A Case of Toxic Epidermal Necrolysis Treated with High Dose Intravenous Immunoglobulin in a 2 Years Old Boy / 소아알레르기및호흡기학회지

Toxic epidermal necrolysis(TEN) is a severe drug induced life-threatening disease and an acute illness. This disease is characterized by rapid onset of widespread necrosis resulting in sloughing of epidermis. The incidence of TEN is very rare, with approximately 0.5 to 1.4 cases per million per year. but TEN has a high mortality rate of 25-40 percent. Therapy for TEN is primarily aimed at supportive care. Treatment with systemic corticosteroid, immunosuppresive agent such as cyclosporine, cyclophosphamide, pentoxifyllin or plasmapheresis have not been shown to improve outcome. Recently, administration of high dose intravenous immunoglobulin(IVIG) has been shown to result in rapid improvement in patients with TEN. There have been several reports of the benefit of IVIG in adult patients with TEN. However we could not find using IVIG in pediatric patient with TEN in Korea. We have experienced improvement in a 2 years old boy with TEN after using high dose IVIG.

Cause of enteroviral infection in children in chungnam area summer, 2005 / 소아과

PURPOSE: Enterovirus infection is a type of viral infection that occurs relatively frequently in children during summer. It has clinical symptoms of non-specific fever, aseptic encephalomeningitis, gastrointestinal diseases, skin rash and, hand-foot-mouth disease. However, it can also occcaisionally, result in fatal symptoms like myocarditis, epicardial inflammation, transverse myelitis, quadriplegia and etc. There have been epidemic enterovirus studies, but not in the Chungnam area. Therefore, we undertook this study in order to comprehend the cause viruses in this area. Methods: We enlisted 157 children hospitalized with enteroviral infections at Soonchunhyang University hospital in Cheonan between May and August 2005. Cerebrospinal fluids or feces were collected during the acute phase after hospitalization, and observed the cytopathic effects caused by enterovirus and using reverse transcription polymerase chain reaction (RT-PCR). RESULTS: The number of children hospitalized due to possible enteroviral infection during the period of study was 157. The number of children who tested positive with the reverse transcription polymerase chain reaction totalled 32 cases (20.4 percent). Among the children with entroviral diseases, 20 were male and 12 were female, thus the sex ratio of male to female was 1.67:1. Their clinical symptoms included fever most frequently (93.7 percent), was followed by headaches (90.0 percent), meningeal irritation signs (65.0 percent), and abdominal pain (30.0 percent). As for the type of isolated enterovirus, there were 17 cases of echovirus 18 and 6 cases of coxsackievirus B5. Furthermore, there were 2 cases of echovirus 9, 1 case of coxsackievirus A6 and coxsackievirus B3, respectively. But 5 cases were not determined by genotype. CONCLUSION: Echovirus 18 is circulating in Korea. We reported on identified enteroviruses, including echovirus 18, using RT-PCR in the Chungnam area during the summer of 2005.

A Case of Epiploic Appendagitis Presented with Right Lower Quadrant Pain of Abdomen / 대한소아소화기영양학회지

An inflammation of an epiploic appendage is a relatively rare cause of acute abdominal pain. It can be clinically misdiagnosed as either acute appendicitis or diverticulitis. Judicious interpretation of imaging with ultrasound or computed tomography may lead to an early diagnosis and prevent unnecessary surgical or medical treatment. Conservative treatment of symptoms is usually sufficient. We have experienced a case of epiploic appendagitis treated by conservative management and report this case with the review of the literature.