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Akgün Ö, Çakmak F, Guliyeva V, Demirkan FG, Tanatar A, Hançerli Torun S, Çin D, Meşe S, Ağaçfidan A, Aktay Ayaz N. Humoral response and safety of BNT162b2 mRNA vaccine in children with rheumatic diseases. Rheumatology (Oxford) 2022; 61:4482-4490. [PMID: 35353139 PMCID: PMC9383626 DOI: 10.1093/rheumatology/keac140] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/02/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) vaccine represents a cornerstone in tackling the pandemic and with the approval of the BNT162b2 mRNA vaccine in December 2020, it has become a beacon of hope for people around the world, including children. This study aimed to present the data on the humoral response and safety of vaccine in a cohort of patients with paediatric rheumatic diseases receiving immunomodulatory treatments. METHODS Forty-one children with paediatric rheumatic diseases were included and were vaccinated with the BNT162b2 mRNA vaccine (two doses of 30 µg administered 3-4 weeks apart). To assess the humoral response, IgG antibodies developed against the S1/Receptor-binding domain (RBD) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein at baseline and 3-4 weeks after the second dose were measured. The possible local and systemic side effects and disease activity scores were evaluated during the study period. RESULTS After the second dose of vaccine, markedly elevated anti-RBD IgG titres were observed in all patients with a median titre of 20 474 AU/ml [interquartile range (IQR) 6534-36 151] with a good safety profile. The median disease duration was 4.3 (IQR 3.5-5.6) years. In the cohort, 14 (34.1%) received conventional DMARDs (cDMARDs), 16 (39%) received biologic DMARDs (bDMARDs) and 11 (26.8%) received a combined therapy (cDMARDs and bDMARDs). Patients treated with combined therapy [median 4695 (IQR 2764-26 491)] had significantly lower median titres of anti-RBD IgG than those receiving only cDMARDs. CONCLUSION Paediatric rheumatic diseases patients receiving immunomodulatory treatments were able to mount an effective humoral response after two dose regimens of BNT162b2 mRNA vaccine safely without interrupting their current treatments.
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Affiliation(s)
- Özlem Akgün
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
| | - Figen Çakmak
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
| | - Vafa Guliyeva
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
| | | | - Ayşe Tanatar
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
| | | | - Dilan Çin
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevim Meşe
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Ağaçfidan
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
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Kaba Ö, Kara M, Bayramoğlu Z, Çalışkan E, Çetin B, Karimov E, Özkuvancı Ü, Özlük Y, Hançerli Torun S, Yürük Yıldırım ZN, Ziylan HO, Somer A. An adolescent girl with obstructive uropathy requiring nephro-ureterectomy was subsequently diagnosed with renal tuberculosis: case report. Paediatr Int Child Health 2021; 41:154-157. [PMID: 32990186 DOI: 10.1080/20469047.2020.1822633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A 15-year-old girl was followed up for 2 years in a district hospital for management of vesicoureteral reflux and, subsequently, hydronephrosis of both kidneys and required bilateral ureteroneocystostomy. Despite surgery, there was continuous progression of the left hydronephrosis. Referral to a tertiary hospital because of continued sterile pyuria prompted investigation for tuberculosis (TB): she was diagnosed with bilateral pulmonary TB and urine culture confirmed Mycobacterium tuberculosis. Despite tuberculous chemotherapy and dexamethasone, she required a left nephrectomy. Histology demonstrated necrotising granulomatous pyelonephritis. She remains well with normal function of the right kidney. Despite the rarity, chronic urinary tract disorders should always prompt investigation for tuberculosis.
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Affiliation(s)
- Özge Kaba
- Department of Pediatrics, Division of Pediatric Infectious Disease, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Manolya Kara
- Department of Pediatrics, Division of Pediatric Infectious Disease, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zuhal Bayramoğlu
- Department of Radiology, Division of Pediatric Radiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emine Çalışkan
- Department of Radiology, Division of Pediatric Radiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Bilal Çetin
- Department of Urology, Division of Pediatric Urology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elnur Karimov
- Department of Pediatrics, Division of Pediatric Infectious Disease, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ünsal Özkuvancı
- Department of Urology, Division of Pediatric Urology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yasemin Özlük
- Department of Pathology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Selda Hançerli Torun
- Department of Pediatrics, Division of Pediatric Infectious Disease, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zeynep Nagehan Yürük Yıldırım
- Department of Pediatrics, Division of Pediatric Nephrology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hasan Orhan Ziylan
- Department of Urology, Division of Pediatric Urology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ayper Somer
- Department of Pediatrics, Division of Pediatric Infectious Disease, Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Radiology, Division of Pediatric Radiology, Seyhan State Hospital, Adana, Turkey
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Bayramoglu Z, Canıpek E, Comert RG, Gasimli N, Kaba O, Sarı Yanartaş M, Hançerli Torun S, Somer A, Erturk SM. Imaging Features of Pediatric COVID-19 on Chest Radiography and Chest CT: A Retrospective, Single-Center Study. Acad Radiol 2021; 28:18-27. [PMID: 33067091 PMCID: PMC7534757 DOI: 10.1016/j.acra.2020.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 12/12/2022]
Abstract
RATIONALE AND OBJECTIVES This study aims to reveal the imaging features of Coronavirus Disease 2019 (COVID-19) in children. MATERIALS AND METHODS Sixty-nine chest radiographs and 37 chest CT examinations of 74 children (36 male; median (interquartile range) age:11 (6.25-15) years, 38 female; median (interquartile range) age: 12 (5.75-16) years) with positive real-time reverse transcription-polymerase chain reaction results between March 10 and May 31, 2020, were evaluated in this retrospective study. Differences in 0-<6, 6-<12, and 12-18 years of age groups were assessed with the Fisher's exact test or Kruskal-Wallis tests. RESULTS Right-sided (3/69, 4.3%) or bilateral (3/69, 4.3%) ground-glass opacities without significant difference in age groups were depicted as radiographic findings related to COVID-19 in children. Opacities were either single (7/37, 18.9%) or bilateral (7/37, 18.9%) around the distal third of the bronchovascular bundle on CT. There was no significant difference in the median size of the largest opacities, total numbers of opacities and involved lobes, and the distance of the closest opacity to the pleura among age groups (p > 0.05). The rate of ground-glass opacities with or without consolidation (17/37, 45.94%) was higher than consolidation alone (6/37, 16.2%). Feeding vessel sign (16/37, 43.2%), halo sign (9/37, 24.3%), pleural thickening (6/37, 16.2%), interlobular interstitial thickening (5/37, 13.5%), and lymphadenopathy (3/37, 8.1%) were other imaging findings. CONCLUSION Unilateral or bilateral distributed ground-glass opacities often associated with feeding vessel sign, halo sign, and pleural thickening on chest CT without significant differences between age groups were findings of COVID-19 in children.
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Affiliation(s)
- Zuhal Bayramoglu
- Radiology Department, Istanbul University, Istanbul Medical Faculty, Fatih, Millet Street, 34390, Istanbul, Turkey.
| | - Eda Canıpek
- Radiology Department, Istanbul University, Istanbul Medical Faculty, Fatih, Millet Street, 34390, Istanbul, Turkey
| | - Rana G Comert
- Radiology Department, Istanbul University, Istanbul Medical Faculty, Fatih, Millet Street, 34390, Istanbul, Turkey
| | - Nilufar Gasimli
- Radiology Department, Istanbul University, Istanbul Medical Faculty, Fatih, Millet Street, 34390, Istanbul, Turkey
| | - Ozge Kaba
- Department of Pediatric Infectious Disease, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Mehpare Sarı Yanartaş
- Department of Pediatric Infectious Disease, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Selda Hançerli Torun
- Department of Pediatric Infectious Disease, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Disease, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Sukru Mehmet Erturk
- Radiology Department, Istanbul University, Istanbul Medical Faculty, Fatih, Millet Street, 34390, Istanbul, Turkey
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Akturk H, Uysalol M, Salman N, Ciblak M, Torun SH, Uzunhan T, Sutcu M, Citak A, Somer A. Benign Acute Childhood Myositis Associated with Influenza: A Cluster of Cases from a Single Centre in the 2013-2014 Cold Season. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791602300309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Influenza associated myositis has generally a clearly defined clinical picture. However, it may cause diagnostic confusion and unnecessary work up due to unfamiliarity with this condition by the medical staff. In this report, retrospective clinical and laboratory data about 10 children with influenza associated myositis diagnosed among all admissions to emergency room of a tertiary referral centre during the cold season of 2013-2014 was presented to increase awareness of this clinical issue. (Hong Kong j.emerg.med. 2016;23:186-191)
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Affiliation(s)
| | - M Uysalol
- Istanbul Medical Faculty, Department of Microbiology, Istanbul, Turkey
| | - N Salman
- Istanbul Medical Faculty, Department of Pediatric Emergency, Istanbul, Turkey
| | - M Ciblak
- Istanbul Medical Faculty, Department of Pediatric Neurology, Istanbul, Turkey
| | - SH Torun
- Istanbul Medical Faculty, Department of Pediatric Emergency, Istanbul, Turkey
| | - T Uzunhan
- Istanbul Medical Faculty, Department of Pediatric Emergency, Istanbul, Turkey
| | - M Sutcu
- Istanbul Medical Faculty, Department of Pediatric Emergency, Istanbul, Turkey
| | - A Citak
- Istanbul Medical Faculty, Department of Microbiology, Istanbul, Turkey
| | - A Somer
- Istanbul Medical Faculty, Department of Pediatric Emergency, Istanbul, Turkey
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Sütçü M, Acar M, Aktürk H, Hançerli Torun S, Beka H, Ağaçfidan A, Salman N, Somer A. Clinical Findings of Pediatric HIV Infection in a Tertiary Center in Turkey. Balkan Med J 2017; 34:239-245. [PMID: 28443591 PMCID: PMC5450864 DOI: 10.4274/balkanmedj.2015.1571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Paediatric HIV infection is different from the adult type of disease in many ways, including transmission routes, clinical findings and treatment strategies. Aims: To evaluate clinical data of paediatric patients with HIV disease. Study Design: Retrospective cross-sectional study. Methods: The charts of 22 paediatric patients diagnosed with HIV infection in our clinic during a 14 year period through 2001-2015 were retrospectively analysed. Clinical data, laboratory findings, treatment modalities and outcomes were recorded. Results: The mean age of diagnosis 61.9±49.2 months and the mean follow-up period was 60.3±37.5 months. Seven patients (31.8%) were foreigners and the most common transmission route was vertical transmission (n=16, 72.7%). The most common presenting symptom and the sign were history of recurrent upper respiratory tract infections (n=8, 36.4%) and lymphadenopathy (n=12, 54.5%), respectively. Recurrent pneumonia (n=6, 27.3%), prolonged fever (n=5, 22.7%), recurrent otitis media (n=4, 18.2%), and gastroenteritis (n=4, 18.2%) were other clinical symptoms. Other than bacterial sinopulmonary infections, tuberculosis was the most frequent opportunistic infection (n=3, 13.6%). Mortality occurred in two patients (9.1%). Conclusion: Although mostly vertically transmitted, HIV infection may be diagnosed throughout the childhood. Frequently encountered signs and symptoms may be the reason for doctor admission. High clinical suspicion together with detailed anamnestic data and physical findings constitute the basis for pediatric HIV diagnosis.
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Affiliation(s)
- Murat Sütçü
- Department of Pediatric Infectious Diseases, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Manolya Acar
- Department of Pediatric Infectious Diseases, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Hacer Aktürk
- Department of Pediatric Infectious Diseases, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Selda Hançerli Torun
- Department of Pediatric Infectious Diseases, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Hayati Beka
- Department of Clinical Microbiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Ali Ağaçfidan
- Department of Clinical Microbiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Nuran Salman
- Department of Pediatric Infectious Diseases, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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