RESUMO
Background: Kawasaki disease is an acute febrile vasculitis of childhood. Macrophage activation syndrome is a rare life threatening complication. Case characteristics: 4-yearold boy with Kawasaki Disease treated with intravenous immunoglobulins. Observation: He developed encephalopathy, hepatosplenomegaly and pancytopenia. Blood investigations and bone marrow aspiration suggested macrophage activation syndrome. Outcome: Good response to pulse methylprednisolone (30 mg/kg/d) for 5 days. Message: Macrophage activation syndrome may complicate Kawasaki disease.
RESUMO
OBJECTIVE: To identify ADHD children, to show the prevalence of the disorder in the age group of 5-12 years and to study their socio-demographic variables, associated medical and co-morbid psychological problems. METHODS: This is a cross-sectional case study of ADHD children presenting to a child guidance clinic in a busy pediatric hospital over a one year period. The diagnosis of ADHD was based on DSM IV criteria. RESULTS: Of the 238 children referred, 37 were diagnosed as ADHD. 64.9% of the referrals were from pediatricians. The prevalence of ADHD in pediatric clinic was 15.5%, the inattention subtype was predominant. The mean age of boys and girls with ADHD was 8.49 years and 6.82 years respectively. The male to female ratio was 6.4:1. Majority of patients were from middle socio-economic status belonging to Hindu families. 27.0% of children had developmental problems. Oppositional defiant disorder was the most prevalent while depression was the least prevalent co morbid problem. CONCLUSION: ADHD is prevalent in India and the bunch of these children are mostly presenting to the pediatrician. They need to be aware of the profile of this disorder for early detection and intervention.