Could recurrent otitis media predict primary antibody deficiencies in Egyptian children?

Reda, Shereen M.; Yousef, Tamer A.; Elfeky, Reem; Sallam, Mohamed T.H.; Gaafar, Reham A.

doi:10.4103/1012-5574.133179

Cited by 2 publications

(6 citation statements)

References 37 publications

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“…For example, the extremely low frequency in the previous Egyptian study could be attributed to a less accurate diagnosis of AOM based on only simple otoscopy, very limited immunological evaluation (only CBC and IgA assay), and inclusion of cases with anatomical risk factors (e.g., 16.3% of cases had adenoid hypertrophy). 10 Predominantly antibody deficiencies were identified in 10/14 cases with IEIs in the current study. Indeed, predominately antibody deficiencies have been more commonly associated with rAOM than combined immunodeficiencies.…”

Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 99%

“…9,24 Interestingly, an Egyptian study on 300 children with rAOM reported IEIs in only two cases (0.7%). 10 The variation among studies may be related to differences in study populations (e.g., age, ethnicity, consanguinity, and inclusion criteria), environmental factors (e.g., attending or having siblings at daycare centers, passive smoking, and overcrowding), extent of immunological investigations, used definitions, and diagnostic criteria of IEIs and rAOM. For example, the extremely low frequency in the previous Egyptian study could be attributed to a less accurate diagnosis of AOM based on only simple otoscopy, very limited immunological evaluation (only CBC and IgA assay), and inclusion of cases with anatomical risk factors (e.g., 16.3% of cases had adenoid hypertrophy).…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Notwithstanding, a previous Egyptian study, using too limited immunological workup, reported IEIs in only 0.7% of children with rAOM, which may provide an inappropriate message to pediatricians and otorhinolaryngologists and calls for more comprehensive studies. 10 In the present study, we aimed to investigate the relative frequency, pattern, and associated factors of IEIs among Egyptian children with rAOM.…”

mentioning

confidence: 99%

“…7,9 A few studies showed the magnitude of IEIs among children with rAOM, showing variable frequencies of 1 to 20%. [9][10][11] Given the high rate of consanguineous marriage (up to 60%) and the lack of nationwide IEIs newborn screening, IEIs may be more frequent and have different patterns among Egyptian children with rAOM compared with their counterparts from western countries. 12,13 Notwithstanding, a previous Egyptian study, using too limited immunological workup, reported IEIs in only 0.7% of children with rAOM, which may provide an inappropriate message to pediatricians and otorhinolaryngologists and calls for more comprehensive studies.…”

mentioning

confidence: 99%

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Inborn Errors of Immunity among Egyptian Children with Recurrent Acute Otitis Media

Elsameea

Abd-Elkader

Fahmy

et al. 2022

J Pediatr Infect Dis

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Objective Our objective was to investigate the relative frequency and pattern of inborn errors of immunity (IEIs) among Egyptian children with recurrent acute otitis media (rAOM). Methods This was a cross-sectional study that included children from the age of 6 months to 16 years with rAOM. Those with structural, functional, and environmental risk factors were excluded. Enrolled children underwent thorough clinical, otorhinolaryngological, and immunological evaluation, including hematological counting, quantitative immunoglobulins assay, lymphocytic flow cytometric immunophenotyping, CH50, and phagocytic function tests. Results The study included 69 children with rAOM (44 boys and 25 girls; median age 30 months). IEIs were identified in 14 children, including transient hypogammaglobulinemia (three cases), selective IgA deficiency (three cases), agammaglobulinemia (two cases), common variable immunodeficiency (two cases), and one case for each of congenital neutropenia, Chediak–Higashi syndrome, hyper IgM syndrome, and Griscelli syndrome. Parental consanguinity and history of unexplained/infection-related siblings' deaths were significantly associated with IEIs (p = 0.018 and 0.003, respectively). AOM and related complications were more frequent among IEI cases (p = 0.018 and 0.032, respectively). IEI cases had lower levels of hemoglobin (10.7 ± 2.80 vs. 12.3 ± 1.64 g/dL; p = 0.002), IgG (203 [78–1,370] vs. 708 [42.3–1,509] mg/dL; p = 0.000), and IgA (24.3 [3–310] vs. 80 [15.6–305] mg/dL; p = 0.009) compared with non-IEI cases. Conclusion The current study identified IEIs in one-fifth of children with rAOM, most of which were predominately antibody deficiencies. An immunological workup for rAOM is particularly important in the presence of certain indicators for IEIs, provided that other more common risk factors are excluded.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 99%