RESUMEN
OBJECTIVE: Severe sepsis remains a leading cause of morbidity and mortality in children. Given the link to pathogenesis, polymorphisms in genes involved in infection and inflammation may influence the outcomes in patients with sepsis and septic shock. The role of mutations within the innate immunity receptor NOD2/CARD15 has recently been demonstrated as a risk factor for bacteremia and mortality in adult patients with sepsis. The aim of this study was to evaluate the role of mutations of the NOD2/CARD15 gene in pediatric patients with sepsis. DESIGN: Prospective cohort study. SETTING: A tertiary care, ten-bed, pediatric intensive care unit. PATIENTS: One hundred twenty-eight patients with sepsis admitted to the pediatric intensive care unit and healthy control group were included. INTERVENTIONS: Venous blood from the children with sepsis and healthy controls was collected to investigate common polymorphisms (Arg702Trp, Gly908Arg, Leu1007fsincC) within the NOD2/CARD15 gene. Standard polymerase chain reaction restriction fragment length polymorphism technique was used to determine NOD2/CARD15 gene polymorphism. MEASUREMENT AND MAIN RESULTS: R702W, G908R, and Leu1007fsinsC variants in the NOD2/CARD15 gene were determined as significant risk factors associated with susceptibility to sepsis (p = .025, p = .031, p = .014, respectively). Sepsis-related mortality was increased in children carrying the Leu1007fsinsC variant (p = .041). CONCLUSIONS: The present article is the first report of clinical implications of NOD2/CARD15 gene variants in children with sepsis. Our findings suggest that common polymorphisms in the NOD2/CARD15 gene may play a major role in susceptibility to sepsis and the outcome of sepsis in children.
Asunto(s)
Predisposición Genética a la Enfermedad , Proteína Adaptadora de Señalización NOD2/genética , Polimorfismo Genético , Sepsis/genética , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Pronóstico , TurquíaRESUMEN
Urticaria is one of the most common dermatoses during the childhood, but it is very rare in the neonates. A 17-day-old infant with a generalized urticaria was admitted to our pediatric emergency unit. The mother of the infant reported having applied water boiled with stinging nettle (Urtica dioica) onto her nipples twice a day (before and after each breastfeeding) for 2 days in order to heal her nipple cracks. Serum total immunoglobulin E (IgE) and specific IgE levels for stinging nettle were high in the infant and the mother. The rashes began to regress within the first day of the hospitalization and disappeared completely on the second day without treatment. The skin prick test with the water boiled with stinging nettle was positive for the infant with significant induration, but not for the mother. Conclusion Reporting the first urticaria case in newborns due to stinging nettle, the authors suggest that breastfeeding mothers should always consult a physician before using skincare products.