Neonatal lupus erythematosus in Thailand.

Systemic lupus erythematosus (SLE) is not uncommon in Thai children and adults but neonatal lupus erythematosus has never been reported in Thailand. A case of NLE born of a mother without prior history of SLE was reported. He was initially misdiagnosed as congenital self-healing histiocytosis because of seborrheic dermatitis-like lesions, petechiae, hepatosplenomegaly and thrombocytopenia. Features supporting the diagnosis of NLE in this case were presented.

Effect of phototherapy on nutrients utilization in newborn infants with jaundice.

The effect of phototherapy on digestion and absorption of nutrients was performed in 25 male, newborn infants with hyperbilirubinemia. The infants were divided into 2 groups; one group was fed with lactose formula whereas the other group received the non-lactose formula. The quantities of daily volume, fat and energy intakes of both groups were similar. Protein intake was significantly higher in the latter group. During 72-hours of phototherapy, there were decreases in serum bilirubin in all infants and mean weight change was decreased in infants fed with non-lactose formula. Treatment by phototherapy in jaundiced infants did not affect protein, fat and energy absorption. The presence of loose stool, lower stool pH and trace in reducing substances in some subjects fed with lactose formula suggests mild lactose intolerance. Prospective study in clinical trial needs to be further assessed and clarified on other nutrients such as amino acids and riboflavin status in these infants during phototherapy.

Neonatal jaundice and glucose-6-phosphate dehydrogenase deficiency.

Ninety-six newborn aged 0-7 days with serum bilirubin of more than 15 mg/dl were studied for the G6PD status using semiquantitative and the assay method. It was found that the result of the 2 methods corresponded. The prevalence of G6PD deficiency was 12.4 per cent (there were 11 boys and one girl). Among the G6PD deficiency and the normal group, there was no difference in the age of the patient, onset of jaundice, bilirubin level, hematocrit status and the reticulocyte count. The semiquantitative method is a reliable as the assay method.

Clinical trial of special premature formula for low-birth-weight infants.

Feeding 25 low birth weight infants during a one month period either with special premature formula or with standard formula resulted in better weight gain, nutritional efficacy, fat absorption, and lower frequency of metabolic acidosis in the special premature formula group. Various biochemical indices demonstrated excellent protein and mineral metabolization of this formula, which seem appropriate for the infants studied (1,000-1,750 g birth weight). Both formulae were well tolerated without any untoward effects.

Immunoglobulins in maternal and umbilical cord blood of Thais.

Quantitative determination of serum immunoglobulins was carried out by radial diffusion technique in 17 mothers and 43 cord blood samples. Mean maternal serum IgG, IgM and IgA were 1471 +/- 349 mg%, 109 +/- 21 mg% and 240 +/- 62 mg% respectively, and these were equivalent to maternal levels in Thai adults. Mean umbilical cord IgG was 1571 +/- 298 mg% and IgM was 10 +/- 5 mg%. IgA was not detected in the cord blood. There were no differences in the immunoglobulin levels between male and female infants. The IgG levels in the maternal sera and those in the cord sera of the corresponding offsprings were almost identical, but those of IgM were markedly different, suggesting a placenta barrier of this latter immunoglobulin. Thus, IgM level above the normal cord blood suggest intrauterine infection.

Haemorrhage in neonatal hepatic necrosis due to herpes infection.

A case of early neonatal severe bleeding and persistent hypoglycemia with a fatal outcome is reported. The autopsy examination revealed the features of neonatal hepatic necrosis. Further study by the electron microscopy indicated the presence of herpes type particles in the nucleus and cytoplasm of the remaining liver cells. Serological study of the maternal blood, post partum, revelaed positive reaction to Herpes simplex virus type 2 at low titer. It is believed that intrauterine herpes infection was responsible for the severe hepatic damage manifesting in complex clinical findings.