Olga Wegner - Academia.edu (original) (raw)
Papers by Olga Wegner
Onkologia Polska, 2010
... Diag nostic problems in this case have been analyzed. The patient was treated with liposomal ... more ... Diag nostic problems in this case have been analyzed. The patient was treated with liposomal amphotericin B and the central venous cathe-ter was removed. ... Dziewczynka została przyjęta ponownie do szpitala po 10-dniowej antybiotykoterapii klarytromycyną. Nadal utrzy-...
Medical Science and Technology, 2007
European Journal of Medical Genetics, 2016
We have recently described a severe haemophilia A and moyamoya (SHAM) syndrome caused by Xq28 del... more We have recently described a severe haemophilia A and moyamoya (SHAM) syndrome caused by Xq28 deletions encompassing F8 and the BRCC3 familial moyamoya gene. The phenotype includes haemophilia A, moyamoya angiopathy, dysmorphia and hypertension. The genetic analysis of the family of our SHAM patient demonstrated carrier state in proband's mother and sister. The patient's mother is apparently well, whereas his currently 18-years-old sister presents with mild haemophilia A, coarctation of the aorta, hypertension, and ventricular arrhythmia. We performed X chromosome inactivation assay based on HpaII methylation analysis of a polymorphic short tandem repeat (STR) in the X linked AR (androgen receptor) gene and used quantitative real-time RT PCR to measure the expression of genes from the deleted region in proband's family members. We found an extremely skewed X chromosome inactivation pattern in the female members of the family leading to preferential inactivation of the X chromosome without Xq28 deletion in patient's sister. We demonstrated differential expression of the genes from the deleted region in four members of the family, that tightly correlates with the clinical features. In conclusion, we show that the haematologic and cardiovascular morbidity and the discrepancy between patient's sister and mother despite the same genetic lesion are due to skewed X chromosome inactivation leading to clinically relevant differential expression of SHAM syndrome genes. This report highlights the role for BRCC3 in cardiovascular physiology and disease, and demonstrates that in some complex hereditary syndromes full diagnostics may require the examination of both genetic and epigenetic events.
BMC Endocrine Disorders, 2015
Background: Platelet hyperreactivity is a factor which contributes towards increased risk of card... more Background: Platelet hyperreactivity is a factor which contributes towards increased risk of cardiovascular events in adults with type 2 diabetes (T2DM). However, little is known about platelets' disturbances among children with type 1 diabetes (T1DM). The aim of the study was to investigate whether platelets' morphology or function are altered in children with type 1 diabetes, potentially predisposing them to cardiovascular events in the future. Methods: The study group consisted of 389 children with T1DM during the 2008-2010 period. Patients with acute diabetes complications and ongoing infections were excluded from the study. An equinumerous (N = 389), age and sex-matched control group was assembled from children undergoing routine, minor surgical procedures in the same hospital. Platelet: count (PLT), mean volume (MPV), distribution width (PDW) and platelet large cell ratio (P-LCR) as well as HbA1c levels were measured. For statistical analysis we used Chi-square tests, the student's t-test, one-way analysis of variance (ANOVA), the Pearson's correlation coefficient and linear regression models in order to adjust for covariates. Results: MPV, PDW and P-LCR were significantly higher among children with diabetes in comparison with the control group (MPV 10.47+/−0.85 fL vs 10.23+/−0.94 fL, p = 0.
Pediatric endocrinology, diabetes, and metabolism, 2008
Based on etiology a new classification for diabetes mellitus was proposed by the Experts of WHO i... more Based on etiology a new classification for diabetes mellitus was proposed by the Experts of WHO in 1999. According to the classification, type 1 diabetes was subclassified as type 1A (autoimmune) and type 1B (idiopathic). Both forms result from the destruction of beta cells, however in type 1A the process is immune-mediated but in type 1B the origin of the beta cells impairment is still unknown. Moreover, subtype B is considered to be very heterogeneous and the diagnostic criteria are still not clear. The purpose of this article was to review studies on the pathogenesis of idiopathic type 1 diabetes.
Pediatric endocrinology, diabetes, and metabolism, 2008
According to the WHO classification, type 1 diabetes is divided into type 1A - autoimmune and typ... more According to the WHO classification, type 1 diabetes is divided into type 1A - autoimmune and type 1B - idiopathic. The pathogenesis of the latter remains unknown. Clinical observations confirm that type 1 diabetes is often associated with the presence of other organ-specific autoantibodies. Besides, the idiopathic type 1 diabetes is suggested as resulted form immune-related beta cell destruction with the defect of humoral response. of the study was to verify the above-mentioned hypothesis by an evaluation of the prevalence of thyroid and coeliac antibodies in children with idiopathic diabetes. The study groups consisted of 37 patients with idiopathic diabetes (group 1B) and 108 patients with autoimmune diabetes (1A). The examined groups were chosen from 569 children with newly diagnosed type 1 diabetes. Anti-islet antibodies (ICA) and antibodies to endomysium were detected by indirect immunofluorescence. Antibodies to tissue transglutaminase were measured by the immunoenzymatic met...
Haemophilia : the official journal of the World Federation of Hemophilia, 2015
caused by the chronic inflammatory eroding process due to chronic synovitis. Consistent with thes... more caused by the chronic inflammatory eroding process due to chronic synovitis. Consistent with these articles that we had reviewed, severe articular cartilage destruction was confirmed by the histologic tests of the femoral head [1,4,6]. Additionally, chronic inflammation also excited at the surface and the inside of the subchondral bone and was eroding the subchondral bone, which was similar to the inflammatory bone loss in rheumatoid arthritis [7]. Although the diagnosis of osteonecrosis was wrong, but to this patient's hip, the articular cartilage damage was so severe and only the THA can stop the hip pain and improve the joint function. So for hip haemophilic arthropathy patients, the cystic degeneration focus seen on the radiographic image may not be the result of osteonecrosis of the femoral head but just a bone defect focus caused by inflammatory bone erosion. We sincerely recommend the orthopaedists to scrupulously analyse the imaging outcomes of haemophilic patient's joint when it shows a cystic change.
Blood, Jan 19, 2014
Figure 1. The radiological and genetic diagnosis of Xq28 linked moyamoya in hemophilia A patient.... more Figure 1. The radiological and genetic diagnosis of Xq28 linked moyamoya in hemophilia A patient. (A) MRI angiography, the arrows show truncation of the internal carotid arteries. (B) Long-range PCR products in 4 members of the family. (C) NGS trace (the location shown on chromosome ideogram) below genes located within the region, which corresponds to the long-range PCR-confirmed Xq28 deletion in a SHAM patient (indicated with red box).
Pediatric endocrinology, diabetes, and metabolism, 2010
The pathogenesis of type 1 diabetes is connected with immune-mediated beta-cell destruction leadi... more The pathogenesis of type 1 diabetes is connected with immune-mediated beta-cell destruction leading to insulin deficiency. The majority of patients will become completely incapable of insulin secretion within a few years, however, some individuals will have persistent beta-cell function years after the diagnosis of diabetes. Despite clinical symptoms of insulin deficiency, residual beta-cell secretion can modify the clinical course and can be an independent factor influencing the delay of development of chronic diabetic complications. The aim of the study was to compare a 10-year clinical course in children with type 1 diabetes with and without preserved beta-cell secretion. 72 children and adolescents with diabetes lasting for minimum 10 years and available biological material to c-peptide evaluation (3-4 years and 10 years from the onset of diabetes) were chosen from 768 children with type 1 diabetes. We assessed fasting c-peptide and recruited 23 out of 72 patients whose concentr...
Medycyna wieku rozwojowego
of this study was the evaluation of some factors having an influence on post-exercise albuminuria... more of this study was the evaluation of some factors having an influence on post-exercise albuminuria level in children with newly diagnosed type 1 diabetes as a prognostic factor of developing nephropathy. 24 newly diagnosed type 1 diabetic children, aged 5.5-16.9 years, mean 10.2+/-3.2, were examined. In order to provoke albuminuria the patients underwent standardized exercise test using treadmill ramp according to the Bruce protocol. Pre- and post-exercise albuminuria and C-peptide levels by radioimmunoassay were evaluated. In urine of patients the albumin / creatinine ratio (ACR) was determined. the tendency towards an increase in ACR ratio in children after exercise (10.5 mg/g (4-27.5) in comparison to the value in pre-exercise urine (7 mg/g (2.5-13), p=0.17) was observed. In 67% of patients (16/24) the ACR ratio was higher in post-exercise urine. In 25% of children (6/24) the ACR ratio was above 30 mg/g which was considered as post-exercise microalbuminuria. Next, parameters of me...
Endokrynologia, diabetologia i choroby przemiany materii wieku rozwojowego : organ Polskiego Towarzystwa Endokrynologów Dziecięcych, 2004
C-peptide level is the most reliable factor evaluating the endogenous insulin secretion in patien... more C-peptide level is the most reliable factor evaluating the endogenous insulin secretion in patients with type 1 diabetes. The aim of the study was to investigate whether the age at onset, gender, presence of autoantibodies and ketoacidosis at diagnosis and insulin requirement, HbA1c levels could be applied to predict the C-peptide levels in the first year of type 1 diabetes in children. 122 type 1 diabetic children, aged: 2-18 years (average 11.2), 44 female and 78 male were studied. Fasting C-peptide levels were examined by radioimmunoassay at diagnosis, after 10 days and after 1, 2, 3, 6 and 12 months of disease. At diagnosis islet cell antibodies (ICA) were detected by indirect immunofluorescence, antibodies to glutamic acid decarboxylase (GADA) and tyrosine phosphatase antibodies (IA2A) were measured by microradioimmunoprecipitation assay. Age at onset was positively correlated to C-peptide levels at each evaluated point of the disease (r=0.3-0.46, p<0.0001). One year after d...
Streszczenie: U dzieci do 3 roku ¿ycia nowotwory w¹troby pochodzenia zarodkowego - hepatoblastoma... more Streszczenie: U dzieci do 3 roku ¿ycia nowotwory w¹troby pochodzenia zarodkowego - hepatoblastoma stano- wi¹ trzeci¹, co do czêstoœci wystêpowania grupê guzów nowotworowych jamy brzusznej. Rosn¹cy guz daje sk¹pe objawy kliniczne i dlatego oko³o 40% dzieci trafia do szpitala w zaawansowanym stadium rozwoju nowotworu. Celem pracy jest przedstawienie trudnoœci diagnostycznych zwi¹zanych z koniecznoœci¹ ró¿nicowania pomiê- dzy guzami zarodkowymi wywodz¹cymi siê z pierwotnych komórek p³ciowych a guzami wywodz¹cymi siê z niezró¿nicowanych komórek w¹troby w zaawansowanych stadiach w¹trobiaka zarodkowego. W pracy przed- stawiono przebieg kliniczny u trojga dzieci hepatoblastoma o korzystnym utkaniu histopatologicznym, lecz ró¿nej wielkoœci i umiejscowieniu guza. Guzom tym towarzyszy³o znaczne podwy¿szenie wartoœci alfa-fetoproteiny, która jest markerem ró¿nych nowotworów o utkaniu zarodkowym. U dwójki dzieci, z uwagi na du¿¹ masê guza w obrêbie jamy brzusznej naciekaj¹cego i przemieszczaj¹c...
Pediatric Diabetes, 2011
of different brands of human insulin and rapid-acting insulin analogs in insulin-naïve children w... more of different brands of human insulin and rapid-acting insulin analogs in insulin-naïve children with type 1 diabetes.
Leukemia & Lymphoma, 2011
Symptomatic, chemotherapy-related hypoglycemia is a rare complication associated with the adminis... more Symptomatic, chemotherapy-related hypoglycemia is a rare complication associated with the administration of purine analogs. The aim of the study was to evaluate 24 h glucose variability and frequency of hypoglycemia among patients with acute lymphoblastic leukemia (ALL) during maintenance therapy (MT). Eighteen children with ALL underwent continuous glucose monitoring (CGM). The number of episodes of hypoglycemia and glucose variability were analyzed. Serum alanine aminotransferase, asparagine aminotransferase, and γ-glutamyl transferase levels were measured as liver function markers. The mean glucose level in CGM equaled 105 ± 13 mg/dL, with standard deviation (SD) 13.8 ± 6.1 mg/dL, and the mean amplitude of glycemic excursions (MAGE) equaled 44.7 ± 19.9 mg/dL. Eight patients had at least one measurement below 70 mg/dL while four patients had measurements below 50 mg/dL. Children with hypoglycemia in CGM examination had a lower median body mass index standard deviation score (BMI Z-score) (-0.65 [-0.94 to -0.27] vs. -0.14 [-0.29 to 0.35]; p = 0.05) and shorter duration of MT (6.5 [4-15] vs. 22.5 [16.5-28] weeks; p = 0.004). Glucose variability parameters were strongly correlated with BMI Z-score and liver function enzymes. Hypoglycemia, particularly at night-time, may develop as a complication of MT in children with ALL. The risk factors for low glucose level are low BMI Z-score and initiation of MT.
Diabetes Research and Clinical Practice, 2009
Onkologia Polska, 2010
... Diag nostic problems in this case have been analyzed. The patient was treated with liposomal ... more ... Diag nostic problems in this case have been analyzed. The patient was treated with liposomal amphotericin B and the central venous cathe-ter was removed. ... Dziewczynka została przyjęta ponownie do szpitala po 10-dniowej antybiotykoterapii klarytromycyną. Nadal utrzy-...
Medical Science and Technology, 2007
European Journal of Medical Genetics, 2016
We have recently described a severe haemophilia A and moyamoya (SHAM) syndrome caused by Xq28 del... more We have recently described a severe haemophilia A and moyamoya (SHAM) syndrome caused by Xq28 deletions encompassing F8 and the BRCC3 familial moyamoya gene. The phenotype includes haemophilia A, moyamoya angiopathy, dysmorphia and hypertension. The genetic analysis of the family of our SHAM patient demonstrated carrier state in proband&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s mother and sister. The patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s mother is apparently well, whereas his currently 18-years-old sister presents with mild haemophilia A, coarctation of the aorta, hypertension, and ventricular arrhythmia. We performed X chromosome inactivation assay based on HpaII methylation analysis of a polymorphic short tandem repeat (STR) in the X linked AR (androgen receptor) gene and used quantitative real-time RT PCR to measure the expression of genes from the deleted region in proband&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s family members. We found an extremely skewed X chromosome inactivation pattern in the female members of the family leading to preferential inactivation of the X chromosome without Xq28 deletion in patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sister. We demonstrated differential expression of the genes from the deleted region in four members of the family, that tightly correlates with the clinical features. In conclusion, we show that the haematologic and cardiovascular morbidity and the discrepancy between patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sister and mother despite the same genetic lesion are due to skewed X chromosome inactivation leading to clinically relevant differential expression of SHAM syndrome genes. This report highlights the role for BRCC3 in cardiovascular physiology and disease, and demonstrates that in some complex hereditary syndromes full diagnostics may require the examination of both genetic and epigenetic events.
BMC Endocrine Disorders, 2015
Background: Platelet hyperreactivity is a factor which contributes towards increased risk of card... more Background: Platelet hyperreactivity is a factor which contributes towards increased risk of cardiovascular events in adults with type 2 diabetes (T2DM). However, little is known about platelets' disturbances among children with type 1 diabetes (T1DM). The aim of the study was to investigate whether platelets' morphology or function are altered in children with type 1 diabetes, potentially predisposing them to cardiovascular events in the future. Methods: The study group consisted of 389 children with T1DM during the 2008-2010 period. Patients with acute diabetes complications and ongoing infections were excluded from the study. An equinumerous (N = 389), age and sex-matched control group was assembled from children undergoing routine, minor surgical procedures in the same hospital. Platelet: count (PLT), mean volume (MPV), distribution width (PDW) and platelet large cell ratio (P-LCR) as well as HbA1c levels were measured. For statistical analysis we used Chi-square tests, the student's t-test, one-way analysis of variance (ANOVA), the Pearson's correlation coefficient and linear regression models in order to adjust for covariates. Results: MPV, PDW and P-LCR were significantly higher among children with diabetes in comparison with the control group (MPV 10.47+/−0.85 fL vs 10.23+/−0.94 fL, p = 0.
Pediatric endocrinology, diabetes, and metabolism, 2008
Based on etiology a new classification for diabetes mellitus was proposed by the Experts of WHO i... more Based on etiology a new classification for diabetes mellitus was proposed by the Experts of WHO in 1999. According to the classification, type 1 diabetes was subclassified as type 1A (autoimmune) and type 1B (idiopathic). Both forms result from the destruction of beta cells, however in type 1A the process is immune-mediated but in type 1B the origin of the beta cells impairment is still unknown. Moreover, subtype B is considered to be very heterogeneous and the diagnostic criteria are still not clear. The purpose of this article was to review studies on the pathogenesis of idiopathic type 1 diabetes.
Pediatric endocrinology, diabetes, and metabolism, 2008
According to the WHO classification, type 1 diabetes is divided into type 1A - autoimmune and typ... more According to the WHO classification, type 1 diabetes is divided into type 1A - autoimmune and type 1B - idiopathic. The pathogenesis of the latter remains unknown. Clinical observations confirm that type 1 diabetes is often associated with the presence of other organ-specific autoantibodies. Besides, the idiopathic type 1 diabetes is suggested as resulted form immune-related beta cell destruction with the defect of humoral response. of the study was to verify the above-mentioned hypothesis by an evaluation of the prevalence of thyroid and coeliac antibodies in children with idiopathic diabetes. The study groups consisted of 37 patients with idiopathic diabetes (group 1B) and 108 patients with autoimmune diabetes (1A). The examined groups were chosen from 569 children with newly diagnosed type 1 diabetes. Anti-islet antibodies (ICA) and antibodies to endomysium were detected by indirect immunofluorescence. Antibodies to tissue transglutaminase were measured by the immunoenzymatic met...
Haemophilia : the official journal of the World Federation of Hemophilia, 2015
caused by the chronic inflammatory eroding process due to chronic synovitis. Consistent with thes... more caused by the chronic inflammatory eroding process due to chronic synovitis. Consistent with these articles that we had reviewed, severe articular cartilage destruction was confirmed by the histologic tests of the femoral head [1,4,6]. Additionally, chronic inflammation also excited at the surface and the inside of the subchondral bone and was eroding the subchondral bone, which was similar to the inflammatory bone loss in rheumatoid arthritis [7]. Although the diagnosis of osteonecrosis was wrong, but to this patient's hip, the articular cartilage damage was so severe and only the THA can stop the hip pain and improve the joint function. So for hip haemophilic arthropathy patients, the cystic degeneration focus seen on the radiographic image may not be the result of osteonecrosis of the femoral head but just a bone defect focus caused by inflammatory bone erosion. We sincerely recommend the orthopaedists to scrupulously analyse the imaging outcomes of haemophilic patient's joint when it shows a cystic change.
Blood, Jan 19, 2014
Figure 1. The radiological and genetic diagnosis of Xq28 linked moyamoya in hemophilia A patient.... more Figure 1. The radiological and genetic diagnosis of Xq28 linked moyamoya in hemophilia A patient. (A) MRI angiography, the arrows show truncation of the internal carotid arteries. (B) Long-range PCR products in 4 members of the family. (C) NGS trace (the location shown on chromosome ideogram) below genes located within the region, which corresponds to the long-range PCR-confirmed Xq28 deletion in a SHAM patient (indicated with red box).
Pediatric endocrinology, diabetes, and metabolism, 2010
The pathogenesis of type 1 diabetes is connected with immune-mediated beta-cell destruction leadi... more The pathogenesis of type 1 diabetes is connected with immune-mediated beta-cell destruction leading to insulin deficiency. The majority of patients will become completely incapable of insulin secretion within a few years, however, some individuals will have persistent beta-cell function years after the diagnosis of diabetes. Despite clinical symptoms of insulin deficiency, residual beta-cell secretion can modify the clinical course and can be an independent factor influencing the delay of development of chronic diabetic complications. The aim of the study was to compare a 10-year clinical course in children with type 1 diabetes with and without preserved beta-cell secretion. 72 children and adolescents with diabetes lasting for minimum 10 years and available biological material to c-peptide evaluation (3-4 years and 10 years from the onset of diabetes) were chosen from 768 children with type 1 diabetes. We assessed fasting c-peptide and recruited 23 out of 72 patients whose concentr...
Medycyna wieku rozwojowego
of this study was the evaluation of some factors having an influence on post-exercise albuminuria... more of this study was the evaluation of some factors having an influence on post-exercise albuminuria level in children with newly diagnosed type 1 diabetes as a prognostic factor of developing nephropathy. 24 newly diagnosed type 1 diabetic children, aged 5.5-16.9 years, mean 10.2+/-3.2, were examined. In order to provoke albuminuria the patients underwent standardized exercise test using treadmill ramp according to the Bruce protocol. Pre- and post-exercise albuminuria and C-peptide levels by radioimmunoassay were evaluated. In urine of patients the albumin / creatinine ratio (ACR) was determined. the tendency towards an increase in ACR ratio in children after exercise (10.5 mg/g (4-27.5) in comparison to the value in pre-exercise urine (7 mg/g (2.5-13), p=0.17) was observed. In 67% of patients (16/24) the ACR ratio was higher in post-exercise urine. In 25% of children (6/24) the ACR ratio was above 30 mg/g which was considered as post-exercise microalbuminuria. Next, parameters of me...
Endokrynologia, diabetologia i choroby przemiany materii wieku rozwojowego : organ Polskiego Towarzystwa Endokrynologów Dziecięcych, 2004
C-peptide level is the most reliable factor evaluating the endogenous insulin secretion in patien... more C-peptide level is the most reliable factor evaluating the endogenous insulin secretion in patients with type 1 diabetes. The aim of the study was to investigate whether the age at onset, gender, presence of autoantibodies and ketoacidosis at diagnosis and insulin requirement, HbA1c levels could be applied to predict the C-peptide levels in the first year of type 1 diabetes in children. 122 type 1 diabetic children, aged: 2-18 years (average 11.2), 44 female and 78 male were studied. Fasting C-peptide levels were examined by radioimmunoassay at diagnosis, after 10 days and after 1, 2, 3, 6 and 12 months of disease. At diagnosis islet cell antibodies (ICA) were detected by indirect immunofluorescence, antibodies to glutamic acid decarboxylase (GADA) and tyrosine phosphatase antibodies (IA2A) were measured by microradioimmunoprecipitation assay. Age at onset was positively correlated to C-peptide levels at each evaluated point of the disease (r=0.3-0.46, p<0.0001). One year after d...
Streszczenie: U dzieci do 3 roku ¿ycia nowotwory w¹troby pochodzenia zarodkowego - hepatoblastoma... more Streszczenie: U dzieci do 3 roku ¿ycia nowotwory w¹troby pochodzenia zarodkowego - hepatoblastoma stano- wi¹ trzeci¹, co do czêstoœci wystêpowania grupê guzów nowotworowych jamy brzusznej. Rosn¹cy guz daje sk¹pe objawy kliniczne i dlatego oko³o 40% dzieci trafia do szpitala w zaawansowanym stadium rozwoju nowotworu. Celem pracy jest przedstawienie trudnoœci diagnostycznych zwi¹zanych z koniecznoœci¹ ró¿nicowania pomiê- dzy guzami zarodkowymi wywodz¹cymi siê z pierwotnych komórek p³ciowych a guzami wywodz¹cymi siê z niezró¿nicowanych komórek w¹troby w zaawansowanych stadiach w¹trobiaka zarodkowego. W pracy przed- stawiono przebieg kliniczny u trojga dzieci hepatoblastoma o korzystnym utkaniu histopatologicznym, lecz ró¿nej wielkoœci i umiejscowieniu guza. Guzom tym towarzyszy³o znaczne podwy¿szenie wartoœci alfa-fetoproteiny, która jest markerem ró¿nych nowotworów o utkaniu zarodkowym. U dwójki dzieci, z uwagi na du¿¹ masê guza w obrêbie jamy brzusznej naciekaj¹cego i przemieszczaj¹c...
Pediatric Diabetes, 2011
of different brands of human insulin and rapid-acting insulin analogs in insulin-naïve children w... more of different brands of human insulin and rapid-acting insulin analogs in insulin-naïve children with type 1 diabetes.
Leukemia & Lymphoma, 2011
Symptomatic, chemotherapy-related hypoglycemia is a rare complication associated with the adminis... more Symptomatic, chemotherapy-related hypoglycemia is a rare complication associated with the administration of purine analogs. The aim of the study was to evaluate 24 h glucose variability and frequency of hypoglycemia among patients with acute lymphoblastic leukemia (ALL) during maintenance therapy (MT). Eighteen children with ALL underwent continuous glucose monitoring (CGM). The number of episodes of hypoglycemia and glucose variability were analyzed. Serum alanine aminotransferase, asparagine aminotransferase, and γ-glutamyl transferase levels were measured as liver function markers. The mean glucose level in CGM equaled 105 ± 13 mg/dL, with standard deviation (SD) 13.8 ± 6.1 mg/dL, and the mean amplitude of glycemic excursions (MAGE) equaled 44.7 ± 19.9 mg/dL. Eight patients had at least one measurement below 70 mg/dL while four patients had measurements below 50 mg/dL. Children with hypoglycemia in CGM examination had a lower median body mass index standard deviation score (BMI Z-score) (-0.65 [-0.94 to -0.27] vs. -0.14 [-0.29 to 0.35]; p = 0.05) and shorter duration of MT (6.5 [4-15] vs. 22.5 [16.5-28] weeks; p = 0.004). Glucose variability parameters were strongly correlated with BMI Z-score and liver function enzymes. Hypoglycemia, particularly at night-time, may develop as a complication of MT in children with ALL. The risk factors for low glucose level are low BMI Z-score and initiation of MT.
Diabetes Research and Clinical Practice, 2009