ABSTRACT
We treated two siblings, a sister and brother, who had features of septo-optic dysplasia, including bilateral optic nerve hypoplasia, absent septum pellucidum, and partial pituitary insufficiency. Additionally, midline central nervous system abnormalities of the corpus callosum and cerebellum were shown. The familial occurrence of this disorder raises the possibility of autosomal-recessive inheritance.
Subject(s)
Abnormalities, Multiple/genetics , Optic Nerve Diseases/genetics , Septum Pellucidum/abnormalities , Abnormalities, Multiple/diagnosis , Agenesis of Corpus Callosum , Cerebellum/abnormalities , Female , Fundus Oculi , Humans , Hypopituitarism/genetics , Infant , Magnetic Resonance Imaging , Male , Optic Nerve Diseases/diagnosis , Tomography, X-Ray ComputedABSTRACT
Anti-peripheral-nerve myelin antibodies (anti-PNM Ab) can be detected in the serum of all patients with acute-phase Guillain-Barré syndrome (GBS) thus far tested. Correlation of the titer of this antibody with the clinical course would help to establish a role for the humoral immune system in the pathophysiology of GBS. In this study, anti-PNM Ab levels were measured in serial serum samples of 7 patients with GBS with an assay that detects antibodies bound to peripheral nerve myelin antigens by fixation of the first component of complement. Although the titers of anti-PNM Ab detected in these patients varied between 0 and 256 U/ml, the antibody titer was always highest on admission (35 to 256 U/ml) and rapidly declined during a one-to-three-week period. Disappearance of antibodies or very low levels of them correlated with cessation of progression and considerable clinical improvement as documented by increased pulmonary vital capacity and muscular strength. Low but measurable antibody titers (5 to 12 U/ml) were frequently found up to four months following the acute neurological deficit. The close temporal relationship between anti-PNM Ab titer and the clinical course in GBS suggests that antibody most likely participates through complement activation in peripheral nerve demyelination.
Subject(s)
Autoantibodies/analysis , Myelin Sheath/immunology , Polyradiculoneuropathy/diagnosis , Adolescent , Biological Transport , Blood , Child , Child, Preschool , Complement Fixation Tests , Female , Humans , Male , Middle Aged , Peripheral Nerves , Plasmapheresis , Polyradiculoneuropathy/etiology , Polyradiculoneuropathy/therapyABSTRACT
The syndrome of opsoclonus and myoclonus may be the first presenting symptom of neuroblastoma. The disorder is often controlled by treatment with adrenocorticotropic hormone (ACTH). A child with this disorder and treated with ACTH gel had abnormal uptake of 67Ga in both adrenal glands during studies to attempt to detect an occult neuroblastoma. Repeat 67Ga scans proved to be normal once the ACTH was discontinued and the patient was treated with prednisone. It is concluded that ACTH stimulation of normal adrenal tissue was responsible for these abnormal findings.
Subject(s)
Adrenal Glands/diagnostic imaging , Adrenocorticotropic Hormone/therapeutic use , Eye Movements , Gallium Radioisotopes , Myoclonus/drug therapy , Adrenal Glands/drug effects , Adrenocorticotropic Hormone/adverse effects , Child, Preschool , Diagnosis, Differential , Humans , Male , Myoclonus/diagnostic imaging , Myoclonus/etiology , Neuroblastoma/complications , Neuroblastoma/diagnostic imaging , Radionuclide ImagingSubject(s)
Hemodynamics , Hypotension/complications , Stress, Physiological/complications , Syncope/physiopathology , Adolescent , Blood Pressure , Child , Child, Preschool , Female , Heart Rate , Humans , Hypotension/blood , Hypotension/physiopathology , Norepinephrine/blood , Syncope/blood , Syncope/complicationsABSTRACT
Congenital facial palsy and ipsilateral deafness were found in two children of unrelated insulin-requiring diabetics. Multidirectional tomography showed hypoplasia of the internal auditory canal in each case but the cochlea, vestibule and semicircular canals were radiologically normal. The malformation in these patients must have been determined before 23 weeks of gestational age when ossification of the inner ear is complete. The association of this malformation and maternal diabetes is unlikely to be coincidental.
Subject(s)
Facial Paralysis/congenital , Hearing Loss/congenital , Petrous Bone/abnormalities , Pregnancy in Diabetics , Adult , Child , Facial Paralysis/complications , Female , Humans , Infant , Male , PregnancyABSTRACT
A review of Weber-Christian syndrome in infancy is presented along with the report of two cases. Both infants had low serum properdin levels, and one patient showed remissions of his disease when he was T-lymphocytopenic. This suggests that the T-lymphocyte may have an important role in the pathogenesis of Weber--Christian syndrome.
