A Case of Mollaret Meningitis

Mollaret meningitis is a recurrent aseptic meningitis with characteristic clinical features and Mollaret cells in cerebrospinal fluid. Since Mollaret first reported Mollaret meningitis in 1944, further reports had been made mainly in Europe. The syndrome consists of brief attacks of meningitis that recur at regular intervals and alternate with a symptom-free period lasting for weeks or months. The symptoms subside as quickly as they develop, and the patient is completely asymptomatic until the next episode, without any residual neurologic abnormalities. Specific changes in the cytologic pattern of the cerebrospinal fluid occur over the course of an attack. In the early stages, polymorphonuclear leukocytes and endothelial cells appear in the cerebrospinal fluid, called Mollaret cell. We experienced a case of Mollaret meningitis in a 15-year-old female child who had 5 episodes of recurrent aseptic meningitis, always accompanied by vesicles on the face and anterior neck. We observed Mollaret cells which had faint, finely vacuolated cytoplasm, eccentrically located nuclei show on Papanicolau stain. We present a case of Mollaret meningitis with a brief review of related literatures.

A Case of Mollaret Meningitis

Mollaret meningitis is a recurrent aseptic meningitis with characteristic clinical features and Mollaret cells in cerebrospinal fluid. Since Mollaret first reported Mollaret meningitis in 1944, further reports had been made mainly in Europe. The syndrome consists of brief attacks of meningitis that recur at regular intervals and alternate with a symptom-free period lasting for weeks or months. The symptoms subside as quickly as they develop, and the patient is completely asymptomatic until the next episode, without any residual neurologic abnormalities. Specific changes in the cytologic pattern of the cerebrospinal fluid occur over the course of an attack. In the early stages, polymorphonuclear leukocytes and endothelial cells appear in the cerebrospinal fluid, called Mollaret cell. We experienced a case of Mollaret meningitis in a 15-year-old female child who had 5 episodes of recurrent aseptic meningitis, always accompanied by vesicles on the face and anterior neck. We observed Mollaret cells which had faint, finely vacuolated cytoplasm, eccentrically located nuclei show on Papanicolau stain. We present a case of Mollaret meningitis with a brief review of related literatures.

A Case of Behcet's Colitis in Children / 대한소화기내시경학회지

Behcet's disease consists of a triad of relapsing inflammatory disease of the eye (iridocyclitis) with painful and recurrent oral and genital ulcerations. Arthritis, thrombophlebitis, neurologic abnormalities, fever, and colitis are associated clinical manifestations. The disease affects predominantly young adults and is very rare in children, especially those under 10 years of age. The proportion of Behcet's colitis in Behcet's disease is about 12%. Ulcerations are localized or diffuse, with the majority occuring in the ileocecal region. Extension to the serosal surface may result in perforation. The frequent complaints are abdominal pain, nausea, vomiting, diarrhea, hematochezia, loss of appetite, loss of weight gain, distention and palpable abdominal mass. The disease is complicated by intestinal obstruction, perforation, fistula formation, abscess formation and hemorrhage. We experienced a case of Behcet's colitis in a 9-year-old boy showing symptoms of abdominal pain, tenderness, and diarrhea. Thus, we report a case of Behcet's colitis with brief review of related literatures.

A Case of Acute Motor Axonal Neuropathy / 대한소아신경학회지

In northern China, annual epidemics of acute-onset flaccid paralysis diagnosed clinically Guillain-Barre syndrome have been observed for at least 20 years. These patients had a distinctive pattern that shares clinical and cerebrospinal fluid findings with demyelinating Guillain-Barr syndrome. But it was different from Guillain-Barr syndrome physiologically and pathologically. Electrodiagnostic studies showed normal motor distal latencies and limb conduction velocity, but reduced compound muscle action potential amplitude. When sensory nerve action potentials are elicitable, F waves are within the range of normal. This disorder was named acute motor axonal neuropathy characterized pathologically by motor nerve fiber degeneration of variable severity and by sparing of sensory fibers. Recovery is usually complete. We experienced a case of acute axonal motor neuropathy, and reported the case with a review of literature.

A Case of VURD Syndrome

VURD syndrome is a disorder characterized by a posterior urethral valve, unilateral reflux, and ipsilateral renal dysplasia. This syndrome is not uncommon, with an incidence in the range of 15 to 20% in patients with posterior urethral valve. Etiology is not clear, but there are a few reports that renal dysplasia is either a result of hydrostatic pressure transmitted to the developing kidney or a common teratogenic factor resulting in urethral obstruction, renal dysplasia, and vesicoureteral reflux. Infants with posterior urethral valves and persistent unilateral reflux after valve resection often have an associated nonfunctioning, dysplastic kidney. Misinterpretation of initial radiographic studies performed without coinciding bladder drainage results in a missed diagnosis of this syndrome and misguided surgical management. Functional assessment by a renal scan with bladder catheter drainage will avoid unnecessary staged or reconstructive procedures. Nephoureterectomy is recommended at about 1 year of age to improve voiding dynamics and to avoid infection. We experienced a case of VURD syndrome, first presenting bilateral hydronephrosis by ultrasonography during the prenatal period. Voiding cystourethrography revealed dilated posterior urethra and left vesicoureteral reflux, and DMSA scan showed a nonfunctioning left kidney.