Encephalitis-Associated Pandemic A [HI N1] 2009 in a Kuwaiti Girl

To report an 11-year-old girl with encephalitis-associated pandemic influenza A [H1N1] 2009 virus infection. An 11-year-old girl presented with a 6-day history of influenza-like illness followed by an altered mental status for 1 day. She tested positive for pandemic influenza A [H1N1] 2009 virus by PCR of her nasal swab. Her CSF analysis was completely normal, including PCR for pandemic influenza A virus. Her brain MRI and EEG showed evidence suggestive of encephalitis. She was treated with oral Oseltamivir with good recovery. This case report shows that neurological complications can occur after respiratory tract infection with pandemic influenza A [H1N1] 2009 Virus

Prevalence and clinical manifestation of celiac disease in Down syndrome patients in Kuwait

Celiac disease is a gluten dependent immune mediated enteropathy. Several gastrointestinal and immune disorders have been found in patients with Down syndrome. The association between Down syndrome and celiac disease has been reported to be between 4-17%. We aimed to look for the Prevalence and clinical manifestation of celiac disease in down syndrome patients in Kuwait. 126 down syndrome patients who where referred to our gastroenterology unit for celiac disease screening from the period 2006 till 2008 were reviewed. Patients charts were reviewed looking for those who have positive antiendomysial antibody and required upper endoscopy to confirm the diagnosis and identifying the number of patients who were proven to have celiac disease by histopathology. Gastrointestinal signs, symptoms and the presence of autoimmune diseases in patients with down syndrome were also reviewed. Out of the 126 down syndrome patients who were screened for celiac disease three patients2.4% were found to have celiac disease. The more frequent symptoms were vague abdominal pain 29 [22.7%], followed by constipation 25 [19.5%], skin rash 10 [7.9%], abdominal distention 10[7.8%], and irritability 7 [5.6%]. Regarding autoimmune diseases hypothyroidism was the most frequent 43 [33.9%], followed by Alopecia 7[5.5%], vitiligo 3 [2.4%], diabetes type 1 2 [1.6%], hepatitis 0 [0%], and pernicious anemia 1 [0.8%].One patient had coexistence of more than one autoimmune disorder hypothyroidism, celiac disease, and juvenile rheumatoid arthritis. screening of celiac disease in Down syndrome patients will help to avoid the harmful consequences of undiagnosed celiac disease, the time interval needs to be determined so, careful evaluation and long term follow up for children with Down syndrome is to be considered in view of the possibility of coexistence of more than one autoimmune disease

Childhood meningitis in Kuwait: epidemiology of etiologic agents and the need for pneumococcal disease prevention

To investigate the epidemiology of the etiologic agents causing bacterial meningitis in Kuwait. This is a retrospective analysis of the medical records of children 1 month to 12 years old who had cerebrospinal fluid [CSF] findings consistent with meningitis. Patients were identified from the records of the Departments of Microbiology and Communicable Diseases in six regional hospitals during 2001. They were divided into bacterial and viral infective groups. Ninety children had CSF findings consistent with meningitis, 44 bacterial [23 culture proven, 21 probable] and 46 viral. Streptococcus pneumoniae and Neisseria meningitidis were the most frequently isolated organisms [44 and 30%, respectively]. A 2-month-old child had Haemophilus influenzae and was the only mortality of this series. S. pneumoniae is the leading bacterial agent causing meningitis in children under the age of 1 year; 61% had bacterial meningitis compared to 37% with viral meningitis. Sequelae were encountered in 23% of bacterial cases. The results indicate that S. pneumoniae is the leading bacterial agent causing meningitis, indicating a need for the introduction of polyvalent pneumococcal vaccine

Antiphospholipid syndrome in an infant presenting with stroke

We report an infant who presented with stroke as a manifestation of antiphospholipid syndrome. To our knowledge, this report is the first case report of primary antiphospholipid syndrome in an infant fro m the Gulf region

Idiopathic pulmonary alveolar microlithiasis in a child

Although pulmonary alveolar microlithiasis is seen mostly in adults, it commonly starts in childhood, but is usually asymptomatic and so not diagnosed. It is of unknown etiology, and it simulates a variety of clinical conditions with almost the same radiologic appearance. The diagnosis rests on the X-ray findings with paucity of clinical signs. There is no known treatment. This is a report of a Kuwaiti child with this condition