Plasma & urinary catecholamines & urinary vanillylmandelic acid levels in patients with generalized vitiligo

Background & objectives: Vitiligo is an acquired skin disease characterized by depigmented areas of the skin. Increased release of catecholamines from autonomic nerve endings in microenvironment of melanocytes in affected skin might be involved in the aetiopathogenesis of vitiligo. Levels of catecholamines are considered as being related to onset or worsening of the disease. Therefore, in this study, the role of catecholamines was evaluated in mapping disease stability and outcome of vitiligo patients undergoing melanocyte transfer. Methods: In this study, circulatory and urinary levels of catecholamine (CA) and vanillylmandelic acid (VMA) were determined in 45 individuals (30 vitiligo patients and 15 healthy controls) using ELISA. Results: A significant increase for plasma and urinary catecholamines along with VMA was observed as compared to healthy controls. When the pre- and post-intervention levels were analyzed in responders and non-responders, respectively, only dopamine showed significant decline in urine, rest of the molecules in plasma as well as urine showed non-significant decline except VMA which showed insignificant increase. Interpretation & conclusions: Levels of plasma/urinary epinephrine, and plasma dopamine, could not be established as biomarkers for disease stability or successful outcome of autologous melanocyte transfer in generalized vitiligo patients. However, dopamine (urine) might be of help in determining the stability in patients with generalized vitiligo undergoing melanocyte transfer. Further studies need to be done on a large sample of patients to confirm our findings.

Solitary rectal ulcer syndrome: uncommon cause of rectal bleeding in children.

Rectal polyp and hemorrhoids are common causes of bleeding per rectum in pediatric age group. However, there are some other causes which should be considered in differential diagnosis. We have acquainted a case of rectal bleeding due to solitary rectal ulcer in a child of 10 year. Colonoscopic examination was required for diagnosis as proctoscopic examination and digital rectal examination missed the diagnosis, probably due to poor co-operation by the patient and rare nature of the disease. Although well recognized in the adult population, the pediatric experience with this condition is limited.