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De Pieri C, Valentini E, Pusiol A, Passone E, Gamalero L, Cogo PE. Infective Uvulitis in a Child. Pediatr Emerg Care 2022; 38:e501-e502. [PMID: 33086360 DOI: 10.1097/pec.0000000000002258] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Infective uvulitis is a rare condition in children. In this report, we describe the case of a 4-year old-patient who presented a group A Streptococcus pharyngitis with uvulitis. No signs of epiglottitis were detected at nasal fibroscopy. She recovered rapidly with intravenous antibiotic therapy and 2 days of corticosteroid. Uvulitis is usually caused by group A Streptococcus or Haemophilus influentiae, but also other bacteria can be detected. Uvulitis can be isolated, or it can occur with epiglottitis and become an emergency.
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Affiliation(s)
- Carlo De Pieri
- From the Division of Pediatrics, Department of Medicine, University of Udine, Udine, Italy
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De Pieri C, Fauroux B, Khirani S, Thierry B, Delacourt C, Cogo P, Amaddeo A. Respiratory polygraphy in subjects with bronchopulmonary dysplasia: a retrospective study. Minerva Pediatr 2020:S0026-4946.20.06088-0. [PMID: 33305917 DOI: 10.23736/s0026-4946.20.06088-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Periodic assessment of the need for oxygen supplementation and/or mechanical ventilation in children with severe bronchopulmonary dysplasia (BPD) is crucial. The aim of the study was to analyze the indications and results of respiratory polygraphies (RP) performed in preterm infants with BPD followed at a tertiary university hospital. METHODS All subjects < 5-year-old with BPD who had a RP between September and February 2018 were included. The indications and results of RP and consequent medical management were analyzed. RESULTS Fourteen infants (9 females, mean gestational age 27.6±3.3 weeks) underwent a RP at mean age of 26.4±19.4 months. Five subjects were evaluated for the need of long-term respiratory support (RS), 3 started continuous positive airway pressure (CPAP), 2 were weaned from RS. Four subjects underwent RP for suspected obstructive sleep apnea (OSA), one started on CPAP. Central apnea syndrome (CSA) was confirmed in 2 subjects and one was started on non-invasive ventilation. RP allowed safe tracheostomy decannulation in 2 subjects. Finally, RP was normal in one patient who had a brief resolved unexplained event (BRUE). CONCLUSIONS RP represents an important tool for the evaluation of children with BPD and leads to important therapeutic decisions.
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Affiliation(s)
- Carlo De Pieri
- Pediatric Non-Invasive Ventilation and Sleep Unit, Hôpital Necker-Enfants Malades, Paris, France
- Division of Pediatric, Department of Medicine, University Hospital of Udine, Udine, Italy
| | - Brigitte Fauroux
- Pediatric Non-Invasive Ventilation and Sleep Unit, Hôpital Necker-Enfants Malades, Paris, France
- Paris Descartes University, Paris, France
- Université de Paris, VIFASOM, Paris, France
| | - Sonia Khirani
- Pediatric Non-Invasive Ventilation and Sleep Unit, Hôpital Necker-Enfants Malades, Paris, France
- ASV Santé, Gennevilliers, France
| | - Briac Thierry
- Pediatric ENT Department, Hôpital Necker-Enfants Malades, Paris, France
| | - Christophe Delacourt
- Paris Descartes University, Paris, France
- Pediatric Pulmonology and Allergy Department, Hôpital Necker-Enfants Malades, Paris, France
| | - Paola Cogo
- Division of Pediatric, Department of Medicine, University Hospital of Udine, Udine, Italy
| | - Alessandro Amaddeo
- Pediatric Non-Invasive Ventilation and Sleep Unit, Hôpital Necker-Enfants Malades, Paris, France -
- Paris Descartes University, Paris, France
- Université de Paris, VIFASOM, Paris, France
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Di Cicco ME, Ferrante G, Amato D, Capizzi A, De Pieri C, Ferraro VA, Furno M, Tranchino V, La Grutta S. Climate Change and Childhood Respiratory Health: A Call to Action for Paediatricians. Int J Environ Res Public Health 2020; 17:E5344. [PMID: 32722291 PMCID: PMC7432234 DOI: 10.3390/ijerph17155344] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/13/2020] [Accepted: 07/20/2020] [Indexed: 12/11/2022]
Abstract
Climate change (CC) is one of the main contributors to health emergencies worldwide. CC appears to be closely interrelated with air pollution, as some pollutants like carbon dioxide (CO2), nitrogen oxides (NOx) and black carbon are naturally occurring greenhouse gases. Air pollution may enhance the allergenicity of some plants and, also, has an adverse effect on respiratory health. Children are a uniquely vulnerable group that suffers disproportionately from CC burden. The increasing global warming related to CC has a big impact on plants' lifecycles, with earlier and longer pollen seasons, as well as higher pollen production, putting children affected by asthma and allergic rhinitis at risk for exacerbations. Extreme weather events may play a role too, not only in the exacerbations of allergic respiratory diseases but, also, in favouring respiratory infections. Even though paediatricians are already seeing the impacts of CC on their patients, their knowledge about CC-related health outcomes with specific regards to children's respiratory health is incomplete. This advocates for paediatricians' increased awareness and a better understanding of the CC impact on children's respiratory health. Having a special responsibility for children, paediatricians should actively be involved in policies aimed to protect the next generation from CC-related adverse health effects. Hence, there is an urgent need for them to take action and successfully educate families about CC issues. This paper aims at reviewing the evidence of CC-related environmental factors such as temperature, humidity, rainfall and extreme events on respiratory allergic diseases and respiratory infections in children and proposing specific actionable items for paediatricians to deal with CC-related health issues in their clinical practice.
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Affiliation(s)
- Maria Elisa Di Cicco
- Department of Paediatrics, University Hospital of Pisa, via Roma 67, 56126 Pisa, Italy;
| | - Giuliana Ferrante
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy
| | - Doriana Amato
- Pediatric Medicine Unit and Pediatric Emergency Department, Pediatric Hospital Giovanni XXIII, via Giovanni Amendola 207, 70123 Bari, Italy; (D.A.); (V.T.)
| | - Antonino Capizzi
- Pediatrics Unit, S. Paolo and S. Corona Hospital, via Genova 30, 17100 Savona, Italy; (A.C.); (M.F.)
| | - Carlo De Pieri
- Pediatrics Clinic, Department of Medicine, University Hospital of Udine, Piazzale S.M. della Misericordia 15, 33100 Udine, Italy;
| | - Valentina Agnese Ferraro
- Unit of Pediatric Allergy and Respiratory Medicine, Department of Women’s and Children’s Health, University of Padova, via Nicolò Giustiniani 2, 35128 Padova, Italy;
| | - Maria Furno
- Pediatrics Unit, S. Paolo and S. Corona Hospital, via Genova 30, 17100 Savona, Italy; (A.C.); (M.F.)
| | - Valentina Tranchino
- Pediatric Medicine Unit and Pediatric Emergency Department, Pediatric Hospital Giovanni XXIII, via Giovanni Amendola 207, 70123 Bari, Italy; (D.A.); (V.T.)
| | - Stefania La Grutta
- National Research Council of Italy, Institute for Research and Biomedical Innovation, IRIB, Via Ugo La Malfa 153, 90146 Palermo, Italy;
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Arigliani M, Valentini E, Stocco C, De Pieri C, Castriotta L, Barbato V, Cuberli E, Orsaria M, Cattarossi L, Cogo P. Regional ventilation inhomogeneity in survivors of extremely preterm birth. Pediatr Pulmonol 2020; 55:1366-1374. [PMID: 32212328 DOI: 10.1002/ppul.24742] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Received: 02/20/2020] [Accepted: 03/13/2020] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Survivors of extreme prematurity may have disrupted lung development. We hypothesized that the multiple breath washout (MBW) index Scond, which is intended to reflect ventilation inhomogeneity from the conducting airways, could be a sensitive marker of respiratory impairment in this group. METHODS Spirometry, TLco, and MBW were cross-sectionally evaluated at 8 to 14 years of age in children born at <28 weeks between 2004 and 2010 in Udine, Italy. Age-matched controls born at term were also included. Bronchopulmonary dysplasia (BPD) was defined as oxygen-dependence at 36 weeks postmenstrual age. The limits of normal were the 5th percentile of the reference population (Global Lung Initiative) for spirometry and TLco and the 95th percentile of controls for Lung Clearance Index, Scond, and Sacin from MBW. RESULTS Results were obtained in 47 extremely preterm children (53% boys, mean ± standard deviation age 11.3 ± 2.0 years, 40% with BPD) and 60 controls (50% boys, 11.6 ± 1.9 years). There were significant differences between preterm children and controls in all lung function outcomes, except for Sacin. Among children born <28 weeks, Scond tended to be frequently abnormal than FEV1 z-score (29% vs 14%, P = .06). At multivariable linear regression, in the preterm group, current asthma was significantly associated with a higher Scond (B = 0.019, 95% confidence interval, 0.000-0.038), whereas BPD was not. CONCLUSION Almost a third of extremely preterm children at school age showed Scond alterations that affected also children without BPD. Longitudinal studies should clarify the prognostic meaning of Scond abnormalities in this group.
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Affiliation(s)
- Michele Arigliani
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Elena Valentini
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Chiara Stocco
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Carlo De Pieri
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Luigi Castriotta
- Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy
| | - Vincenzo Barbato
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Elisa Cuberli
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Maria Orsaria
- Department of Medicine, Surgical Pathology Section, University Hospital of Udine, Udine, Italy
| | - Luigi Cattarossi
- Department of Medicine, Neonatal Intensive Care Unit, University Hospital of Udine, Udine, Italy
| | - Paola Cogo
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
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De Pieri C, Amaddeo A, Fauroux B. About the role of polysomnography in weaning and titration of home oxygen therapy in children with bronchopulmonary dysplasia. J Matern Fetal Neonatal Med 2018; 33:875. [PMID: 30001649 DOI: 10.1080/14767058.2018.1500548] [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: 10/28/2022]
Affiliation(s)
- Carlo De Pieri
- Division of Pediatrics, Department of Medicine, University of Udine, Udine, Italy
| | - Alessandro Amaddeo
- Pediatric Noninvasive Ventilation and Sleep Unit, Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker Enfants Malades, Paris, France.,Paris Descartes University, Paris, France
| | - Brigitte Fauroux
- Pediatric Noninvasive Ventilation and Sleep Unit, Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker Enfants Malades, Paris, France.,Paris Descartes University, Paris, France
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De Pieri C, Bravar G, Dolcemascolo V, Dallorto A, De Colle MC, Cogo PE. Hoofbeats, Zebras, and a Child with Vomiting. Neuropediatrics 2018; 49:158-159. [PMID: 29396962 DOI: 10.1055/s-0038-1623533] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Carlo De Pieri
- Division of Pediatrics, Department of Medicine, University of Udine, Udine, Italy
| | - Giulia Bravar
- Department of Pediatrics, University of Trieste, Trieste, Italy
| | | | - Anna Dallorto
- Institute of Diagnostic Radiology, Department of Medicine, University Hospital of Udine, Udine, Italy
| | | | - Paola Elisa Cogo
- Division of Pediatrics, Department of Medicine, University of Udine, Udine, Italy
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De Pieri C, Cogo P, Barbato A. Tracheomalacia Due to Esophageal Achalasia. Arch Bronconeumol 2016; 53:78-79. [PMID: 27364977 DOI: 10.1016/j.arbres.2016.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/10/2016] [Accepted: 05/11/2016] [Indexed: 11/20/2022]
Affiliation(s)
- Carlo De Pieri
- Division of Pediatrics, Department of Clinical and Experimental Medical Sciences, University of Udine, Udine, Italia.
| | - Paola Cogo
- Division of Pediatrics, Department of Clinical and Experimental Medical Sciences, University of Udine, Udine, Italia
| | - Angelo Barbato
- Pediatric Bronchoscopy Unit, Department of Women's and Children's Health, University of Padova/General Hospital, Padova, Italia
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De Pieri C, Taddio A, Insalaco A, Barbi E, Lepore L, Ventura A, Tommasini A. Different presentations of mevalonate kinase deficiency: a case series. Clin Exp Rheumatol 2015; 33:437-442. [PMID: 25897835] [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] [Received: 07/17/2014] [Accepted: 12/19/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES We aimed to raise awareness among paediatricians and physicians about this often misunderstood condition. METHODS We discussed the clinical profiles associated with late or wrong diagnosis of mevalonate kinase deficency (MKD) in a single centre case series. RESULTS We analysed the most common challenges and pitfalls that a clinician might face during the diagnostic process. Five main clinical profiles were characterised. CONCLUSIONS We propose a new perspective on MKD, suggesting that the presentation of this disease can vary from patient to patient.
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Affiliation(s)
- Carlo De Pieri
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Andrea Taddio
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo; and Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Antonella Insalaco
- Operative Unit of Rheumatology, Department of Paediatric Medicine, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Egidio Barbi
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Loredana Lepore
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Alessandro Ventura
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo; and Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Alberto Tommasini
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
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De Pieri C, Vuch J, De Martino E, Bianco AM, Ronfani L, Athanasakis E, Bortot B, Crovella S, Taddio A, Severini GM, Tommasini A. Genetic profiling of autoinflammatory disorders in patients with periodic fever: a prospective study. Pediatr Rheumatol Online J 2015; 13:11. [PMID: 25866490 PMCID: PMC4393620 DOI: 10.1186/s12969-015-0006-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 03/20/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Periodic fever syndromes (PFS) are an emerging group of autoinflammatory disorders. Clinical overlap exists and multiple genetic analyses may be needed to assist diagnosis. We evaluated the diagnostic value of a 5-gene sequencing panel (5GP) in patients with undiagnosed PFS. METHODS Simultaneous double strand Sanger sequencing of MEFV, MVK, TNFRSF1A, NLRP3, NLRP12 genes was performed in 42 patients with unexplained PFS. Clinical features were correlated with genetic results. RESULTS None of 42 patients analyzed displayed a causative genotype. However, single or multiple genetic variants of uncertain significance were detected in 24 subjects. Only in 5 subjects a definite diagnosis was made by taking into account both genetic and clinical data (2 TRAPS syndrome; 2 FMF; 1 FCAS). Statistical analysis showed that patients carrying genetic variants in one or more of the five selected genes displayed a significantly lower response to glucocorticoids compared with subjects who had completely negative genetic results. CONCLUSIONS The sequencing of multiple genes is of little help in the diagnostics of PFS and can often lead to results of uncertain interpretation, thus the clinically driven sequencing of single genes should remain the recommended approach. However, the presence of single or multiple genetic variants of uncertain significance, even if not allowing any specific diagnosis, correlated with a poorer response to glucocorticoids, possibly indicating a multifactorial subgroup of PFS with differential response to pharmacological treatment.
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Affiliation(s)
- Carlo De Pieri
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Eleonora De Martino
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Anna M Bianco
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Luca Ronfani
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Barbara Bortot
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Sergio Crovella
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy ,University of Trieste, Trieste, Italy
| | - Andrea Taddio
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy ,University of Trieste, Trieste, Italy
| | - Giovanni M Severini
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Alberto Tommasini
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
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Abstract
The causes of extremely elevated IgA, whether isolated or associated with an increase in other classes of immunoglobulin, are poorly defined in paediatrics. We reviewed the diagnostic significance of very high IgA levels (greater than 3 SD above the mean for age) in a cohort of patients referred to a tertiary care children's hospital. Hyper-IgA was found in 91 of 6364 subjects (1.4%) and in 68 cases was not associated with an increased IgG and/or IgM level. Most subjects with hyper-IgA (73.5%) had a severe immune defect, a chronic rheumatic disease or inflammatory bowel disease, while these conditions were very rare in a control group with normal IgA values (8%). Although our results may in part reflect the experience of a tertiary care centre, we suggest that hyper-IgA in children should always arouse suspicion of a serious disease.
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Affiliation(s)
| | - Serena Pastore
- University of Trieste, Trieste, Italy Institute of Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Carlo De Pieri
- Institute of Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Oriano Radillo
- Department of Advanced Diagnostic and Clinical Trials, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Andrea Taddio
- University of Trieste, Trieste, Italy Institute of Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Alessandro Ventura
- University of Trieste, Trieste, Italy Institute of Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Alberto Tommasini
- Institute of Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
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De Pieri C, Vuch J, Athanasakis E, Severini GM, Crovella S, Bianco AM, Tommasini A. F402L variant in NLRP12 in subjects with undiagnosed periodic fevers and in healthy controls. Clin Exp Rheumatol 2014; 32:993-994. [PMID: 25327218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 06/25/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Carlo De Pieri
- Department of Paediatrics, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
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De Pieri C, Vuch J, Bianco AM, Barbieri F, Pastore S, Ronfani L, Crovella S, Taddio A, Severini GM, Tommasini A. Genetic profiling of auto-inflammatory disorders in patients with periodic fever: a prospective study. Pediatr Rheumatol Online J 2014. [PMCID: PMC4184337 DOI: 10.1186/1546-0096-12-s1-p83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Pastore SI, Copetti V, De Pieri C, Radillo O, Taddio A, Ventura A, Tommasini A. Clinical significance of hyper-IGA in a pediatric laboratory series. Pediatr Rheumatol Online J 2014. [PMCID: PMC4191150 DOI: 10.1186/1546-0096-12-s1-p170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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