[Idiopathic pulmonary hemosiderosis rescue treatment with chloroquine: a case report]

Idiopathic pulmonary haemosiderosis is a rare but potentially lethal disorder. Long-term treatment with corticosteroids may improve the prognosis of this disease. Other immunosuppressive agents have been used in a small number of cases with encouraging results. We report a case of a twelve year old girl presenting a severe form of Idiopathic pulmonary haemosiderosis treated long-term high-dose steroids. That leeds to significant side effects. Chloroquine used after inefficiency of Azathioprine induced a subsequent remission

[ malignant adrenocortical carcinoma of the child to a comment]

Malignant corticossurrenaloma is very rare in childhood. It occurs more often before the age of 5 years. Its pathogeny remains unknown but a genetic predisposition was suggested. The tumor is usually of secreting type and revealed by virilisation and/or Cushing syndrome, seldom by feminization and exceptionally by Conn syndrome. We report the case of a 7 years old girl who presented with a hetero-sexual precocious pseudo-puberty associated to a Cushing syndrome. The clinical examination found an abdominal mass. Hormonal investigation confirmed androgen and gluco-corticoid hypersecretion. Malignancy of the tumor was evoked by MRI. Evolution was marked by a tumoral rupture which required a laparotomy in emergency. The anatomo-pathological examination confirmed the diagnosis. In spite of a favorable immediate post operative evolution, the child died eight days later. Through this observation, we discuss the clinical, biological, therapeutic and evolutive aspects of this affection

[Acute post-streptococcal glomerulonephritis and pneumonia. About 6 cases]

Acute post-streptococcal glomerulonephritis [GNA] typically occurs 7-14 days after streptococcal infection, however some children can develop GNA concomitantly with bacterial pneumonia. ONA and pneumonia is a rare association, its often underestimated, its etiopathogenie remains still not clear. The purpose of this study is to analyse the etiopathogeny, clinical course and the outcome of this association. It is about 6 children hospitalized for GNA and pneumonia among 417 cases of GNA admitted between 1982 and 2003. All patients had at the time of admission abnormal urianalysis associated with respiratory manifestations. The evolution was favorable at 5 patients while the last one presented an empyema, nephrotic syndrome and died by pulmonary emboly. In conclusion the presence of a renal symptomatology at a child with pneumonia should be evaluated for concomitant GNA. This glomerulonephrite has generally a good prognosis, but sometimes specific therapeutic interventions are necessary to avoid the risk of renal failure