Displaying publications 1 - 20 of 98 in total

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  1. Fulltext Kawasaki Disease with Hepatobiliary Manifestations
    Suhaini SA, Azidin AH, Cheah CS, Lee Wei Li W, Khoo MS, Ismail NAS, et al.
    Medicina (Kaunas), 2022 Dec 12;58(12).
    PMID: 36557034 DOI: 10.3390/medicina58121833
    Background and Objectives: Kawasaki Disease (KD) incidence has been on the rise globally throughout the years, particularly in the Asia Pacific region. KD can be diagnosed based on several clinical criteria. Due to its systemic inflammatory nature, multi-organ involvement has been observed, making the diagnosis of KD more challenging. Notably, several studies have reported KD patients presenting with hepatobiliary abnormalities. Nonetheless, comprehensive data regarding the hepatobiliary manifestations of KD are limited in Malaysia, justifying a more in-depth study of the disease in this country. Thus, in this article, we aim to discuss KD patients in Malaysia with hepatobiliary manifestations. Materials and Methods: A total of six KD patients with hepatobiliary findings who presented at Hospital Canselor Tuanku Muhriz (HCTM) from 2004 to 2021 were selected and included. Variables including the initial presenting signs and symptoms, clinical progress, laboratory investigations such as liver function test (LFT), and ultrasound findings of hepatobiliary system were reviewed and analyzed. Results: Out of these six KD patients, there were two patients complicated with hepatitis and one patient with gallbladder hydrops. Different clinical features including jaundice (n = 3) and hepatomegaly (n = 4) were also observed. All patients received both aspirin and intravenous immunoglobulin (IVIG) as their first-line treatment and all of them responded well to IVIG. The majority of them (n = 5) had a complete recovery and did not have any cardiovascular and hepatobiliary sequelae. Conclusions: Despite KD mostly being diagnosed with the classical clinical criteria, patients with atypical presentations should always alert physicians of KD as one of the possible differential diagnoses. This study discovered that hepatobiliary manifestations in KD patients were not uncommon. More awareness on the epidemiology, diagnosis, and management of KD patients with hepatobiliary manifestations are required to allow for the initiation of prompt treatment, thus preventing further complications.
    Matched MeSH terms: Immunoglobulins, Intravenous/therapeutic use
  2. Factors associated with outcomes of severe acute necrotizing encephalopathy: A multicentre experience in Malaysia
    Lee VWM, Khoo TB, Teh CM, Heng HS, Li L, Yusof YLM, et al.
    Dev Med Child Neurol, 2023 Sep;65(9):1256-1263.
    PMID: 36748407 DOI: 10.1111/dmcn.15536
    This case series compared clinical variables and various combinations of immunotherapy received with outcomes of patients with severe acute necrotizing encephalopathy (ANE). We performed a retrospective review of clinical variables, immunotherapy received, and outcomes (based on the modified Rankin Scale) in Malaysia between February 2019 and January 2020. Twenty-seven children (12 male), aged 7 months to 14 years (mean 4 years) at diagnosis were included. Of these, 23 had an ANE severity score of 5 to 9 out of 9 (high risk). Eleven patients received tocilizumab (four in combination with methylprednisolone [MTP], seven with MTP + intravenous immunoglobulin [IVIG]) and 16 did not (two received MTP alone, 14 received MTP + IVIG). Nine died. Among the survivors, six had good outcomes (modified Rankin Score 0-2) at 6 months follow-up. All patients who received tocilizumab in combination with MTP + IVIG survived. Twenty children received first immunotherapy within 48 hours of admission. No significant association was found between the timing of first immunotherapy with outcomes. Those with brainstem dysfunction (p = 0.016) were observed to have poorer outcomes. This study showed a trend towards better survival when those with severe ANE were treated with tocilizumab in combination with MTP + IVIG. However, larger studies will be needed to determine the effect of this regime on the long-term outcomes.
    Matched MeSH terms: Immunoglobulins, Intravenous/therapeutic use
  3. Case of human rabies despite post-exposure prophylaxis (PEP) and complete recovery after intrathecal rabies immunoglobulin (RIG)
    Ing SK, Ng Han Sim B, Lee YH, Ling TY
    BMJ Case Rep, 2023 Sep 04;16(9).
    PMID: 37666566 DOI: 10.1136/bcr-2023-256408
    Rabies, a fatal viral zoonotic disease, has become a public health concern in Sarawak, Malaysia. Despite pre-exposure and post-exposure prophylaxis being available, there has been limited progress in developing treatments for rabies, emphasising the pressing need for productive solutions. We present a laboratory-confirmed human rabies case in which the patient survived without neurological sequelae after receiving intrathecal rabies immunoglobulin.
    Matched MeSH terms: Immunoglobulins/therapeutic use
  4. Fulltext Immunodeficiency and Thymoma: A Case Report on Good Syndrome, a Diagnosis Frequently Missed and Forgotten
    Tang ASO, Loh WH, Wong QY, Yeo ST, Ng WL, Teoh PI, et al.
    Am J Case Rep, 2021 Mar 13;22:e928659.
    PMID: 33712551 DOI: 10.12659/AJCR.928659
    BACKGROUND Good syndrome (thymoma with immunodeficiency) is a frequently missed and forgotten entity. It is a rare cause of combined B and T cell immunodeficiency in adults. To date, fewer than 200 patients with Good syndrome have been reported in the literature. CASE REPORT We report a case of type AB Masaoka-Koga stage I thymoma which predated the evidence of immune dysregulation by 5 years, manifesting as bilateral cytomegalovirus retinitis, multiple bouts of pneumonia, and bronchiectasis in a HIV-seronegative 55-year-old man. Intravitreal ganciclovir was administered in addition to intravenous systemic ganciclovir, which resulted in severe neutropenic sepsis. A thorough immunodeficiency workup confirmed the presence of hypogammaglobulinemia with complete absence of B cells and reduced CD4/CD8 ratio. The patient responded well to monthly intravenous immunoglobulin replacement therapy, with no further episodes of infection since then. The immunoglobulin level doubled after 1 year of treatment. However, as the patient refused further intravitreal and CMV-targeted treatment, his vision did not recover. CONCLUSIONS Clinicians should be aware that thymoma can precede the onset of immunodeficiency. Clinical suspicion should be heightened in at-risk patients who present with multiple bouts of infection, particularly in thymoma cases with adult-onset immune dysfunction. It is of paramount importance to follow up those patients with annual clinical reviews and immunodeficiency screening.
    Matched MeSH terms: Immunoglobulins, Intravenous
  5. Precocious puberty after surgery for craniopharyngioma
    Yadav M, Nagappan N, Iyngkaran N
    J Pediatr, 1980 Mar;96(3 Pt 1):515-6.
    PMID: 7359251
    Matched MeSH terms: Immunoglobulins/analysis*
  6. Heat inactivation of serum potentiates anti-cardiolipin antibody binding in ELISA
    Cheng HM, Ngeow YF, Sam CK
    J Immunol Methods, 1989 Nov 30;124(2):235-8.
    PMID: 2600427
    Heat treatment of sera at 56 degrees C for 30 min results in positive ELISA reactions for anti-cardiolipin antibody (aCL) in sera that had undetectable or low levels of aCL before heat inactivation. The positive, potentiated reactivity of the heated sera in the aCL ELISA could be inhibited with the cardiolipin antigen and was abolished by prior IgG depletion using staphylococcal protein A. The heat-potentiating effect of aCL binding in ELISA was evident in both normal human sera and clinical sera including sera from patients with systemic lupus erythematosus and syphilis.
    Matched MeSH terms: Immunoglobulins/isolation & purification*
  7. Epidemiology, clinical characteristics, and immediate outcome of Kawasaki disease: a population-based study from a tropical country
    Mat Bah MN, Alias EY, Razak H, Sapian MH, Foo FH, Abdullah N
    Eur J Pediatr, 2021 Aug;180(8):2599-2606.
    PMID: 34086103 DOI: 10.1007/s00431-021-04135-7
    Data on Kawasaki disease from tropical countries are scarce. Hence, this population-based study aims to determine the epidemiology, clinical characteristics, and outcome of Kawasaki disease in children enrolled in the Kawasaki disease registry between 2006 and 2019 in Southern Malaysia. Diagnosis of Kawasaki disease was made using standard criteria. Primary outcome measure was a coronary artery aneurysm. Multivariable logistic regression was used to analyze the associated risk factors for coronary artery aneurysm. There were 661 Kawasaki disease, with 27% incomplete and 11% atypical presentations. Male-to-female ratio was 2:1, and median age of diagnosis was 1.4 years (interquartile range 9 to 32 months). Incidence in children of less than 5 years was 14.8 (95% confidence interval [CI]: 13.6 to 16.0) per 100,000 population, higher in males (19/100,000) and Chinese (22/100,000), with a gradual increase from 5.7/100,000 in 2006 to 19.6/100,000 in 2019, p < 0.001. Incidence in children between 5 and 9 years old was 1.3 (95% CI: 0.9 to 1.6) per 100,000 population and remained stable over time. There was a seasonal pattern with peak incidence during the rainy season. Out of 625 intravenous immunoglobulins (IVIG)-treated Kawasaki disease, 7.4% were resistant, and 9% had coronary artery aneurysms. Atypical presentation, male sex, late diagnosis, and IVIG resistance were independent risk factors for coronary artery aneurysms.Conclusions: Despite the tropical climate, Kawasaki disease epidemiology is similar to non-tropic regions with seasonal patterns and a rising incidence. Atypical presentation, male sex, late diagnosis, and IVIG resistance were significantly associated with coronary artery aneurysms. What is Known: • Kawasaki disease predominantly occurs in males, children less than 5 years old, and the Asian population. • Male sex, late diagnosis, incomplete Kawasaki disease, and IVIG resistance were associated with coronary artery aneurysms. What is New: • In multi-ethnic Asian countries such as Malaysia, ethnic Chinese have a higher prevalence of Kawasaki disease compared to other ethnicities. • Kawasaki disease with atypical presentation can occur in both complete and incomplete Kawasaki disease and is significantly associated with a coronary artery aneurysm.
    Matched MeSH terms: Immunoglobulins, Intravenous/therapeutic use
  8. A Systematic Review and Meta-regression Analysis on the Impact of Increasing IgG Trough Level on Infection Rates in Primary Immunodeficiency Patients on Intravenous IgG Therapy
    Lee JL, Mohamed Shah N, Makmor-Bakry M, Islahudin FH, Alias H, Noh LM, et al.
    J Clin Immunol, 2020 07;40(5):682-698.
    PMID: 32417999 DOI: 10.1007/s10875-020-00788-5
    PURPOSE: We conducted a systematic review and meta-regression analysis to evaluate the impact of increasing immunoglobulin G (IgG) trough levels on the clinical outcomes in patients with PID receiving intravenous immunoglobulin G (IVIG) treatment.

    METHODS: Systematic search was conducted in PubMed and Cochrane. Other relevant articles were searched by reviewing the references of the reviewed article. All clinical trials with documented IgG trough levels and clinical outcome of interest in patients receiving IVIG treatment were eligible to be included in this review. Meta-regression analysis was conducted using Comprehensive Meta-analysis Software. Additional sensitivity analyses were undertaken to evaluate the robustness of the overall results.

    RESULTS: Twenty-eight clinical studies with 1218 patients reported from year 2001 to 2018 were included. The mean IVIG dose used ranges from 387 to 560 mg/kg every 3 to 4 weekly, and mean IgG trough obtained ranges from 660 to 1280 mg/dL. Random-effects meta-regression slope shows that IgG trough level increases significantly by 73 mg/dL with every increase of 100 mg/kg dose of IVIG (p 

    Matched MeSH terms: Immunoglobulins, Intravenous/therapeutic use*
  9. The application of Artocarpus integer seed lectin-M in the detection and isolation of selective human serum acute-phase proteins and immunoglobulins
    Hashim OH, Ahmad F, Shuib AS
    Immunol Invest, 2001 May;30(2):131-41.
    PMID: 11465670
    Champedak (Artocarpus integer) lectin-M is a lectin with high specificity and affinity for the core-mannosyl residues of the N-linked oligosaccharides of glycoproteins. We have studied the interaction of the champedak seed lectin with human serum glycoproteins that were resolved by 2-dimensional (2-D) gel electrophoresis. The lectin demonstrated strong interaction with haptoglobin beta chain, orosomucoid, alpha1-antitrypsin, alpha2-HS glycoprotein, transferrin, hemopexin, alpha1B-glycoprotein, and the heavy chains of IgA, IgM and IgG of the human serum. With exceptions of the heavy chains of the immunoglobulins and alpha1B-glycoprotein, all the other lectin-M-probed glycopeptides are acute-phase proteins. The use of champedak lectin-M to probe for serum glycoproteins that were separated in a 2-D gel electrophoresis and Western blotting technique may be conveniently applied to analyse the acute-phase and humoral immune responses simultaneously. Subjecting human serum to immobilised-lectin-M affinity chromatography was able to isolate intact haptoglobin, alpha1-antitrypsin, alpha1B-glycoprotein, hemopexin and IgA.
    Matched MeSH terms: Immunoglobulins/metabolism*
  10. Normal plasma-immunoglobulin levels in Malaysians
    Yadav M, Shah FH
    Lancet, 1973 Aug 25;2(7826):450-1.
    PMID: 4124938
    Matched MeSH terms: Immunoglobulins/analysis*
  11. Fulltext Different IVIG glycoforms affect in vitro inhibition of anti-ganglioside antibody-mediated complement deposition
    Sudo M, Yamaguchi Y, Späth PJ, Matsumoto-Morita K, Ong BK, Shahrizaila N, et al.
    PLoS One, 2014;9(9):e107772.
    PMID: 25259950 DOI: 10.1371/journal.pone.0107772
    Intravenous immunoglobulin (IVIG) is the first line treatment for Guillain-Barré syndrome and multifocal motor neuropathy, which are caused by anti-ganglioside antibody-mediated complement-dependent cytotoxicity. IVIG has many potential mechanisms of action, and sialylation of the IgG Fc portion reportedly has an anti-inflammatory effect in antibody-dependent cell-mediated cytotoxicity models. We investigated the effects of different IVIG glycoforms on the inhibition of antibody-mediated complement-dependent cytotoxicity. Deglycosylated, degalactosylated, galactosylated and sialylated IgG were prepared from IVIG following treatment with glycosidases and glycosyltransferases. Sera from patients with Guillain-Barré syndrome, Miller Fisher syndrome and multifocal motor neuropathy associated with anti-ganglioside antibodies were used. Inhibition of complement deposition subsequent to IgG or IgM autoantibody binding to ganglioside, GM1 or GQ1b was assessed on microtiter plates. Sialylated and galactosylated IVIGs more effectively inhibited C3 deposition than original IVIG or enzyme-treated IVIGs (agalactosylated and deglycosylated IVIGs). Therefore, sialylated and galactosylated IVIGs may be more effective than conventional IVIG in the treatment of complement-dependent autoimmune diseases.
    Matched MeSH terms: Immunoglobulins, Intravenous/immunology*; Immunoglobulins, Intravenous/metabolism; Immunoglobulins, Intravenous/pharmacology
  12. Fulltext Current perspectives and challenges of primary immunodeficiency disease in Malaysia
    Intan Juliana Abd Hamid, Zarina Thasneem Zainudeen, Ilie Fadzilah Hashim
    Malaysian Journal of Paediatrics and Child Health, 2019;25(2):1-6.
    MyJurnal
    Primary immunodeficiency disease (PID) or inborn error of immunity is a heterogeneous group of inherited diseases affecting the immune system resulting in increased susceptibility to infections, immune dysregulation, autoimmune manifestations, lymphoproliferation and malignancy. Cases of PIDs have been reported in Malaysia since 1977 and the numbers of reported cases steadily increased for the past 30 years with more trained clinical immunologist available, better immunodiagnostic facilities, wider immunoglobulin replacement therapy availability and improved techniques in haematopoietic stem cell transplantation for PIDs. In this article, we highlight some of the limitations and challenges in the diagnosis and therapy of PID, and more recent efforts to establish PID services in Malaysia.
    Matched MeSH terms: Immunoglobulins
  13. What are the effects of intravenous immunoglobulins on seizures and quality of life of people with epilepsy? A Cochrane Review summary with commentary
    Ahmad Fauzi A, Patrick Engkasan J
    Dev Med Child Neurol, 2021 05;63(5):501-502.
    PMID: 33559130 DOI: 10.1111/dmcn.14835
    Matched MeSH terms: Immunoglobulins, Intravenous
  14. Fulltext The protective effects of antigen-specific IgY on pyocyanin-treated human lymphoma Raji cells
    Susilowati H, Artanto S, Yulianto HDK, Sosroseno W, Hutomo S
    F1000Res, 2019;8:1008.
    PMID: 32025288 DOI: 10.12688/f1000research.19327.2
    Background: Pyocyanin (PCN), a highly pathogenic pigment produced by Pseudomonas aeruginosa, induces caspase 3-dependent human B cell (Raji cells) death. The aim of the present study, therefore, was to assess whether antigen-specific IgY antibodies may be protective on PCN-induced Raji cell death. Methods: Chickens were subcutaneously immunized with Freund's complete adjuvant containing PCN, and then given two boosted immunizations.  Anti-PCN IgY antibodies were purified from egg yolk and detected using an agar gel precipitation test (AGPT) and ELISA. Protective effects of antigen-specific IgY on Raji cells were tested using a cell viability assay. Results: AGPT results showed the formation of strong immune complex precipitates, whilst ELISA further confirmed the presence of IgY antibodies specific to PCN at significant concentration. Further experiments showed that anti-PCN IgY antibodies significantly increased PCN-treated Raji cell viability in a dose-dependent fashion (p<0.05). Conclusions: The results of the present study suggest that anti-PCN IgY antibodies may be protective on PCN-induced Raji cell death.
    Matched MeSH terms: Immunoglobulins
  15. Fulltext Dengue Maculopathy with Foveolitis in a Postpartum Female
    Kan KW, Sylves P, Nik-Ahmad-Zuky NL, Shatriah I
    Cureus, 2017 Dec 13;9(12):e1942.
    PMID: 29468098 DOI: 10.7759/cureus.1942
    Dengue fever is common in the tropics and its clinical manifestations and complications are well-known. However, dengue-related ocular complications are rare. Here we present a postpartum female who complained of bilateral central scotoma, at five days after the clinical diagnosis of dengue fever. The ocular examination was suggestive of dengue maculopathy and foveolitis. She was treated with a combination of intravenous methylprednisolone and immunoglobulin. The final visual recovery was good.
    Matched MeSH terms: Immunoglobulins
  16. An immunohistochemical study of CD1a and CD83-positive infiltrating dendritic cell density in cervical neoplasia
    Hayati AR, Zulkarnaen M
    Int J Gynecol Pathol, 2007 Jan;26(1):83-8.
    PMID: 17197902
    Cervical carcinoma is the second leading cancer in women in Malaysia, after breast cancer. Human papillomavirus (HPV) has been implicated in the development of dysplasia or cervical intraepithelial neoplasia and progression to squamous cell carcinoma. Because of the confinement of the human papillomavirus infection within the epithelial layer, the presence of dentritic cells or Langerhans cells in epithelial layer of the ectocervix is paramount in producing immune response. The mature dentritic cells express CD83 and high CD40/80/86, whereas the immature cells express CD1a and low CD40/80/86. By identifying CD1a and CD83, theoretically, both immature and mature dentritic cell populations can be studied. In view of the facts, we investigated the infiltrating cell density of mature and immature dentritic cells in cervical neoplasia.
    Matched MeSH terms: Immunoglobulins/immunology; Immunoglobulins/metabolism*
  17. Fulltext Association of the receptor for advanced glycation end-products (RAGE) gene polymorphisms in Malaysian patients with chronic kidney disease
    Wong FN, Chua KH, Kuppusamy UR, Wong CM, Lim SK, Tan JA
    PeerJ, 2016;4:e1908.
    PMID: 27114872 DOI: 10.7717/peerj.1908
    Chronic kidney disease (CKD) is a condition associated with progressive loss of kidney function and kidney damage. The two common causes of CKD are diabetes mellitus and hypertension. Other causes of CKD also include polycystic kidney disease, obstructive uropathy and primary glomerulonephritis. The receptor for advanced glycation end-products (RAGE) is a multi-ligand cell surface receptor of the immunoglobulin superfamily and it has been associated with kidney disease in both non-diabetic and diabetic patients. Presently, data on the association between RAGE polymorphisms and CKD in the Malaysian population is limited, while numerous studies have reported associations of RAGE polymorphisms with diabetic complications in other populations. The present study aims to explore the possibility of using RAGE polymorphisms as candidate markers of CKD in Malaysian population by using association analysis.
    Matched MeSH terms: Immunoglobulins
  18. Fulltext High dose intravenous immunoglobulin for systemic lupus erythematosus with lupus nephritis and associated studies - case report
    Lim SK, Tan SY
    JUMMEC, 2007;10(2):51-56.
    MyJurnal
    Systemic lupus erythematosus (SLE) is one of the commonest systemic autoimmune diseases that can present with variable clinical manifestations. Intravenous Immunoglobulin (IVIG) has been used as a salvage therapy for severe lupus with encouraging results though there is yet randomised trial to support the usage. This report highlights the efficacy and safety of high dose IVIG in SLE patients with multi-organ involvement particularly lupus nephritis. We also reviewed the literature on the usage of IVIG for lupus nephritis. However, more studies are needed to further clarify the optimal therapeutic dosage and regime for IVIG and to identify the group of patients who might benefit the most from this expensive therapy.
    Matched MeSH terms: Immunoglobulins, Intravenous
  19. Fulltext Diabetic neuropathic cachexia in a young woman
    Yusof NA, Idris NS, Zin FM
    Korean J Fam Med, 2018 Nov 30.
    PMID: 30497111 DOI: 10.4082/kjfm.17.0127
    Profound weight loss with painful symmetrical peripheral neuropathy in diabetic patients was first described as diabetic neuropathic cachexia more than 4 decades ago. It is a distinct type of diabetic peripheral neuropathy that occurs in the absence of other microvascular and autonomic complications of diabetes. The mechanism and precipitating cause are unknown. It was reported to have good prognosis with spontaneous recovery within months to 2 years. However, it was frequently missed by clinicians because the profound weight loss is the most outstanding complaint, rather than the pain, numbness, or weakness. This often leads to extensive investigation to exclude more sinister causes of weight loss, particularly malignancy. We report a case of a young woman with well-controlled diabetes who presented with profound unintentional weight loss (26 kg), symmetrical debilitating thigh pain, and clinical signs of peripheral neuropathy. As the disease entity may mimic an inflammatory demyelinating cause of neuropathy, she was treated with a trial of intravenous immunoglobulin, which failed to give any significant benefit. However, she recovered after 6 months without any specific treatment, other than an antidepressant for the neuropathic pain and ongoing rehabilitation.
    Matched MeSH terms: Immunoglobulins, Intravenous
  20. Fulltext Glucocorticoid versus immunoglobulin in the treatment of COVID-19-associated fulminant myocarditis
    Kow CS, Hasan SS
    Infection, 2020 10;48(5):805-806.
    PMID: 32388676 DOI: 10.1007/s15010-020-01441-4
    Matched MeSH terms: Immunoglobulins
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