[Inhaled corticosteroids treatment in infants with asthma: report of 60 cases]

The aim of this report was to evaluate clinical course of asthma in infants with long term inhaled corticosteroid therapy. We reviewed retrospectively 60 infants with asthma requiring inhaled corticosteroid-therapy at Infantile Medecine A Department in Children's Hospital of Tunis, during six years [1998 -2003]. We evaluated asthma control and treatment side-effects. 60 infants [43 males and 17 females] with asthma were given inhaled corticosteroids. The mean age at diagnosis was 11.2 months [2.5 -30 months]. The mean age at the beginning of the treatment was 17 months [3 - 42 months]. All patients were given beclomethasone propionate during a period of 23.5 months in average [9 - 66 months] with a mean daily dose of 697micro g [400 - 750 microg] initially. Patients were followed up and reevaluated 44 +/- [16.3] months later [19-99 months]. Before treatment, 34 infants had moderate asthma [56.7 percent] and 26 infants had severe asthma [43.3 percent] [according to DeBlic classification]. After corticosteroid therapy, clinical course improved in 57 patients [95 per cent] who developed intermittent asthma, while three patients developed moderate to severe asthma [p < 0.001]. The mean weight of patients passed from + 0.22 SD to + 0.33 SD [p = 0.313]. The mean height of patients passed from + 0.04 SD to + 0.48 SD [p < 0,001]. 10 per cent of patients developed local side effects related to inhalation. inhaled corticosteroids allowed asthma control in infants without compromising growth at meaddle term

[Bronchogenic cyst: an uncommon cause of Congenital Lobar Emphysema]

We report a case of a one-month-old boy who developed respiratory distress. Chest-X- ray and CT scans showed over distension of the left upper lobe and mediastinal shift in favour of congenital lobar emphysema [CLE]. One month after uneventful lobectomy, he was admitted at hospital for another episode of respiratory distress. Chest radiograph revealed relapse of compressive emphysema in the remaining left lobe. Gastro esophageal transit and MRI were performed, showing mediastinal cystic mass. Thus, patient underwent thoracotomy. Surgical examination found a subcarinal bronchogenic cyst that compressed main left bronchus, causing the emphysema of upper and lower left lobes. Histological examination of removed cyst confirmed these data. Authors discuss causes of diagnosis delay

[Intrathoracic extramedullary haematopoiesis: a study of 1 case]

Intrathoracic extramedullary haematopoiesis [IEH] is a rare entity accompanying some chronic haematologic diseases. The authors report the case of a 16 year old beta thalassemia girl with IEH, presenting in the form of asymptomatic posterior mediastinial mass. Computed tomography scanning and magnetic resonance imaging of the chest showed multiples polylobar paravertebral masses which have the characteristics of IEM. The radiological diagnosis is essential to avoid biopsy and surgery which can be very harmful because of the extreme vascularity of the haematopoietic tissue