[ transfusion related incidents in polytransfused children: the experience of 11 years of paediatric activity]

In this study, we suggest analyzing the main transfusionnel incidents arisen during the activity of transfusion in the day hospital of the national center of bone-marrow transplant. It was a retrospective study over 11 years enlisting 200 patients all transfused at least once. They were distributed into 111 boys and 89 girls. Their average age was of 9 years [1-25 years]. We call incidental transfusionnel any unexpected or unwanted effect of transfusion origin. This incident is immediate when it arises during 8 days following the transfusion, it is delayed exceeded these deadlines. During these 11 years of activities our 200 patients received 22680 pockets of blood. The main transfusion indications were beta thalassemia major in 135 cases and sickle cell disease in 48 cases. Thirty five immediate incidents arose [17.5 per cent] [0.016 incidents / patient/ year]. Twenty eight delayed incidents were noted [14 per cent] [0.012 incidents / patient/ year]. The transfusions related incidents stay rare events. However their census and their compulsory declaration are indispensables to improve the transfusion security

[Rickets secondary to celiac disease [a study of new case]]

Rickets secondary to celiac disease is rarely reported in children. We report a new paediatric observation. A 4-year-old girl presented for pallor associated with genu valgum evolving since the age of 3 years. She had experienced intermittent diarrhea since the age of 2 years. Physical examination revealed signs of rickets. Phosphocalcic assessment was disturbed with hypocalcaemia, hyperparathyroidism, low urinary calcium level and elevated level of serum total alkaline phosphatase. Radiography revealed metaphysical epiphysis abnormalities. The result of antibody screening for celiac disease [anti-gliadin, antiendyomysial and antitissue transglutaminase antibodies] was highly positive. Histological examination of duodenal biopsy showed an atrophy of the intestinal mucous membrane suggestive of celiac disease. Treatment with a gluten-free diety yielded remarkable improvement. Celiac disease should be considered in children with rickets, especially because intestinal symptoms may be mild