Tourette's Syndrome Manifests as Chronic Persistent Cough

Tourette's syndrome (TS) is a neuropsychiatric disorder characterized by the presence of involuntary motor and phonic tics. Phonic tics can mimic respiratory system disorders such as asthma, and upper and lower respiratory system infections. We report on twins with chronic persistent cough (CPC) : one of whom was followed as an asthmatic for a year and the other was diagnosed with recurrent respiratory tract infection. A careful history and neurologic assessment suggested that TS might be responsible for the first twin's symptoms but that the second one was probably in early TS. All the symptoms of the first patient diagnosed as TS showed a complete improvement with pharmacological treatment in two weeks. Since the history of CPC may in reality be TS, we recommend that TS should be considered in the differential diagnosis of pediatric CPC.

Rhabdomyolysis in Celiac Disease

A 12-year-old female presented with chronic diarrhea, fatigue, failure to thrive, sudden weakness of her upper and lower extremities and inability to walk. On neurological examination, atrophy was found of the lower extremity muscles, coupled with muscle weakness. Hypokalemia and a high creatine kinase (CK) level were detected. Antigliadin IgA, IgG and antiendomysial antibodies were positive. A duodenal biopsy revealed the classical findings of celiac disease. To our knowledge this is the first childhood case of celiac disease presenting with rhabdomyolysis.