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This article discusses a rare case of bilateral idiopathic orbital myositis in a 13-year-old boy. The patient presented with bulging eyes and double vision, and imaging revealed enlargement of the extraocular muscles in both eyes. Blood tests ruled out other underlying diseases, and the patient responded well to treatment with corticosteroids. Biopsy was not performed due to the invasiveness of the procedure, but the patient's symptoms improved and there was no recurrence after discontinuing the medication. The authors recommend biopsy in cases of steroid resistance or relapse. [Extracted from the article]

Abstract Background Asthma is a complex phenotype that is influenced by both genetic and environmental factors. Genome-wide linkage and association studies have been performed to identify susceptibility genes for asthma. These studies identified new genes and pathways implicated in this disease, many of which were previously unknown. Objective To perform a large-scale genotyping study to identify asthma-susceptibility genes in the Japanese population. Methods We performed a large-scale, three-stage association study on 288 atopic asthmatics and 1032 controls, by using multiplex PCR-Invader assay methods at 82,935 single nucleotide polymorphisms (SNPs) (1st stage). SNPs that were strongly associated with asthma were further genotyped in samples from asthmatic families (216 families, 762 members, 2nd stage), 541 independent patients, and 744 controls (3rd stage). Results SNPs located in the 5' region of PEX19 (rs2820421) were significantly associated with P < 0.05 through the 1st to the 3rd stage analyses; however, the P values did not reach statistically significant levels (combined, P = 3.8 × 10-5; statistically significant levels with Bonferroni correction, P = 6.57 × 10-7). SNPs on HPCAL1 (rs3771140) and on IL18R1 (rs3213733) were associated with asthma in the 1st and 2nd stage analyses, but the associations were not observed in the 3rd stage analysis. Conclusion No association attained genome-wide significance, but several loci for possible association emerged. Future studies are required to validate these results for the prevention and treatment of asthma.

Introduction: Component-resolved diagnostics is used to diagnose food allergies. However, few reports have evaluated the severity of peach fruit allergy using peach allergen components, including Pru p 7. Objective: This study aimed to predict peach fruit allergy severity based on the presence of specific IgE (sIgE) antibodies (Abs) to peach allergenic components. Methods: Twenty-seven patients with peach fruit allergy were enrolled and classified into two groups: the local reaction (LR) group, including 12 patients with only oral or throat mucosal symptoms, and the systemic reaction (SR) group, including 15 patients, 10 of whom experienced anaphylaxis. Serum sIgE Abs against crude peach extract – Pru p 1, 2, 3, 4, and 7 – and tree pollen were measured. Results: sIgE Ab titers of Pru p 1 and 4 and alder pollen in the LR group were significantly higher than those in the SR group. sIgE against Pru p 7 was significantly higher in the SR group than in the LR group. The frequencies of sIgE Abs against Pru p 1, 4, and 7 in the LR group were 91.7, 66.7, and 16.7%, respectively, while in the SR group these were 80, 20, and 60%. Sensitization to Pru p 2 and 3 was detected but limited in all patients. Conclusions: These findings suggest that sensitization to Pru p 1 and Pru p 4 is associated with local symptoms, and sensitization to Pru p 7 is associated with SR and anaphylaxis. To predict the severity of peach fruit allergy, it is useful to assess sIgE Ab reactions combining Pru p 1, 4, and 7. [ABSTRACT FROM AUTHOR]

Childhood Guillain-Barré syndrome (GBS) occasionally leads to respiratory failure early after onset, requiring long-term ventilation management after tracheal intubation. However, patients requiring tracheostomy management are rare. In the present study, a case of a 12-year-old boy with GBS who required artificial respiration management due to rapid progression of respiratory muscle paralysis is reported. Intravenous immunoglobulin (IVIg) and pulse steroid therapy were provided; however, both were ineffective and tracheostomy was necessary 26 days after onset. A second course of IVIg and pulse steroid therapy was administered on day 34. With continued rehabilitation, the patient was able to walk long distances on day 74 and was subsequently discharged on day 89. In cases of severe GBS, when IVIg and pulse steroid therapy do not improve the respiratory muscle strength of the patient, early tracheostomy may improve the patient's quality of life during artificial respiration management. [ABSTRACT FROM AUTHOR]

Background: Fluticasone propionate 50 μg/salmeterol xinafoate 25 μg (FP/SAL) is widely used in adults and children with asthma, but there is sparse information on its use in very young children. Methods: This was a randomized, double‐blind, multicentre, controlled trial conducted in children aged 8 months to 4 years. During a 2‐week run‐in period, they all received FP twice daily. At randomization, they commenced FP/SAL or FP twice daily for 8 weeks. All were then given FP/SAL only, in a 16‐week open‐label study continuation. Medications were inhaled through an AeroChamber Plus with attached face mask. The primary end‐point was mean change in total asthma symptom scores from baseline to the last 7 days of the double‐blind period. Analyses were undertaken in all children randomized to treatment and who received at least one dose of study medication. Results: Three hundred children were randomized 1:1 to receive FP/SAL or FP. Mean change from baseline in total asthma symptom scores was –3.97 for FP/SAL and –3.01 with FP. The between‐group difference was not statistically significant (P = 0.21; 95% confidence interval: −2.47, 0.54). No new safety signals were seen with FP/SAL. Conclusion: This is the first randomized, double‐blind study of this size to evaluate FP/SAL in very young children with asthma. FP/SAL did not show superior efficacy to FP; no clear add‐on effect of SAL was demonstrated. No clinically significant differences in safety were noted with FP/SAL usage. [ABSTRACT FROM AUTHOR]

Coronal short tau inversion recovery magnetic resonance imaging shows high signal intensity in the left hip. gl Oral lesions are often observed in patients with inflammatory bowel disease (IBD), particularly paediatric patients with Crohn's disease.[1] This combination often presents as aphthae with longitudinal presentation or skip lesions separated by normal-appearing mucosa buccally or labially. Though her oral symptoms and perianal lesions improved, perianal lesions recurred after gingivitis, and numerous aphthae were observed. GLO:81V/01dec22:jpc16260-fig-0001.jpg PHOTO (COLOR): 1 (a, b) The patient presented with oral aphthae with longitudinal ulcers in the soft palate and gingivitis in both molar regions. [Extracted from the article]