Status of Alternative Therapies Used by the Children Visiting the 'Growth Clinic' / 대한소아내분비학회지

PURPOSE: Although growth hormone treatment is now widely used to treat some group of children with short stature, it is still expensive and many parents are seeking alternative therapies. We report the current status of alternative therapies for children visiting the 'growth clinic' in a single tertiary center. METHODS: Questionnaire about the usage of alternative therapy was used. Parents were asked whether they used alternative therapies and where they achieved the information. Also, they were asked whether the treatment was effective, and whether they would continue to use the alternative therapy. RESULTS: Two hundred and twenty nine children (127 boys, 102 girls) visiting the growth clinic in Dongsan Medical Center from February 2005 to January 2006 were analyzed. Their ages were between 6.1 years to 15.4 years (mean 10.4 years). Height Standard Deviation Score (SDS) were between -3.2 to 1.0 (mean -1.1). Twelve boys (9.4%) and 7 girls (6.9%) were more than zero in height SDS value. Among 145 children (63.3%) who used the alternative therapy, supplemental foods and oriental herbs were most widely used (43.3% each) followed by over-the-counter drugs. They attained the information most frequently from their neighbors followed by television, newspaper, and internet. More than half (57.9%) of the parents answered that the alternative therapies were not effective. However, 46.9% of the parents answered they would continuously use the therapy though it is ineffective. CONCLUSION: Many patients visiting the 'growth clinic' for short stature had experiences on the alternative therapies. Although these therapies seemed not quite effective, many parents answered that they would continue alternative therapy.

Supraventricular tachycardia in a neonate with cardiac rhabdomyoma and tuberous sclerosis / 소아과

Primary tumors of the heart are uncommon among pediatric patients. Rhabdomyoma is the most frequent cardiac tumor in infants and children, which is commonly associated with tuberous sclerosis. Tuberous sclerosis is a neurocutaneous syndrome affecting the brain, heart, skin, and other organs. Cardiac rhadomyomas are reported in 50-64% of infants with tuberous sclerosis. Tuberous sclerosis involves multiple locations in the atrium, ventricle and septum, and may induce mechanical obstruction of the outflow tract and heart failure depending on the location, number, size, and degree of invasion of tumors. Arrhythmias may also develop in infants with cardiac rhadomyomas, but only a few of these patients require prolonged anti-arrhythmic therapy because arrhythmia often disappears with spontaneous regression of the tumors, and the ultimate prognosis may be decided by the cerebral manifestations.

Change of absolute neutrophil count after intravenous immunoglobulin administration for the children with idiopathic thrombocytopenic purpura / 소아과

PURPOSE: Intravenous immunoglobulin (IVIG) is effective for the treatment of idiopathic thrombocytopenic purpura (ITP) in children. Recently, several reports have been published that show its impact on the absolute neutrophil count. The present study was performed to confirm these findings. METHODS: Data on 26 ITP patients were analyzed. Patients with febrile illness or increased C-reactive protein levels at presentation, which would influence the neutrophil counts, were excluded to determine the sole impact of IVIG. In addition, patients who received steroid treatment were also excluded. RESULTS: Sixteen boys and ten girls were analyzed. For patients who received an IVIG dose of 0.4 g/kg/day (n=17), the absolute neutrophil count (ANC) measured next day was significantly decreased. For patients who received an IVIG dose of 1 g/kg/day (n=9), the ANC measured the next day was also significantly decreased. However, the decrease was more profound in the high-dose group compared to the low-dose group. Among six cases with profoundly decreased ANC greater than 1,000/ mm3, four patients (67%) received IVIG at a dose of 1 g/kg/day. All four cases with increased ANC were treated with IVIG dose of 0.4 g/kg/day, and three cases (75%) among them had a febrile reaction during IVIG administration. None of the cases with decreased ANC had a febrile reaction. No cases had infectious complications reported. CONCLUSION: IVIG treatment for ITP patients appears to suppress the ANC. This decrease of ANC was more pronounced when a higher dose of IVIG was used. Some cases with increased ANC counts after IVIG use were found only in low-dose IVIG group, and was associated with febrile reactions during IVIG use.

Growth Hormone Therapy in Russell-Silver Syndrome / 대한소아내분비학회지

Russell-Silver syndrome is characterized by low birth weight, growth retardation, delayed bone age, asymmetry, abnormal sexual development, cranio-facial disproportion, short little finger and clinodactyly. Short stature is the major concern, so there have been interests treating Russell-Silver syndrome with human growth hormone. However, there are no large-scale controlled studies to confirm the effectiveness of growth hormone therapy until now because of the rarity of this disorder. In Korea, we cannot find reports dealing with growth hormone treatment in Russell-Silver syndrome. We present three children with Russell-Silver syndrome who showed accelerated growth with growth hormone treatment.