[Graves's disease in children and adolescent: study of seven cases]

In spite of its rarity in the paediatric age. Graves' disease constitutes the principal aetiology of hyperthyroidism in child. Our goal is to analyze the clinical and evolutive particularities of Graves's disease in children. We studied retrospectively seven cases of Graves' disease in children enrolled in the pediatrics department of Sousse during ten years period [1993-2002]. There were six girls and one boy [sex - ratio = 0.16] aged 4.5 to 16 years [mean age: nine years and one month].The diagnosis has been established clinically on the presence of classic symptoms of the illness associated to the biological and radiological findings. As part of research of possible associations with this illness, we observed solely in a case, in addition of Graves's disease, the coexistence of Down syndrome and coeliac disease, rarely described., -Among the HLA antigens predisposing the Graves's disease, we only found HLA B8 antigen in a patient. The evolution under antithyroid drug treatment [ATD] has been marked by fast disappearance of functional signs in all patients. However, biological and clinical euthyroiidism was more difficult to achieve. The treatment has been stopped in only one patient after 40 months period. Graves' disease is usually easy to recognize but difficult to treat. Radical treatments [thyroidectomy or radioactive iodine therapy] are indicated in second intention after having tempted ATD beforehand

Henochschonlein purpura in children: clinical and evolutive study of 122 cases

Analyze the clinical and evolutive particularities of Henoch Schonlein purpura in children. We studied retrospectively 122 cases enrolled in the pediatrics department of Sousse during 10 years period [1992-2001]. It is about 66 boys and 56 girls [sex - ratio= 1.18] aged 3 to 13 years [mean age: 7 years and half]. The diagnosis has been established clinically on the presence of cutaneous syndrome with symmetrical declivitous region purpura in all patients with articular syndrome [9 leases] and /or digestive syndrome [65cases]. Complications were variable: digestive hemorrhage [19cases], occlusive syndrome [2 cases], renal involvement at variable severity [56 cases], scrotal and testicular complications [1l cases], cardiac complications [tamponade in a case]. Henoch Schonlein purpura was associated with a primary antiphospholipid syndrome in a case, renal tuberculosis in a case and cholestatic hepatitis A in another case. All patient receeved symptomatic treatment [rest in bed +/- antalgic treatment]. Digestive rest was prescribed for 20 patients presenting severe abdominal pains with corticosteroid during 2 at 4 weeks [1-2mg/kg/d] in eight cases. Corticosteroid-cyclophosphamid association was prescribed for 2 patients with severe renal involvement; one of them benefitted of extra-renal purification. One or several relapses of Henoch Schonlein purpura were noted in 13 patients. All sick evolved favorably same those presenting renal or cardiac involvement [middle receding of 5 years]