Clinical Study of Recurrent Parotitis in Children

PURPOSE: Recurrent parotitis is defined as a recurrent parotid inflammation, generally associated with sialectasis of the parotid gland. It can often be misdiagnosed as recurrent mumps. We studied the clinical and laboratory features of recurrent parotitis. METHODS: Outpatient clinical records of 23 cases were analyzed retrospectively between April 1993 and March 1999. Follow-up after the last outpatient clinic visit was carried out by telephone interview. RESULTS: Mean age of onset was 3.7+/-2.1 yr with 16 cases (69.6%) of 2-4 yr being predominant. Males (56.5%) were affected more than females. Mean number of recurrence per year for patients who recurred more than 3 times was 1.8/yr. Most parotid swellings subsided within 3-7 days. Laboratory findings at first visits were as follows:WBC 14,100+/-7,660/mm3 (neutrophil 56.6+/-18.9%, lymphocyte 35.5+/-17.6%), ESR 19.3+/-7.6mm/hr in males and 24.7+/-6.8 mm/hr in females and amylase 407.4+/-391.8IU/L. An eosinophil count over 250/mm3 was found in 6 out of 23 cases and IgE levels over 150IU/ml was found in 3 out of 14 cases. Anti-mumps IgG was positive in 10 out of 16 cases but anti-mumps IgM was all negative. CONCLUSION: Recurrent parotitis is not uncommon in childhood. Careful history taking and follow-up observation are important for the diagnosis of recurrent parotitis. The clinicians should reassure patients and their parents of the benign disease process.

A Case of Acute Renal Failure Following Intravenous Immunoglobulin Therapy in a Child

Intravenous immunoglobulin (IVIG) therapy is associated with a number of complications, including rare acute renal failure (ARF). Although the cause of IVIG-associated ARF is unknown, it may be related to the stabilizing agent used in IVIG preparations. ARF following IVIG infusion has not been previously described in children. We report a 4-year-old girl with Kawasaki disease who suffered from ARF following IVIG containing maltose. The previously healthy child had no underlying renal disease. She was given a 2g/kg body weight of IVIG (I.V.-Globulin S, Green Cross, IgG:maltose=1:2) for 10 hours. From the second day of IVIG administration, a gradual reduction of daily urine output was observed with an increase of BUN and creatinine levels, which by the fourth day of treatment reached 43.8mg/dL and 4.7mg/dL, respectively. A conservative ARF treatment resulted in a gradual increase in urine output, together with a decrease in BUN and creatinine levels, which after 7 days returned to normal levels. In view of the increasing use of IVIG in medicine, it is imperative that clinicians be aware of this unusual form of renal injury.

Clinicopathologic and Epidemiologic Study of Childhood Nephrotic Syndrome in Daejeon

Cytologic findings from five cases with variable types of Hodgkin's disease were reviewed with special emphasis on the Reed-Sternberg (R-S) cells and their variants, Typical R-S and Hodgkin's cells were mono- or binucleated, and nuclei had rounded smooth con- tour. Acidophilic prominent nucleoli with perinucleolar halo were conspicuous. In comparison to typical Reed-Sternberg cells, L & H (lymphocytic and histiocytic) cells in the lymphocyte predominant type tended to show pop-corn like irregular nuclear contour and to lack the prominent nucleoli. Lacunar cells in the nodular sclerosis type had multilobated nuclei with prominent acidophilic nucleoli. There was no prominent perinucleolar halo in L & H and lacunar cells. In conjuction with the number of Reed-Sternberg cells and back ground findings observed on the smears, the characteristic features of R-S cells and their variants allowed to make typing of Hodgkin's disease.

A Case of 7q-Syndrome

Interstitial deletion of the long arm of the chromosome 7 is a well-defined syndrome which usually arises de novo. But there were few case reports in Korea. A male premature newborn infant that we have experienced had broad nasal bridge with bulbous nasal tip, large low-set ears, chorioretinal atrophy, hypoplasia of the aortic arch, micropenis, feeding difficuties and severe growth retardation, which are characteristic clinical features of the 7q deletion syndrome and confirmed to be a 7q-(q31qter) syndrome by chromosomal study.