[Infectious diseases--new horizons].

During the last decade we have witnessed important developments in the field of infectious diseases. These developments have in a large part been made possible due to our entry into the genomic period. The main areas of progress include diagnosis, understanding of the pathophysiology, genetics, anti-microbial therapy and the prevention of disease by new vaccines.

[Pediatric infectious diseases--an ongoing battle].

Eleven articles are included in this special issue of Harefuah dedicated to pediatric infectious diseases. Herein, they present the problems and dilemmas pediatricians, as well as general practitioners, face in current practice. In spite of tremendous achievements in prevention, diagnosis and treatment, infectious diseases remain a major concern in pediatrics.

Subcutaneous immunoglobulins: product characteristics and their role in primary immunodeficiency disease.

Research on the role of subcutaneous immunoglobulin in primary immunodeficiency disease (PIDD) is ongoing. We analyzed pivotal studies for four subcutaneous immunoglobulin products: IGSC 10% (Gammagard(®) Liquid), IGIV-C 10% (Gamunex(®)-C), IGSC 16% (Vivaglobin(®)) and IGSC 20% (Hizentra(®)). To identify similarities and differences between products, we examined infusion parameters, adverse event profiles and improvements in tolerability over time.

Specific self-antigen-driven immune response in pericardial effusion as an isolated GVHD manifestation.

Pericardial effusion and cardiac tamponade have been described as GVHD manifestations in the post transplant period. Direct evidence of GVHD-related TCR or B-cell receptor clones in patients with pericardial effusion has never been described. Using several methods, including FACS and spectratyping analysis to assess T- and B-cell clonality and to quantify TCR excision circles to assess newly thymus-derived T cells, we were able to show expansion of oligoclonal T-cell populations and the possible presence of early/premature B cells in the pericardial effusion but not in peripheral mononuclear cells.

Molecular assessment of thymus capabilities in the evaluation of T-cell immunodeficiency.

T-cell immunodeficiency may pose a diagnostic challenge to clinicians, especially when the basic T-cell immune workup is not sufficiently informative. An intensive assessment of thymus capabilities that involves either measuring the recent thymic emigrant cells or analyzing the T-cell receptor (TCR) repertoire is often required to estimate the severity and nature of the immune disorder. A comprehensive T-cell immune workup, including TCR excision circles (TRECs) and TCR repertoire analyses, was performed in three patients with various degrees of severity of T-cell immunodeficiency.