A Case of Melkersson-Rosenthal Syndrome

Melkersson-Rosenthal syndrome(MRS) is a rare disorder, having a symptom triad of recurrent facial palsy, orofacial swelling and fissured tongue(lingua plicata). This disorder is usually recurrent or progressive, and monosymptomatic or oligosymptomatic forms have been reported to be more common than classic forms. Generally, MRS occurs in young adults at the end of the second decade of life and incidence of the disease in childhood is known to be very low. Although the clinical manifestation of MRS in children is similar to that in adults, early diagnosis and management is essential to avoid long-lasting functional disorders and psychological problems. We experienced MRS in a 13 year old boy with a history of recurrent facial palsy. We report this case with review of related literature.

A Case of Graves Disease with Kyphosis by Osteoporosis

Graves disease is the most common clinical feature of hyperthyroidism in childhood. Clinical manifestations include emotional lability, hyperactivity, tremor, excessive sweating, exophthalmos and weight loss. In Graves disease, osteoporosis could occur because of a disturbance of mineral homeostasis which rarely develops from reduced calcium absorption of the gastrointestinal tract and increased urinary calcium excretion related to an increased bone resorption. We report a case of Graves disease with spinal deformity caused by osteoporosis in a 12-year-old female who was presented with back pain, anterior neck mass and kyphosis. Laboratory findings revealed hyperthyroidsm, hypercalciuria in 24-hour urine and normal serum parathyroid hormone. On radiologic examination, multiple osteoporosis and a spinal compression fracture were observed. The bone mineral density was decreased at the hip and lumbar spine on the bone densitometry. After initiating antithyroid drug, calcitonin and vitamin D, she returned to a euthyroid state and her back pain was improved. Bone density was also increased one year later.