Infection associated hemophagocytic syndrome: a report of 50 children.

Fifty children were diagnosed with infection associated hemophagocytic syndrome (IAHS) over the 10 year period from January 1988 through December 1997 at Queen Sirikit National Institute of Child Health, Thailand. Their ages ranged from 2 months to 14 years (mean 4.14 years). There was no difference in sex. Bacterial, mycobacterial, viral, fungal and protozoa were the associated infections in some of these patients. Supportive with specific therapy for the underlying disease was administered aggressively in all patients. Intravenous immuneglobulin (IVIG) was given in 8 patients. Thirty-five patients (70%) died, mostly as a result of coagulopathy with multiple organ failure and opportunistic infections. Two patients developed acute lymphoblastic leukemia 25 days and 3 months after recovering from IAHS.

Wilms' tumor with metastasis to duodenum - the first reported case in Thailand.

A case of Wilms' tumor with gastrointestinal tract metastasis of the duodenum was documented in a 22 month - old - child. She had been diagnosed with Wilms' tumor stage III, treated surgically and by radiation and chemotherapy about 1 year previously. While she was still on chemotherapy, she developed hematemesis and clinical signs of partial gut obstruction. Gastroscopy and upper gastrointestinal series showed an intraluminal vascular mass in the duodenal bulb and histologically proved to be Wilms' tumor. We believe this is the first report in the world of Wilms' tumor with gastrointestinal tract metastasis.

Neonatal screening program in Rajavithi Hospital, Thailand.

A pilot study was conducted in order to identify the cases and determine the incidence of congenital hypothyroidism, phenylketonuria (PKU) and glucose-6 phosphate dehydrogenase (G6PD) deficiency in the newborn infants born at Rajavithi Hospital. During May 1995 - July 1998, 32,407 out of 49,092 (66%) infants were screened for congenital hypothyroidism by measuring thyroid stimulating hormone (TSH) by radioimmunometric assay method. Seven cases of congenital hypothyroidism were identified (incidence of 1 : 4,629 live births). The recall rate was 0.66%. The screening for PKU was done on 17,421 out of 29,443 (59.14%) infants by measuring phenylalanine level by Guthrie method during June 1996 to July 1998. There was no PKU found. From January 1996 to July 1998. 24,714 newborn infants were screened for G6PD deficiency by fluorescent screening technique. The total incidence of 5.13% was found. The incidence in males and females was 9.13% and 1.66% respectively. This study confirms the benefit of the screening program in early detection and treatment of the disorders.

Purpura fulminans produced by Aeromonas hydrophila: a case report.

A case of purpura fulminans produced by Aeromonas hydrophila in a twelve year-old Thai boy was reported. The patient also had aplastic anemia which facilitated the severity of disease. He died despite appropriate antimicrobial therapy.

Atypical lymphocyte in dengue hemorrhagic fever: its value in diagnosis.

Simple peripheral and buffy coat smear were studied in 40 serological confirmed dengue hemorrhagic fever patients, and in other patients with viral and bacterial infections. Atypical lymphocytosis was found in majority of dengue hemorrhagic fever both associated with secondary and also in dengue fever with primary infection as compared to other infections. The time course relationship of atypical lymphocytosis, platelet and hematocrit level were discussed, concerning their value as diagnostic and prognostic criteria in dengue hemorrhagic fever.