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or Mycobacterium tuberculosis infection (TBC-I) in children
54
Tubercle and Lung Disease: Supplement 2
335-PA10 Cytogenetic effects of isoniazid (INH) monotherapy and/or Mycobacterium tuberculosis infection (TBC-I) in children Spyridis, P., Kitsiou, S., Galla, A., Tsezou, A., Gourgiotis, D., Siakavellas, C., Kavazarakis, E., Sinaniotis, C. 2nd Dept. of Pediatrics, University of Athens, Greece
This study was undertaken to determine the effects of INH monotherapy and TBC-I itself on chromatid/ chromosomal breakage and sister chromatid exchange frequency (SCE) in lymphocytes of children with TBCI. 28 boys and 32 girls, 2-13 yrs old were evaluated at the time of diagnosis (internal controls) and after completion of INH prophylaxis; 30/60 received daily INH (10 mg/kg) for 6 mos (group I), while in the rest, 30/60, the drug was administered at the same dosage only for the first 2 mos and then twice weekly (20 mg/kg/d) for 4 mos (group II). The general control group included 30 healthy children (15 d and 15 ~?, 1-13 yrs old). The results showed that TBC-I induced only the chromosomal breakage (p = 0.04, t-test). A significant increase of SCE frequency after 6 mos INH treatment was found in both groups I and II (p = 0.0005 and p = 0.0005 Multivariate Analysis of Variance, paired t-test); however the highest SCE/cell frequency did not exceed the upper normal values (18 SCE/cell). A significant increase was also found in chromatid and chromosomal aberrations after 6 mos INH prophylaxis in both groups I and II (group I: p -- 0.02, p = 0.03 respectively, group II: p = 0.004, p = 0.04 respectively, Multivariate Analysis of Variance, paired t-test). No difference was shown either in SCE or chromatid/chromosomal breakage after the completion of INH prophylaxis between children undergoing the two different INH regimens.
339-PA10 Lung tuberculosis in children of Croatia in relation to clinical experience, war circumstances and epidemiologic data Medar-Lasic, M., Zimic, L., Zoricic-Letoja, I. Hospital for Respiratory Diseases of Children, Zagreb, Croatia
During the period 1983-95. We examined 736 children (0-14 y) with newly diagnosed lung TB. The data were analysed in relation to age, sex, BCG vacctination, tuberculin test, X-ray, infection origin, bronchoscopic finding and migration. 695 (94.5%) children had primary, 41 (5.5%) postprimary lung TB. 591 out of 695 (85%) children with primary TB were aged 5-9 years. There were 382 (55%) boys. 591 (85%) had normal BCG vaccination. Family TB contact was confirmed in 512 (73.7%) and hyperergic PPD3 in 50% of the children. The X-ray examination showed changes in hilar glands in 73.6% of cases. Bronchoscopic findings corresponded with X-ray, i.e. compression of the bronchi was found in 60% of cases. Mycobacterium tb was found in 11.4% of children. Since the beginning of the war there were 229 cases of newly diagnosed lung TB, 22 of whom (9.6%) were refugees from Bosnia and Hercegowina and 14 (6.1%) displaced children from occupied Croatia. My.tb. was found in all of these cases. From 1983-90,
there were no TB meningitis. One refugee child came from Kosovo in 1991, then one from Vukovar and one from Bosnia in 1992, and one from Bosnia in 1993. None of them had been innoculated with BCG vaccine. Since 1992, we had 2 cases of bone TB. The increase in the frequency of TB in Croatia since 1992, data on TB meningitis and bone TB are most probably consequence of war-related stress and migration of the population displaced persons from the occupied regions of Croatia and refugees from BH where TB has always been a large epidemiologic problem.
351-PA10
Tuberculous lymphadenitis in children
Zimic, L., Medar-Lasic, M., Zoricic-Letoja, I. Hospital for Respiratory Diseases of Children and Adolescents, Zagreb, Croatia
The authors present 15 cases of TB of peripheral adenitis in children treated at the Hospital for Respiratory Diseases of Children and Adolescents, Zagreb, Croatia, during the period from 1983-93. In 13 of them TB was found in the neck (almost always cervical) and in 2 in the abdominal lymph glands. The patients were aged 8 years and younger. Contact with TB was identified in 5 children. One child had not been BCG-vaccinated. The mean value of TBN (PPD3) was 6 ram. M. tuberculosis was isolated from extirpated lymph nodes in 3 children, and histopathologic findings indicated TB in all 15 patients. These cases are presented with the purpose of pointing out that after elimination of all possible etiologic factors in the course of differential diagnosis TB is to be considered a probable etiologic entity.
444-PA10 Enzymes in serum of children, fast and slow isoniazid acetylators Dodig, S., Medar-Lasir, M., Zimir, L., Ziv~i(, J., Cepelak I. Specialty Hospital for Respiratory Diseases of Children, Zagreb, Croatia
For 12 weeks catalytic activities of aminotransferases, gammaglutamyltransferase and alkaline phosphatase have been monitored on sera of 69 children on antituberculotic therapy (fast isoniazid acetylators, n = 33; slow isoniazid acetylators, n = 36). A significant increase has been most frequently observed in the activities of AST and ALT in sera of both phenotypes throughout the period of treatment. The determination of the catalytic activities of GGT is found to be justified in both phenotypes, and those of alkaline phosphatase in slow acetylators depending on the drug added to the isoniazid therapy.
PULMONARY EPIDEMIOLOGY 128-PA10 Occupational Lung Disease among black TB patients - a rural South African experience Hibbeler, F.B. Health Services Development Unit, Witwatersrand University, Johannesburg, South Africa
This paper reports on a descriptive study conducted to
Tubercle and Lung Disease: Supplement 2
335-PA10 Cytogenetic effects of isoniazid (INH) monotherapy and/or Mycobacterium tuberculosis infection (TBC-I) in children Spyridis, P., Kitsiou, S., Galla, A., Tsezou, A., Gourgiotis, D., Siakavellas, C., Kavazarakis, E., Sinaniotis, C. 2nd Dept. of Pediatrics, University of Athens, Greece
This study was undertaken to determine the effects of INH monotherapy and TBC-I itself on chromatid/ chromosomal breakage and sister chromatid exchange frequency (SCE) in lymphocytes of children with TBCI. 28 boys and 32 girls, 2-13 yrs old were evaluated at the time of diagnosis (internal controls) and after completion of INH prophylaxis; 30/60 received daily INH (10 mg/kg) for 6 mos (group I), while in the rest, 30/60, the drug was administered at the same dosage only for the first 2 mos and then twice weekly (20 mg/kg/d) for 4 mos (group II). The general control group included 30 healthy children (15 d and 15 ~?, 1-13 yrs old). The results showed that TBC-I induced only the chromosomal breakage (p = 0.04, t-test). A significant increase of SCE frequency after 6 mos INH treatment was found in both groups I and II (p = 0.0005 and p = 0.0005 Multivariate Analysis of Variance, paired t-test); however the highest SCE/cell frequency did not exceed the upper normal values (18 SCE/cell). A significant increase was also found in chromatid and chromosomal aberrations after 6 mos INH prophylaxis in both groups I and II (group I: p -- 0.02, p = 0.03 respectively, group II: p = 0.004, p = 0.04 respectively, Multivariate Analysis of Variance, paired t-test). No difference was shown either in SCE or chromatid/chromosomal breakage after the completion of INH prophylaxis between children undergoing the two different INH regimens.
339-PA10 Lung tuberculosis in children of Croatia in relation to clinical experience, war circumstances and epidemiologic data Medar-Lasic, M., Zimic, L., Zoricic-Letoja, I. Hospital for Respiratory Diseases of Children, Zagreb, Croatia
During the period 1983-95. We examined 736 children (0-14 y) with newly diagnosed lung TB. The data were analysed in relation to age, sex, BCG vacctination, tuberculin test, X-ray, infection origin, bronchoscopic finding and migration. 695 (94.5%) children had primary, 41 (5.5%) postprimary lung TB. 591 out of 695 (85%) children with primary TB were aged 5-9 years. There were 382 (55%) boys. 591 (85%) had normal BCG vaccination. Family TB contact was confirmed in 512 (73.7%) and hyperergic PPD3 in 50% of the children. The X-ray examination showed changes in hilar glands in 73.6% of cases. Bronchoscopic findings corresponded with X-ray, i.e. compression of the bronchi was found in 60% of cases. Mycobacterium tb was found in 11.4% of children. Since the beginning of the war there were 229 cases of newly diagnosed lung TB, 22 of whom (9.6%) were refugees from Bosnia and Hercegowina and 14 (6.1%) displaced children from occupied Croatia. My.tb. was found in all of these cases. From 1983-90,
there were no TB meningitis. One refugee child came from Kosovo in 1991, then one from Vukovar and one from Bosnia in 1992, and one from Bosnia in 1993. None of them had been innoculated with BCG vaccine. Since 1992, we had 2 cases of bone TB. The increase in the frequency of TB in Croatia since 1992, data on TB meningitis and bone TB are most probably consequence of war-related stress and migration of the population displaced persons from the occupied regions of Croatia and refugees from BH where TB has always been a large epidemiologic problem.
351-PA10
Tuberculous lymphadenitis in children
Zimic, L., Medar-Lasic, M., Zoricic-Letoja, I. Hospital for Respiratory Diseases of Children and Adolescents, Zagreb, Croatia
The authors present 15 cases of TB of peripheral adenitis in children treated at the Hospital for Respiratory Diseases of Children and Adolescents, Zagreb, Croatia, during the period from 1983-93. In 13 of them TB was found in the neck (almost always cervical) and in 2 in the abdominal lymph glands. The patients were aged 8 years and younger. Contact with TB was identified in 5 children. One child had not been BCG-vaccinated. The mean value of TBN (PPD3) was 6 ram. M. tuberculosis was isolated from extirpated lymph nodes in 3 children, and histopathologic findings indicated TB in all 15 patients. These cases are presented with the purpose of pointing out that after elimination of all possible etiologic factors in the course of differential diagnosis TB is to be considered a probable etiologic entity.
444-PA10 Enzymes in serum of children, fast and slow isoniazid acetylators Dodig, S., Medar-Lasir, M., Zimir, L., Ziv~i(, J., Cepelak I. Specialty Hospital for Respiratory Diseases of Children, Zagreb, Croatia
For 12 weeks catalytic activities of aminotransferases, gammaglutamyltransferase and alkaline phosphatase have been monitored on sera of 69 children on antituberculotic therapy (fast isoniazid acetylators, n = 33; slow isoniazid acetylators, n = 36). A significant increase has been most frequently observed in the activities of AST and ALT in sera of both phenotypes throughout the period of treatment. The determination of the catalytic activities of GGT is found to be justified in both phenotypes, and those of alkaline phosphatase in slow acetylators depending on the drug added to the isoniazid therapy.
PULMONARY EPIDEMIOLOGY 128-PA10 Occupational Lung Disease among black TB patients - a rural South African experience Hibbeler, F.B. Health Services Development Unit, Witwatersrand University, Johannesburg, South Africa
This paper reports on a descriptive study conducted to