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Ip WCT, Shea YF, Ling TK, Law CY, Lam CW, Chiu PKC. A curious case of early-onset dementia. Hong Kong Med J 2023; 29:359.e1-359.e3. [PMID: 37316159 DOI: 10.12809/hkmj2210106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Affiliation(s)
- W C T Ip
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - Y F Shea
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - T K Ling
- Division of Chemical Pathology, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - C Y Law
- Division of Chemical Pathology, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - C W Lam
- Division of Chemical Pathology, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
- Department of Pathology, The University of Hong Kong, Hong Kong SAR, China
| | - P K C Chiu
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
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Ip WCT, Shea YF, Tong HF, Law CY, Lam CW, Chiu PKC. A curious case of small vessel vascular dementia. Hong Kong Med J 2023; 29:174.e1-174.e3. [PMID: 37088704 DOI: 10.12809/hkmj2210093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Affiliation(s)
- W C T Ip
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - Y F Shea
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - H F Tong
- Division of Chemical Pathology, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
- Department of Pathology, Princess Margaret Hospital, Hong Kong SAR, China
| | - C Y Law
- Division of Chemical Pathology, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - C W Lam
- Division of Chemical Pathology, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
- Department of Pathology, The University of Hong Kong, Hong Kong SAR, China
| | - P K C Chiu
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
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Lui DTW, Lee CH, Chow WS, Lee ACH, Tam AR, Cheung CYY, Fong CHY, Kwok STM, Law CY, To KKW, Lam CW, Tan KCB, Woo YC, Hung IFN, Lam KSL. Development of a prediction score (ThyroCOVID) for identifying abnormal thyroid function in COVID-19 patients. J Endocrinol Invest 2022; 45:2149-2156. [PMID: 35831586 PMCID: PMC9281239 DOI: 10.1007/s40618-022-01854-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE Thyroid dysfunction in COVID-19 carries clinical and prognostic implications. In this study, we developed a prediction score (ThyroCOVID) for abnormal thyroid function (TFT) on admission amongst COVID-19 patients. METHODS Consecutive COVID-19 patients admitted to Queen Mary Hospital were prospectively recruited during July 2020-May 2021. Thyroid-stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were measured on admission. Multivariable logistic regression analysis was performed to identify independent determinants of abnormal TFTs. ThyroCOVID was developed based on a clinical model with the lowest Akaike information criteria. RESULTS Five hundred and forty six COVID-19 patients were recruited (median age 50 years, 45.4% men, 72.9% mild disease on admission). 84 patients (15.4%) had abnormal TFTs on admission. Patients with abnormal TFTs were more likely to be older, have more comorbidities, symptomatic, have worse COVID-19 severity, higher SARS-CoV-2 viral loads and more adverse profile of acute-phase reactants, haematological and biochemical parameters. ThyroCOVID consisted of five parameters: symptoms (malaise), comorbidities (ischaemic heart disease/congestive heart failure) and laboratory parameters (lymphocyte count, C-reactive protein, and SARS-CoV-2 cycle threshold values). It was able to identify abnormal TFT on admission with an AUROC of 0.73 (95% CI 0.67-0.79). The optimal cut-off of 0.15 had a sensitivity of 75.0%, specificity of 65.2%, negative predictive value of 93.5% and positive predictive value of 28.1% in identifying abnormal TFTs on admission amongst COVID-19 patients. CONCLUSION ThyroCOVID, a prediction score to identify COVID-19 patients at risk of having abnormal TFT on admission, was developed based on a cohort of predominantly non-severe COVID-19 patients.
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Affiliation(s)
- D. T. W. Lui
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - C. H. Lee
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - W. S. Chow
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - A. C. H. Lee
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - A. R. Tam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - C. Y. Y. Cheung
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - C. H. Y. Fong
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - S. T. M. Kwok
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - C. Y. Law
- Division of Chemical Pathology, Queen Mary Hospital, Hong Kong, China
| | - K. K. W. To
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - C. W. Lam
- Department of Pathology, The University of Hong Kong, Hong Kong, China
| | - K. C. B. Tan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Y. C. Woo
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - I. F. N. Hung
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - K. S. L. Lam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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Chua GT, Wong JSC, Chung J, Lam I, Kwong J, Leung K, Law CY, Lam CW, Kwok J, Chu PWK, Au EYL, Lam CK, Mak D, Fong NC, Leung D, Wong WHS, Ho MHK, Tsao SSL, Wong CS, Yam JC, Tso WWY, To KKW, Tam PKH, Chan GCF, Leung WH, Yuen KY, Novelli V, Klein N, Levin M, Whitaker E, Lau YL, Ip P, Kwan MYW. Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2: a case report. Hong Kong Med J 2022; 28:76-78. [DOI: 10.12809/hkmj219689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Gilbert T Chua
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Joshua SC Wong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - Jaime Chung
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - Ivan Lam
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - Joyce Kwong
- Haematology Laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong
| | - Kate Leung
- Haematology Laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong
| | - CY Law
- Division of Chemical Pathology, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - CW Lam
- Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Janette Kwok
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - Patrick WK Chu
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - Elaine YL Au
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - Crystal K Lam
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - Daniel Mak
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - NC Fong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - Daniel Leung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Wilfred HS Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Marco HK Ho
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Sabrina SL Tsao
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Christina S Wong
- Division of Dermatology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong
| | - Winnie WY Tso
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kelvin KW To
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Paul KH Tam
- Division of Paediatric Surgery, Department of Surgery, The University of Hong Kong, Hong Kong; Dr Li Dak-Sum Research Centre, The University of Hong Kong–Karolinska Institutet Collaboration in Regenerative Medicine, The University of Hong Kong, Hong Kong
| | - Godfrey CF Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - WH Leung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - KY Yuen
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Vas Novelli
- Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children, London, United Kingdom; Institute of Child Health, University College London, London, United Kingdom
| | - Nigel Klein
- Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children, London, United Kingdom; Institute of Child Health, University College London, London, United Kingdom
| | - Michael Levin
- Section of Paediatrics, Imperial College London, London, United Kingdom
| | - Elizabeth Whitaker
- Paediatric Infectious Diseases Department, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - YL Lau
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Mike YW Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
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Pandian BG, Sireesha P, Ng YP, Raj SD, Law CY, Patrick CEM. Assessing the knowledge of private university students on self-medication practices, Malaysia. ACTA ACUST UNITED AC 2019. [DOI: 10.4103/mtsp.mtsp_13_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mak CM, Chen SP, Mok NS, Siu WK, Lee HH, Ching CK, Tsui PT, Fong NC, Yuen YP, Poon WT, Law CY, Chong YK, Chan YW, Yung TC, Fan KY, Lam CW. Genetic basis of channelopathies and cardiomyopathies in Hong Kong Chinese patients: a 10-year regional laboratory experience. Hong Kong Med J 2018; 24:340-349. [PMID: 29497013 DOI: 10.12809/hkmj176870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Hereditary channelopathies and cardiomyopathies are potentially lethal and are clinically and genetically heterogeneous, involving at least 90 genes. Genetic testing can provide an accurate diagnosis, guide treatment, and enable cascade screening. The genetic basis among the Hong Kong Chinese population is largely unknown. We aimed to report on 28 unrelated patients with positive genetic findings detected from January 2006 to December 2015. METHODS Sanger sequencing was performed for 28 unrelated patients with a clinical diagnosis of channelopathies or cardiomyopathies, testing for the following genes: KCNQ1,KCNH2,KCNE1,KCNE2, and SCN5A, for long QT syndrome; SCN5A for Brugada syndrome; RYR2 for catecholaminergic polymorphic ventricular tachycardia; MYH7 and MYBPC3 for hypertrophic cardiomyopathy; LMNA for dilated cardiomyopathy; and PKP2 and DSP for arrhythmogenic right ventricular dysplasia/cardiomyopathy. RESULTS There were 17 males and 11 females; their mean age at diagnosis was 39 years (range, 1-80 years). The major clinical presentations included syncope, palpitations, and abnormal electrocardiography findings. A family history was present in 13 (46%) patients. There were 26 different heterozygous mutations detected, of which six were novel-two in SCN5A (NM_198056.2:c.429del and c.2024-11T>A), two in MYBPC3 (NM_000256.3:c.906-22G>A and c.2105_2106del), and two in LMNA (NM_170707.3:c.73C>A and c.1209_1213dup). CONCLUSIONS We have characterised the genetic heterogeneity in channelopathies and cardiomyopathies among Hong Kong Chinese patients in a 10-year case series. Correct interpretation of genetic findings is difficult and requires expertise and experience. Caution regarding issues of non-penetrance, variable expressivity, phenotype-genotype correlation, susceptibility risk, and digenic inheritance is necessary for genetic counselling and cascade screening.
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Affiliation(s)
- C M Mak
- Chemical Pathology Laboratory, Kowloon West Cluster Laboratory Genetic Service, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - S Pl Chen
- Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - N S Mok
- Department of Medicine, Princess Margaret Hospital, Laichikok, Hong Kong
| | - W K Siu
- Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - H Hc Lee
- Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - C K Ching
- Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - P T Tsui
- Department of Medicine, Princess Margaret Hospital, Laichikok, Hong Kong
| | - N C Fong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Y P Yuen
- Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - W T Poon
- Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - C Y Law
- Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Y K Chong
- Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Y W Chan
- Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - T C Yung
- Department of Paediatric Cardiology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - K Yy Fan
- Department of Cardiac Medicine, Grantham Hospital, Wong Chuk Hang, Hong Kong
| | - C W Lam
- Department of Pathology, The University of Hong Kong, Pokfulam, Hong Kong
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Abstract
Aim To study the adequacy of trauma documentation in accident and emergency (A&E) attendance records. Method We reviewed the A&E attendance records of major trauma requiring trauma-team care in the resuscitation room from January to June 1999 and July to December 2001. Thirty-eight items including the history, symptoms and signs of injury were scored with reference to the teaching of the Advanced Trauma Life Support course. The mean score and rate of documentation of each item were calculated. Additional items on biomechanics and environmental factors of injury were also examined. The performance of emergency medicine trainees and non-emergency medicine trainees was analysed. Results A total of 128 records were included, 46 and 82 records being from 1999 and 2001 respectively. The maximum documentation score was 38. The mean documentation score in 2001 was 23.27; and this was significantly better than 20.37 in 1999 (p < 0.05). The documentation rates of pre-hospital, biomechanics and environmental items were poor. Notably, 15 out of the 38 items were preformatted in the A&E records and 11 of these preformatted items had documentation rates of > 80%. Emergency medicine trainees had better scores in 2001 than in 1999. However, non-emergency medicine trainees did not show improvement in their documentation. Conclusion Trauma documentation has improved since 1999 for emergency medicine trainees. Preformatted charts may increase the rate of documentation. Information on pre-hospital care and injury mechanism was not well documented.
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Law CY, Yeung WL, Cheung YF, Chan HF, Fung E, Hui J, Yung IO, Yuen YP, Chan AO, Lam CW. A common PRRT2 mutation in familial paroxysmal kinesigenic dyskinesia in Hong Kong: a case series of 16 patients. Hong Kong Med J 2016; 22:619-22. [PMID: 27920401 DOI: 10.12809/hkmj154579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- C Y Law
- Department of Pathology, The University of Hong Kong, Pokfulam, Hong Kong
| | - W L Yeung
- Department of Paediatrics and Adolescent Medicine, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - Y F Cheung
- Division of Neurology, Department of Medicine, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - H F Chan
- Division of Neurology, Department of Medicine, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - E Fung
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - J Hui
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - I Ok Yung
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - Y P Yuen
- Department of Chemical Pathology, Prince of Wales Hospital, Shatin, Hong Kong
| | - A Ok Chan
- Division of Clinical Biochemistry, Queen Mary Hospital, Pokfulam, Hong Kong
| | - C W Lam
- Department of Pathology, The University of Hong Kong, Pokfulam, Hong Kong
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Pan NY, Law CY, Tsang WK, Lee KL, Wong KC, Tam KF. Giant Cell Tumour of the Axial Skeleton: Report of Four Cases. Hong Kong J Radiol 2014. [DOI: 10.12809/hkjr1411064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Mak CM, Chan KY, Yau EKC, Chen SPL, Siu WK, Law CY, Lam CW, Chan AYW. Genetic diagnosis of severe myoclonic epilepsy of infancy (Dravet syndrome) with SCN1A mutations in the Hong Kong Chinese patients. Hong Kong Med J 2011; 17:500-502. [PMID: 22147323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Epilepsy is a clinically and genetically heterogeneous group of disorders. The advent of molecular genetics brings unprecedented advancement in diagnostic molecular pathology and reduces over-reliance on traditional clinical classification. Severe myoclonic epilepsy of infancy or Dravet syndrome is a catastrophic infantile-onset epilepsy. We report two unrelated Hong Kong Chinese patients with this condition presenting with febrile seizures, epilepsy with different semiologies, psychomotor retardation, and recurrent status epilepticus. Two different mutations were characterised, viz NM_001165963.1: c.680T>G; NP_001159435.1: p.I227S and NM_001165963.1: c.3953T>G; NP_001159435.1: p.L1318R (novel). Genetic characterisation conveys a definitive diagnosis and is important from the perspective of selecting anti-epileptic drug therapy and genetic counselling.
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Affiliation(s)
- Chloe M Mak
- Kowloon West Cluster Laboratory Genetic Service, Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong.
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