A case of Thrombasthenia

A 6 year 6month-old boy was admitted with complains of severe spontaneou epistaxis and easy brusability. He was one of five siblings, and two of them died of recurred severe epistaxis at their age of six years. There was no history of bleeding tendency to his antecedents and parents, whose marriage was unrelated. Platelet count and partial thromboplastin time were noraml with prolonged bleeding time, but clot retraction was poor. Platelet adhesion(Salzman method) was decreased and platelet aggregation test showed flat curve with no response to epinephrine and ADP. These tests of other were normal. Diagnosis of thrombasthenia was made with the above history and laboratory results.

A case of Thrombasthenia

A 6 year 6month-old boy was admitted with complains of severe spontaneou epistaxis and easy brusability. He was one of five siblings, and two of them died of recurred severe epistaxis at their age of six years. There was no history of bleeding tendency to his antecedents and parents, whose marriage was unrelated. Platelet count and partial thromboplastin time were noraml with prolonged bleeding time, but clot retraction was poor. Platelet adhesion(Salzman method) was decreased and platelet aggregation test showed flat curve with no response to epinephrine and ADP. These tests of other were normal. Diagnosis of thrombasthenia was made with the above history and laboratory results.

Peptic ulcer in childhood

Peptic ulcer disease in children presents an interesting and sometimes difficult problem to the clinicians. Since the incidence is quite small in children, only small collected series have been reported in the literature. With the improvement of diagnostic aids (particularly radiologic equipments and greater attention paid by clinicians, peptic ulcers have been detected with increasing frequency. However, there is a paucity of information available concerning this disease in infancy and childhood in Korea. The symptoms and signs of peptic ulcer disease in childhood are obscure and have many differences from those of tihe adult, which too often go unrecogntzed until complications set in. The authors made on clinical observation on 14 patients with peptic ulcer under the age of 15 years, who had been admitted to the department of pediatrics of National Medical Center from Aug, 1972 to July 1978. The age, sex and seasonal incidences, type and location of ulcer, symptom curation, clinical and laboratory findings, complications and prognosis were analyzed and the data are summerized as follows. 1) The incidence of peptic ulcer in childhood was 0.33% of a total 4221 admissions, and the average number of patients of peptic ulcer per year was 2.3. 2) Among 14 patients, 9 cases (68%) were between 12 and 15 years of age, 4 patients (28%) between 7 and 11, and the majority (93%) were between the ages of 7 and 15. The youngest patients wea 4 year old male. 3) Sex incidence showed that males predominated in a proportion of 13:1. 4) Seasonal incidence was relatively high (inspring) (28.6%) and autumn (42.9%). 5) Three cases (21.5%) had gastric ulcer and 11 cases (78.5%) had duodenal (ulcer, 12 cases were diagnosed as primary type and 2 cases were) thought to be secondary type due to steroid therapy. 6) Duration of symptoms were variable, with the range between 1 week and 3 years. 7) The majority have abdominal pain (100%), vomiting (85.6%) and epigstric tenderness (71.4%), Other symptoms and signs were anemia (42.9%), indigestion (38.5%), melena (38.5%), epigastric pain (28.6%), general weakness (21.5%), weight loss (14.3%) and abdominal rigidity (14.3%). 8) Gastric analysis was performed in 5 patients, 2 of these patients had slight hyperchlorhydria, but 3 cases showed normal results. 9) Complications were found in 4 patients (28.6%). These were perforation (2 cases, 14.3%) and obstruction (2 cases 14.3%). Postoperative condition during hospitalization was excellent. 10) Among the chronic primary ulcer patients (12 cases), ulcer symptoms disappeared in 10 cases with medical treatment such as antacids, tranquilizers and other conservative treatments and within one month after treatments were discharged with improvement.