[Value of procalcitonin measurement in materno foetal infection]

Materno foetal infection [MFI] remains one of the major causes of neonatal morbidity and mortality. Early detection of neonatal sepsis can be difficult, because the first signs of the disease may be unspecific and similar to symptoms of other non-infectious processes. We aimed to investigate the role of procalcitonin [PCT] in the diagnosis of fetal infection [MFI], and to compare it with those of the C-reactive protein [CRP]. We have conducted a prospective study during 20 months; which concerned 25 new-borns suspected of MFI and admitted before 12 hours of life. All newborn had anamnestic and / or physical signs of possible infection. MFI was confirmed in newborns with positive bacterial analysis. CRP and PCT were determined in the sera at H12, H24, H36 and H48. Newborns were divided into: patients with recognized MFI [group 1], patients with possible MFI [group 2] and non infected newborns [group 3]: The specificity of PCT was 80% versus 27% for the CRP. Negative predictive value of PCT was 85% versus 66% for the CRP. The mean values, at H12, H24, H36 and H48, of PCT for newborn who had MFI were statistically grater than those for no infused group [p <0.05]. No statistical difference was observed concerning CRP values. PCT may a useful tool in early diagnosing of MFI; it has better specificity and negative predictive value than CRP

[Clinical and etiological features of primary adrenal insufficiencies in children]

The chronic primary adrenal insufficiency or Addison's disease is uncommon in children and belongs generally to a complex syndrome. Study of the clinical and aetiological features of primary adrenal insufficiencies in children. In a retrospective study, we reviewed clinical and diagnostic data of all cases of Addison's disease admitted within a period of 15 years [from January 1991 to December 2006], in a department of paediatrics. Cases due to congenital adrenal hyperplasia were excluded. 6 cases of Addison's disease were diagnosed. Five patients are the product of consanguineous marriage. The age at the diagnosis of adrenal insufficiency yarned from 15 months to 9 years 8 months. The adrenal insufficiency was associated to Allgrove syndrome in three cases, to autoimmune polyendocrinopathy type 1 in one patient and to probable peroxisomal disease in another one. The etiological disease was not determined in one patient. A substitutive hormonal therapy was conducted in all patients. During a mean follow-up of 26 months, two adrenal crises were noted. larger studies about Addison's disease are needed to confirm the preponderance of the Allgrove syndrome

[Brucellosis. report of a case]

The brucellosis is an infectious disease caused by brucella. We reported a case of brucellosis in a 14 year old boy admitted for a trailing fever and slimming. The diagnosis was confirmed by two blood cultures and the serodiagnosis of Wright. He was treated by rifampicin and doxycyclin. Two weeks later, he developed a brucella arthritis [spondylodiscitis]. The evolution after six months of treatment was good. This arthritis must be searched earlier with the radiologic explorations

[Digeorge syndrome in a new born: DEL22q11.2 IN Tuple1 Locus]

The DiGeorge syndrome is a genetic anomaly due to the microdeletion 22q11.2. This syndrome is characterized by a large variability in the clinical features. In this report we describe a DiGeorge syndrome diagnosed in a new born of a diabetic mother. He presented mild dysmorphia, ventricular septal defect and hypocalcaemia due to hypoparathyroidism. The diagnosis was confirmed by the cytogenetic study

[Doose syndrome or myoclonic-astatic epilepsy: two new Tunisian cases]

Myoclonic astatic epilepsy belongs to the epilepsies with generalized seizures. It occurs in 1-2 per cent of all childhood epilepsies up to age 9. The disease is characterized by age of onset mostly between 2 and 6 years and by various clinical and EEG criteria [myoclonic or astatic seizures, 4-7 Hz background rhythm, polyspikes and waves in electroencephalogram]. The authors report two cases answering these criteria. It is about 2 old boys respectively of 2 years and a half and of 18 months during first seizures. Attacks were polymorphic associating myoclonic seizures, absences and astatic crises causing traumatism. These attacks are associated to clonic generalized seizures in one case. The electroencephalograph showed a thorough rhythm of 4-7 Hz. Cerebral imaging was normal at the 2 childs. The psychomotor development is normal in spite of the rebel character of crises justifying the use of several therapeutic alternatives during the evolution