 cases), and digital subtraction angiography (3 cases). Misdiagnosis rate was 36.7%, while missed diagnosis rate 10%. 26 cases received surgery and were confirmed finally. Aberrant arterial supply mainly originated from thoracic aorta (22 cases) and abdominal aorta (5 cases). Hypoplasia and chronic inflammation were shown by postoperative histopathological examinations in all children with surgery. There was no operative mortality. Encapsulated pleural effusion occurred in one patient as only post-operation complication. All were discharged after successful treatment.

CONCLUSION

Chest X-ray and color Doppler ultrasound can be used for routine screening for PS. Technique of choice for confirmation is three-dimensional chest CT. Identifying anomalous systemic artery is key for confirmed diagnosis. Surgery is recommended as early as possible. X-ray plus ultrasound as routine screening combined with three-dimensional CT for definitive diagnosis and video-assisted thoracoscopic surgery might be best choice for PS in future.