Papers by Dr. Deepika tiwari
Indian Journal of Pediatrics, Apr 16, 2019
To the Editor: Macro-Aspartate transaminase (AST) is a rare and benign cause of isolated elevatio... more To the Editor: Macro-Aspartate transaminase (AST) is a rare and benign cause of isolated elevation of AST levels. It is a type of macro enzyme which often persists for longer periods and can lead to expensive follow-up and testing. Macro AST has familial occurrence with unknown inheritance and penetrance. A heterozygous mutation in glutamate oxaloacetate transaminase 1 (GOT1) is associated with familial macro-AST [1]. Mutation analysis can support the diagnosis but is not widely available. This mutation has not yet been reported from India. We herein report a case of Macro AST in an asymptomatic child with significantly raised paternal AST levels suggesting familial predisposition. An eight-year-old asymptomatic male child was referred to us for an isolated elevation in AST levels with no previous drug history. Physical examination was normal. We found AST levels between 190 to 242 (Normal 0-40) IU/L for two consecutive years (2016 to 2018) suggesting overproduction of abnormal AST (t1/2 normal AST-17 h) [2], while other liver function tests were normal. Abdominal ultrasound showed mild hepatomegaly. Hepatitis B surface antigen (HBsAg), Hepatitis B virus (HBV) DNA, Anti-HCV, Hepatitis C virus (HCV) RNA, Human immunodeficiency virus
Pediatric Hematology Oncology Journal, 2016
Pediatric education and research, 2019
Vaccines
Since the coronavirus disease (COVID-19) pandemic hit the globe in early 2020, we have steadily g... more Since the coronavirus disease (COVID-19) pandemic hit the globe in early 2020, we have steadily gained insight into its pathogenesis; thereby improving surveillance and preventive measures. In contrast to other respiratory viruses, neonates and young children infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have a milder clinical presentation, with only a small proportion needing hospitalization and intensive care support. With the emergence of novel variants and improved testing services, there has been a higher incidence of COVID-19 disease reported among children and neonates. Despite this, the proportion of young children with severe disease has not increased. Key mechanisms that protect young children from severe COVID-19 disease include the placental barrier, differential expression of angiotensin-converting enzyme 2 (ACE-2) receptors, immature immune response, and passive transfer of antibodies via placenta and human milk. Implementing mass vaccinati...
Indian Journal of Pediatrics
Pediatric Education and Research, 2019
The Indian Journal of Pediatrics, 2019
To the Editor: Macro-Aspartate transaminase (AST) is a rare and benign cause of isolated elevatio... more To the Editor: Macro-Aspartate transaminase (AST) is a rare and benign cause of isolated elevation of AST levels. It is a type of macro enzyme which often persists for longer periods and can lead to expensive follow-up and testing. Macro AST has familial occurrence with unknown inheritance and penetrance. A heterozygous mutation in glutamate oxaloacetate transaminase 1 (GOT1) is associated with familial macro-AST [1]. Mutation analysis can support the diagnosis but is not widely available. This mutation has not yet been reported from India. We herein report a case of Macro AST in an asymptomatic child with significantly raised paternal AST levels suggesting familial predisposition. An eight-year-old asymptomatic male child was referred to us for an isolated elevation in AST levels with no previous drug history. Physical examination was normal. We found AST levels between 190 to 242 (Normal 0-40) IU/L for two consecutive years (2016 to 2018) suggesting overproduction of abnormal AST (t1/2 normal AST-17 h) [2], while other liver function tests were normal. Abdominal ultrasound showed mild hepatomegaly. Hepatitis B surface antigen (HBsAg), Hepatitis B virus (HBV) DNA, Anti-HCV, Hepatitis C virus (HCV) RNA, Human immunodeficiency virus
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Papers by Dr. Deepika tiwari