A Case of Congenital Chylothorax in a Premature Infant

We experienced a case of isolated fetal pleural effusion diagnosed by antenatal ultrasonogram in the 33th week of gestational age. Chest PA at birth showed massive pleural effusion in both lungs. The serous pleural fluid changed to a milky nature after feeding so we diagnosed it as congenital chylothorax. The infant was managed by chest tube drainage, NPO & TPN with good response and was discharged on the 28th hospital day. We report the case with a brief review of its related literature.

Systemic Interferon-Gamma Therapy for Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: Atopic dermatitis is a chronic, inflammatory skin disease characterized by intense pruritus and an immunologic profile consistent with allergic disease. It is associated with increased eosinophil and IgE level and decreased INF-gamma production. We describe the result of a treatment with INF-gammaand assess the clinical, immunologic, and laboratory data of 12 patients with atopic dermatitis. METHODS: Twelve patients were treated for 12 weeks with 2x106 units/m2 INF-gamma by subcutaneous injection. General hematologic tests were done, and total eosinophil counts, eosinophil fractions, neutrophil fractions, and IgE levels were measured before the treatment, 2 weeks after the treatment, 12 weeks after the treatment serially. We also followed up the patients for 12 weeks after discontinuing INF-gammatherapy. RESULTS: All patients showed clinically significant improvement after 12 weeks of the systemic INF-gammatherapy. There was no clinical aggravation during the therapy period and the follow-up 4 weeks without the therapy. But the recurrence rate in the 12 weeks after discontinuing the therapy was about 40%. Eosinophil counts and eosinophil fractions were significantly decreased after the therapy. And, eosinophil counts and eosinophil fractions were increased in clinically aggravated patients during the 12 weeks of off-therapy. CONCLUSION: We conclude that INF-gammais an effective therapy in atopic dermatitis without significant side effects. The eosinophil counts and eosinophil fractions were decreased during the INF-gamma therapy, and increased in clinically aggravated patients after the off-therapy. There was no aggravation during the therapy. But 5 patients were clinically aggravated during the 12 weeks of off-therapy. Further studies for a long-term maintenance therapy and its side effect might be needed in chronic atopic dermatitis.