ABSTRACT
OBJECTIVE: To describe the features of Frey syndrome (auriculotemporal nerve dysfunction with gustatory flushing) in childhood. STUDY DESIGN: A multicenter, retrospective, descriptive observational national case series study was conducted with the help of French academic societies. Diagnostic criteria were based on clinical history, and sometimes also on photographs or provocation tests. RESULTS: Forty-eight cases were identified, with 2 subtypes: 35 unilateral and 13 bilateral. Associated sweating was reported in only 10% of cases. Diagnosis was made in only 20% of children at the first consultation and inappropriate dietary restriction was prescribed for 21%. Instrumented vaginal delivery was significantly associated with unilateral forms (OR [unilateral vs bilateral] = 29; 95% CI 3.99-311.58; P < .001). The outcome was favorable overall with 57% regression, 20% recovery, and only 23% persistence of initial symptoms. Regression was more frequent in unilateral forms (OR = 6.60; 95% CI 1.23-44.04; P = .016), observed in 69% of unilateral forms at a median age of 27 (24-48) months. Recovery predominated in bilateral forms (OR = 0.05; 95% CI 0-0.38; P = .001), observed in 58% of bilateral cases at a median age of 8 (7-9) months. CONCLUSIONS: Frey syndrome in childhood is a rare but benign condition with mild symptoms and a favorable outcome in most cases. Unilateral forms are mostly associated with instrumented delivery. Pediatricians should be familiar with this disorder in order to avoid misdiagnosis, mainly as food allergy, and unnecessary referrals and tests.
Subject(s)
Sweating, Gustatory/diagnosis , Child , Child, Preschool , Diagnosis, Differential , Female , Food Hypersensitivity/diagnosis , Humans , Infant , Infant, Newborn , Male , Outcome Assessment, Health Care , Referral and Consultation , Retrospective Studies , Sweating, Gustatory/complications , Sweating, Gustatory/therapyABSTRACT
OBJECTIVE: To study the incidence of Kawasaki disease in the population of the French West Indies. METHODS: Fifty-six children where enrolled between January 1, 1995 and December 31, 2000), in this retrospective study in Guadeloupe (French West Indies), according to the diagnostic criteria of the American Heart Association. RESULTS: There were 31 boys and 25 girls. Their mean age at the time of diagnosis was 26.5 +/- 22 months. The mean incidence was 25.4/100 000 children aged under 5, per year. Cardiac involvement was noted in 17.8% of the cases during the first 3 months, with good outcome in all the children followed-up. CONCLUSION: The incidence of Kawasaki disease in Guadeloupe is high. The absence of epidemiological, clinical or biological predictive criteria of cardiac involvement should prompt the early use of immunoglobulins, notably in atypical presentations of the disease.