Showing posts with label autoimmune disorder. Show all posts
Showing posts with label autoimmune disorder. Show all posts

Friday, July 24, 2015

Antibiotic Usage and Juvenile Idiopathic Arthritis—an Interesting Association

By: Lewis First, MD, MS; Editor-in-Chief   

          We all know that drugs can have unexpected side effects.  This week, Horten et al. (doi: 10.1542/peds.2015-0036) share a possible association between antibiotic exposure and juvenile idiopathic arthritis (JIA).   In a case-control study looking at children with newly diagnosed JIA and a matched set of controls, the authors kept track of the number and timing of antibiotic courses prior to diagnosis adjusting for key confounders.  
     The results are a significant association as you might expect by the fact that we are highlighting this study—but what does it mean and why would taking antibiotics lead to an autoimmune disease like JIA?  The authors offer their take in the Discussion section of the study and so do infectious disease experts Drs. Jennifer Goldman and Mary Anne Jackson in an accompanying commentary (doi: 10.1542/peds.2015-1296).   
     There is a lot to be learned and thought about in this study and commentary.  In turn, be aware of this association and perhaps families who ask for antibiotics for what is likely something viral might be less apt to request them as a result of sharing what you learn with them from this article.

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Friday, December 5, 2014

Is There an Association between Caesarean Section and Chronic Immune Disorder Development?

USAF photo by Tech. Sgt. Suzanne M. Day
By: Lewis First, MD, MS; Editor-in-Chief 

Sometimes we receive manuscripts that point out associations we have never before considered—and this week one such study is being published in our journal regarding the association between the increased rate of caesarean sections and the increased prevalence of chronic immune diseases like asthma, allergy, inflammatory bowel disease and type-1 diabetes.

Bisgaard et al. (doi:10.1542/peds.2014-0596) studied more than 2 million term children in a Danish registry from time of birth over 35 years and tracked them for hospitalization for chronic immune diseases such as those just mentioned above.

Controlling for confounders, the authors found that children delivered by caesarean section had an increased association with a variety of chronic immune diseases but not all of them (e.g., type-1 diabetes, psoriasis or celiac disease).

Just what role a caesarean section might play in association with an increased risk of a chronic immune disease is the basis for an interesting discussion section in this study—and you should not be immune to reading it to learn more. 

Related Reading:

Monday, September 9, 2013

Pediatric Myasthenia: What Do We Know About This Disorder?

While pediatric myasthenia is not common, it can and does occur, but not with the regularity that results in substantive studies summarizing diagnostic and management information about this disorder. Too often, the patient numbers in the studies that have been published are small ones.

Fortunately, VanderPluym et al. (doi: 10.1542/peds.2013-0814) have collected 57 confirmed cases of myasthenia in two years of surveillance using a Canadian database and share their presentation as well as a lot of descriptive data on how their diagnosis was confirmed and treated in what they claim is the largest series of pediatric myasthenia patients studied in North America.

If you need to refresh your knowledge of this disorder, or simply compare your management of a patient or patients with myasthenia with those of patients followed across Canada, then read this eye-opening study and learn more.