An unusual case of ear pain in a child

Fong, Pei Yuan; Yong, Jenica Su-ern; Koh, Lynn Huiting

doi:10.47102/annals-acadmedsg.2022117

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Earlier studies have observed severity and chronicity of the HLA-B27 associated joint disease [ 20 , 27 – 29 ]. In the present study, the HLA-B27 positivity correlated also with worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

Disease characteristics of HLA-B27 positive and negative finnish patients with juvenile idiopathic arthritis - results of the 18-year cohort follow-up study

Peltoniemi,

Glerup,

Lahdenne

et al. 2023

Pediatr Rheumatol

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Background The aim of this long-term follow-up study was to compare the disease characteristics of HLA-B27 positive and negative patients with juvenile idiopathic arthritis (JIA). Methods The study is a cohort study with consecutive cases of newly diagnosed Finnish patients with JIA according to the International League of Associations for Rheumatology (ILAR) criteria [1]. Patients were enrolled between 1997 and 2000 from a defined area of Southern Finland. Clinical data including disease activity and serology were registered during a mean period of 17.5 years. Results 159 patients completed the 18-year follow-up study. HLA-B27 was available for 151 patients, of which 25% were HLA-B27 positive. Chronic uveitis was diagnosed in 30% of HLA-B27 positive and 29% of HLA-B27 negative patients. HLA-B27 positive patients had a lower prevalence of temporomandibular (TMJ) involvement than the antigen negative ones, 19% versus 28%. None of the HLA-B27 positive patients had cervical spine affected compared to 11% of antigen negative patients (p = 0.022). Of the HLA-B27 positive patients, 54% had had biological medication at some point during follow-up versus 25% in the negative group (p = 0.003). At last follow-up, 32% of antigen positive patients were not in remission compared to 18% of the antigen negative (p = 0.017). Conclusions The use of biological medication was more common in HLA-B27 positive patients with JIA. At the 18-year follow-up, more antigen positive patients had active disease compared HLA-B27 negative patients. This real-world follow-up study indicates that the prospects for worse outcome with HLA-B27 positivity in long-term should be taken into consideration.

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Section: Discussionmentioning

confidence: 99%

Disease characteristics of HLA-B27 positive and negative finnish patients with juvenile idiopathic arthritis - results of the 18-year cohort follow-up study

Peltoniemi,

Glerup,

Lahdenne

et al. 2023

Pediatr Rheumatol

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Reevaluating the Causes of Otitis Externa: A Case Report

Lim,

Tan

2024

Cureus

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A 28-year-old female domestic helper presented to the Ear, Nose, and Throat clinic complaining of three weeks of right otalgia associated with a right blocked ear. The hearing was otherwise normal, and she denied otorrhoea, dizziness or imbalance, ear digging, or water contact, and has no history of ear eczema. She has no other past medical history and no recent travel history. On examination, numerous whitish ovoid lesions were seen lining the entire right external auditory canal (EAC), admixed with debris, and the canal was inflamed. Her tympanic membrane was intact. The contralateral ear was normal. She was diagnosed with otoacariasis. The ear mites were unable to be retrieved for a direct microscopic examination, but based on the ovoid, smooth, and translucent morphology of the mites, they likely belong to the Acaridae or Chortoglyphidae families of mites. She underwent aural toileting for complete removal of the ear mites and was prescribed ear drops containing dexamethasone and polymyxin B sulfate for 2 weeks. She was reviewed using the otomicroscopy technique two weeks later and had made an uneventful recovery with no recurrence of ear mites.

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An unusual case of ear pain in a child

Cited by 2 publications

References 8 publications

Disease characteristics of HLA-B27 positive and negative finnish patients with juvenile idiopathic arthritis - results of the 18-year cohort follow-up study

Disease characteristics of HLA-B27 positive and negative finnish patients with juvenile idiopathic arthritis - results of the 18-year cohort follow-up study

Reevaluating the Causes of Otitis Externa: A Case Report

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