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Journal : Paediatrica Indonesiana

Inverse association between positive tuberculin tests and positive allergy skin tests in children Nur Rochmah; Dyahris Kuntartiwi; Anang Endaryanto; Aryanto Harsono
Paediatrica Indonesiana Vol 49 No 1 (2009): January 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (96.142 KB) | DOI: 10.14238/pi49.1.2009.7-10

Abstract

Background  The  association between  Mycobacterium  tuberculosisinfection  and  atopy remains controversial. Reaction to tuberculosisinfection  is  mediated  by  Th-1  immune responses whereas allergicreactions are mediated  by  Th- 2 immune response. In patients withatopic syndrome who also suffer from tuberculosis infection,  theTh-2  response will be suppressed  and  allergy manifestations willdecrease. Therefore, it  is  important to determine the appropriateallergy test and to predict outcome after completing tuberculosistreatment.Objective  To  evaluate the influence  of  a positive tuberculin teston  skin test results in diagnosing atopic disease.Methods  A cross sectional study was  conducted  in  the  pediatricallergy  outpatient  clinic, Soetomo Hospital, Surabaya, Indonesiabetween 2004  and  2007. Eighty-five patients were enrolled inthis study.  The  tuberculin test was performed  on  all patientswith allergy.  The  allergy test was carried  out  by  performing a skinscratch test.Results  There  was a weak inverse correlation between positivetuberculin tests and positive allergy skin tests in children (housedust  mite, food  and  pet  allergies).  The  correlation between apositive  tuberculin  test  and  house  dust  mite allergy test wasr:  -0.364  (P=O.OOl;  a=O.Ol).  The  correlation  between  thetuberculin  test  and  food allergies was  r:  -0.420  (P=O.OOl;a=O.Ol).  The  correlation between the tuberculin test  and  petallergies was  r:  -0.344  (P=  0.001;  a=O.Ol).Conclusions  A positive tuberculin test  is  weakly correlated withpositive allergy skin test results, suggesting  that  it  is  appropriate  todo allergy skin testing even in children with a positive tuberculintest.
Ethical aspects of gender assignment in ambiguous genitalia - congenital adrenal hyperplasia: a case report Nur Rochmah; Muhammad Faizi; Adwina Nurlita Kusuma Wardhani
Paediatrica Indonesiana Vol 61 No 6 (2021): November 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.6.2021.356-8

Abstract

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder commonly caused by mutation of the CYP21A2 gene, resulting in deficiency of an enzyme required for cortisol synthesis in the adrenal cortex. In 90-95% of cases, the deficient enzyme is 21-hydroxylase (21-OH), with an incidence ranging from 1 in 5,000 to 15,000 live births across various ethnic and racial backgrounds. In classical 21-OH deficiency (21-OHD) CAH, excessive androgen exposure in the fetus results in virilization at birth.1 The management of ambiguous genitalia in children with CAH presents a unique and ethically challenging decision-making dilemma for the medical team. Insensitive and poorly informed statements made in the delivery room may cause long-term psychological problems for the families. It is important to refrain from assigning gender until sufficient diagnostic information can be gathered. Parents, as guardians, and the supporting medical team must make decisions on behalf of the child, with the goal of enabling the child to grow into a healthy and happy adult with his or her assigned gender.2,3 We report a case of a child with CAH, focusing on the ethical challenges in management of ambiguous genitalia.