Publications by authors named "Wetzke M"

Seasonal respiratory syncytial virus (RSV) lower respiratory infections (RSV-LRI) and bronchiolitis in children remain a high burden to medical facilities. Studies evaluating the practical approach in outpatient settings are scarce. We conducted a survey to provide an insight into management in pediatric offices in Germany.

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Article Synopsis
  • Primary ciliary dyskinesia (PCD) is a rare genetic disorder that affects ciliary function, leading to airway clearance issues and sometimes organ positioning defects (laterality defects), with a study conducted across 19 countries to analyze gene defects and their clinical implications.
  • The study involved 1236 individuals with a variety of pathogenic DNA variants and found significant geographical differences in PCD genotypes, with varying rates of laterality defects and distinct genetic characteristics linked to different countries.
  • Results revealed that individuals with PCD often have lower lung function (measured by forced expiratory volume) and that the presence of certain genetic variants can correlate with more severe clinical outcomes, highlighting the importance of genetic understanding in diagnosing
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Introduction: Childhood interstitial lung disease (chILD) is a heterogeneous group of mostly chronic respiratory disorders. Assessment of health-related quality of life (HrQoL) in chILD has become increasingly important in clinical care and research. The aim of this study was to assess differences between patient-reported (self) and caregiver-reported (proxy) HrQoL scores.

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Respiratory syncytial virus (RSV) is a common cause of acute lower respiratory tract infection in infants, older adults and the immunocompromised. Effective directly acting antivirals are not yet available for clinical use. To address this, we screen the ReFRAME drug-repurposing library consisting of 12,000 small molecules against RSV.

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Background: Pulmonary Alveolar Proteinosis (PAP) is extremely rare and can be caused by hereditary dysfunction of the granulocyte macrophage colony-stimulating factor receptor (GM-CSF) receptor, autoantibodies against GM-CSF, or other diseases leading to alveolar macrophage (AM) dysfunction. This leads to protein accumulation in the lung and severe dyspnea and hypoxemia. Whole lung lavage (WLL) is the first line treatment strategy.

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Relapsing polychondritis (RP) is a rare immune-mediated disease that primarily affects the cartilaginous structures of the ears, nose and airways. The clinical spectrum ranges from mild to severe disease characterized by progressive destruction of cartilage in the tracheobronchial tree leading to airway obstruction and acute respiratory failure. Early diagnosis is crucial to prevent irreversible airway damage and life-threatening complications.

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Background: Post-COVID syndrome (PCS) can adversely affect the quality of life of patients and their families. In particular, the degree of cardiac impairment in children with PCS is unknown.

Objective: The aim of this study was to identify potential cardiac inflammatory sequelae in children with PCS compared with healthy controls.

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Background: Respiratory syncytial virus (RSV) causes respiratory tract disease in seasonal waves, primarily in infants and young children. This study aims to quantify the number of RSV-related hospitalizations in children ≤2 years of age and to determine corresponding resource use and costs in Germany.

Methods: We retrospectively analyzed population-wide hospital data from the Institute for the Hospital Remuneration System (InEK) from 2019 to 2022.

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Article Synopsis
  • - Whole-exome sequencing helps diagnose primary ciliary dyskinesia (PCD) but often uncovers variants of uncertain significance (VUS), complicating results in about 30% of patients.
  • - The study focused on 16 adults with bronchiectasis and inconclusive whole-exome sequencing results, using transmission electron microscopy (TEM) and specialized software to analyze ciliary structures.
  • - Results showed that while eight patients had normal ciliary structure, six exhibited notable defects linked to VUS, and one had a defect confirming clinical relevance, indicating that TEM can effectively clarify genotype-phenotype correlations in PCD cases.
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Background: Respiratory syncytial virus (RSV) is known as a major cause of respiratory tract infection in adults and children. Human-to-human transmission occurs via droplets as well as direct and indirect contact (e.g.

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Triple-combination cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy with elexacaftor/tezacaftor/ivacaftor (ETI) was introduced in August 2020 in Germany for people with CF (pwCF) ≥12 years (yrs.) of age and in June 2021 for pwCF ≥6 yrs of age. In this single-center study, we analyzed longitudinal data on the percent-predicted forced expiratory volume (ppFEV1) and body-mass-index (BMI) for 12 months (mo.

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Background: Paediatric community-acquired pneumonia (CAP) is a leading cause of paediatric morbidity. However, particularly for outpatients with paediatric CAP, data on aetiology and management are scarce.

Methods: The prospective pedCAPNETZ study multicentrically enrols children and adolescents with outpatient-treated or hospitalised paediatric CAP in Germany.

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Background: The majority of patients with childhood interstitial lung disease (chILD) caused by pathogenic variants in ATP binding cassette subfamily A member 3 (ABCA3) develop severe respiratory insufficiency within their first year of life and succumb to disease if not lung transplanted. This register-based cohort study reviews patients with ABCA3 lung disease who survived beyond the age of 1 year.

Method: Over a 21-year period, patients diagnosed as chILD due to ABCA3 deficiency were identified from the Kids Lung Register database.

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Article Synopsis
  • - Monogenic autoinflammatory diseases (AID) are genetic conditions that lead to unexplained or excessive inflammation due to defects in the innate immune system, and accurate diagnosis relies on identifying specific genetic variants.
  • - Researchers conducted whole exome sequencing (WES) on 125 children suspected of having monogenic AID, using a step-wise strategy that first analyzed a small panel of known relevant genes, then expanded to a larger gene panel.
  • - The study found that analyzing the smaller gene panel (13 genes) diagnosed 16% of patients, while the larger panel (542 genes) diagnosed 20.8%, but WES analysis did not improve diagnostic yield, indicating that targeted gene panels are sufficient for early diagnosis in
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Objective: Diffuse alveolar hemorrhage (DAH) in children is a rare condition resulting from different underlying diseases. This study aimed at describing characteristics and diagnostic measures in children with ILD (children's interstitial lung disease, chILD) and DAH to improve the diagnostic approach by increasing clinician's awareness of diagnostic shortcomings.

Patients And Methods: A retrospective data analysis of patients with ILD and DAH treated in our own or collaborating centers between 01/07/1997 and 31/12/2020 was performed.

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Background: Monitoring disease progression in childhood interstitial lung diseases (chILD) is essential. No information for the minimal important difference (MID), which is defined as the smallest change in a parameter that is perceived as important prompting a clinician to change the treatment, is available. We calculated MIDs for vital signs (respiratory rate, peripheral oxygen saturation in room air, Fan severity score) and health-related quality of life (HrQoL) scores.

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An extremely dystrophic, premature female infant, born at 25 3/7 weeks of gestational age (birth weight: 430 g) with severe pulmonary hypertension (PH), was admitted to our neonatal intensive care unit (ICU) requiring cardiorespiratory support, including mechanical ventilation and pulmonary vasodilators such as inhaled nitric oxide (iNO) and continuous intravenous sildenafil infusions. The diagnosis of bronchopulmonary dysplasia (BPD) was made. A hemodynamically relevant, persistent ductus arteriosus (PDA) was surgically ligated after failed pharmacologic PDA closure using indomethacin and ibuprofen.

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Sarcoidosis is a chronic granulomatous disorder affecting the lungs, skin, and many other organs. Twin studies suggest that genetic factors account, to a large degree, for the etiology of the disorder. Hence, theoretically, we could postulate that the phenomenon of superimposed mosaicism in the form of a pronounced segmental involvement, overlaying the disseminated non-segmental lesions, should also occur in sarcoidosis.

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Article Synopsis
  • Gain-of-function variants in the STING gene are responsible for STING-Associated Vasculopathy with onset in Infancy (SAVI), previously thought to only occur with heterozygous mutations.
  • Recent findings highlight a specific homozygous variant, c.841C>T, causing SAVI in four unrelated patients, all presenting with interstitial lung disease and varying disease severity.
  • This research challenges the established view of SAVI as an autosomal dominant condition, suggesting an autosomal recessive inheritance pattern and potentially aiding in diagnosis and treatment approaches.
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  • A study during the COVID-19 pandemic examined the impact of SARS-CoV-2 seropositivity on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptoms among children and adolescents in Germany.
  • Out of 634 participants, 31.2% reported symptoms linked to ME/CFS, with a noticeable difference between those who were seropositive and seronegative for the virus.
  • The adjusted risk ratio indicated that the relationship between SARS-CoV-2 infection and symptoms of ME/CFS was less significant after accounting for factors like age, sex, and preexisting conditions.
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Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by impaired mucociliary clearance leading to irreversible lung damage. In contrast to other rare lung diseases like cystic fibrosis (CF), there are only few clinical trials and limited evidence-based treatments. Management is mainly based on expert opinions and treatment is challenging due to a wide range of clinical manifestations and disease severity.

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Background: No results of controlled trials are available for any of the few treatments offered to children with interstitial lung diseases (chILD). We evaluated hydroxychloroquine (HCQ) in a phase 2, prospective, multicentre, 1:1-randomized, double-blind, placebo-controlled, parallel-group/crossover trial. HCQ (START arm) or placebo were given for 4 weeks.

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Variable disease course and outcomes have been reported in children's interstitial lung disease associated with (Filamin A gene) variants. To further delineate long-term respiratory outcomes and identify potential contributing factors to severe disease course. We retrospectively collected longitudinal data from three centers on nine cases (one male) with variants and early respiratory disease onset (within the first 24 mo of life).

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Article Synopsis
  • * Infection rates were higher among children with a migrant background, and younger children under three had higher initial seropositivity rates compared to older kids.
  • * The findings suggest that serologic testing could give a better estimation of actual infection rates since many cases don't show symptoms, highlighting the importance of understanding infection spread and risks.
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