ABSTRACT
Two girls aged 1.5 and 3 years, presented with a skin rash, loss of proximal muscle power and malaise. The younger girl recovered quickly after a short course of corticosteroids but the elder girl proved more difficult to treat effectively with corticosteroids, methotrexate, ciclosporin, intravenous immunoglobulins and hydroxychloroquine. This combination of symptoms should make one consider the diagnosis of juvenile dermatomyositis (JDM). To make the diagnosis of JDM, a characteristic skin rash, proximal muscle weakness, elevated muscle enzymes and, possibly, an abnormal EMG or muscle biopsy should be present. Treatment consists, of steroids and, if necessary, immunosuppressive agents or intravenous immunoglobulins. If cutaneous lesions are serious or persistent, hydroxychloroquine may also be prescribed.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Dermatomyositis/pathology , Immunosuppressive Agents/therapeutic use , Child, Preschool , Dermatomyositis/drug therapy , Drug Therapy, Combination , Face/pathology , Female , Humans , Infant , Muscle, Skeletal/pathology , Prognosis , Treatment OutcomeSubject(s)
Cystic Fibrosis/genetics , Membrane Proteins/genetics , Point Mutation , Sequence Deletion , Alleles , Base Sequence , Child , Child, Preschool , Cystic Fibrosis Transmembrane Conductance Regulator , DNA Mutational Analysis , Female , Humans , Infant , Male , Molecular Sequence Data , Polymerase Chain Reaction , Polymorphism, Single-Stranded ConformationalABSTRACT
Q-fever occurs in The Netherlands in childhood more often than used to be believed. We treated an 8-month-old infant with congestive myocarditis associated with a seroconversion against Coxiella burnetii. The infection was probably caused by the father, who a few weeks earlier had visited his native Surinam, where he frequently was surrounded by domestic animals and drank raw cow's milk. After 2.5 years the child's general and cardial conditions are good although digoxin therapy is still necessary.
Subject(s)
Myocarditis/etiology , Q Fever/complications , Antibodies, Bacterial/isolation & purification , Coxiella/immunology , Humans , Infant , Male , Q Fever/diagnosis , Q Fever/transmissionABSTRACT
A retrospective study extending over five years was made of the consequences of ingestion of undesirable substances by children. Despite the publicity on this subject it remains a serious medical problem. An annual average of 90 children were seen in the emergency department. Complications are caused mostly by oil products but also by drugs and household products. On average 55% of the children were hospitalized. With regard to the indication for endoscopical examination of the oesophagus and stomach after ingestion of caustic substances, insufficient arguments for performance of this examination in all children were found in the literature. We advocate a prospective study of this question. With regard to the indication for hospitalization of children after ingestion of tobacco, we are of the opinion that many children may be kept under observation in their homes after being watched for one hour.
