ABSTRACT
PURPOSE: Infant leukemia is rare and accounts for 5% of leukemia in children. It differs from childhood leukemia in biologic and clinical features and has a poor prognosis. Research on infant leukemia is difficult due to the scarcity of cases. We studied the clinical progress and prognosis of infant leukemia diagnosed in our hospital, in order to contribute to the treatment and prognosis of infant leukemia. METHODS: The patients who were diagnosed with leukemia in the first 12 months of life were analysed between January 1991 and December 2000 in Yonsei Medical Center. We analysed the sex, age, clinical features, treatment outcome, prognostic factor, and survival rate. RESULTS: Among a total of 41 cases, 19 cases were diagnosed with acute lymphoblastic leukemia (ALL), 15 cases with acute myelogenous leukemia (AML), 2 cases with chronic myelogenous leukemia (CML), and 5 cases were unclassifed. Twenty-two were males and 19 females; age at diagnosis was 4 months in ALL, 8 months in AML, and 4 months in CML. Common clinical features at diagnosis were pale appearance and fever, others were poor oral intake, abdominal distension, and irritability. Hyperleukocytosis with average over 20,000/mm3, anemia, and thrombocytopenia were seen. By immunologic surface marker analysis, 8 of 15 B-lineage ALL were CALLA negative, early pre-B ALL. The remission induction rate was 79% in ALL and 60% in AML. The 5 year-survival rate of 41 patients was 29.2%. Sex, age at diagnosis, white blood cell count > 50 109/L, hepatomegaly, and CNS involvement were not prognostic factors. CONCLUSION: Infant leukemia differs from childhood leukemia in biological and clinical features and has a poor prognosis. Therefore, further clinical research is needed to improve the outcome of infant leukemia.
Subject(s)
Child , Female , Humans , Infant , Male , Anemia , Diagnosis , Fever , Hepatomegaly , Leukemia , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Leukemia, Myeloid, Acute , Leukocyte Count , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Prognosis , Remission Induction , Survival Rate , Thrombocytopenia , Treatment OutcomeABSTRACT
Skin atrophy is one of the most common side effects of topical steroid use and results from decreased skin proalphaI collagen mRNA production due to specific alterations in collagen gene transcription or from reduced collagen mRNA stability. This report describes a case of a 8 year-old-girl who visited our hospital with a complaint of ambiguous genitalia. She was observed to have atrophic labia majora and atrophic striae resembling scrotal rugae. However, her serum levels of FSH, LH, 17-KS, 17-OHCS, 5-DHT, DHT and DHEA-S were all in normal range and her karyotype was 46,XX. Abdominal and pelvic ultrasonogram showed a normal uterus and ovaries. Careful history taking revealed frequent use of steroid ointment due to vulvar pruritus for 2 years and she was finally diagnosed to have atrophy of external genitalia induced by long-term use of topical steroid.
Subject(s)
Female , Atrophy , Collagen , Disorders of Sex Development , Genitalia , Karyotype , Ovary , Pruritus , Reference Values , RNA Stability , RNA, Messenger , Skin , Ultrasonography , UterusABSTRACT
The finding of extraluminal gas on plain abdominal radiogram is usually associated with a perforated viscus, and an emergency laparatomy is indicated. But we report herein an immature neonate with spontaneous pneumoperitoneum that was treated successfully with conservative management, although this infant she showed positive result in stool occult blood test. As this case shows, the finding of pneumoperitoneum is not of a surgical emergency, because there are many benign explanations for pneumoperitoneum. A through history taking and physical examination are most important in differentiating between surgical and nonsurgical pneumoperitonium.