ABSTRACT
BACKGROUND AND PURPOSE: Cardiovascular and pulmonary involvement is frequent among patients with systemic lupus erythematosus (SLE). It is important that the frequency and characteristics of pulmonary and cardiovascular involvement in childhood-onset SLE are understood. Thus, we conducted a retrospective analysis of childhood-onset SLE at a tertiary medical center in Taipei. METHODS: Children with SLE diagnosed at the National Taiwan University Hospital between 1985 and 2004 were evaluated by chart review. Records included the age at diagnosis, gender, family history, presenting manifestations with American Rheumatism Association criteria and initial laboratory data, other associated complications and duration of follow-up. RESULTS: A total of 157 cases were included. The male-to-female ratio was 18:82, with the mean age at diagnosis 12.2 years. Overall, pulmonary and cardiovascular involvements were recorded in 89 patients (56.7%) and 75 patients (47.8%), respectively. Among the more frequent lung disorders were pneumonia treated under hospitalization (in 36.9% of patients), increased pulmonary interstitial marking or infiltration (35.0%), and pleuritis (33.1%). The more common cardiovascular manifestations included cardiomegaly (in 33.8%), pericarditis (28.7%) and arrhythmia/conduction anomaly (12.7%). CONCLUSIONS: The frequencies of pulmonary and cardiovascular complications were high. Blood creatinine >1 mg/dL, hematuria and anemia with hemoglobin <12 g/dL obtained at diagnosis of SLE were associated with cardiovascular complications during the disease course, while anti-double stranded DNA at diagnosis was associated with pulmonary complications.
Subject(s)
Lupus Erythematosus, Systemic/complications , Adolescent , Age of Onset , Child , Child, Preschool , Female , Heart Diseases/diagnostic imaging , Heart Diseases/epidemiology , Heart Diseases/etiology , Heart Diseases/pathology , Humans , Lung Diseases/diagnostic imaging , Lung Diseases/epidemiology , Lung Diseases/etiology , Lung Diseases/pathology , Lupus Erythematosus, Systemic/diagnosis , Male , Radiography , Retrospective Studies , Taiwan , UltrasonographyABSTRACT
The authors experienced a case of acute lymphoblastic leukemia whose leukemic karyotypes were associated with changes in chromosome 21 ploidy, and she was also found to have an arachnoid cyst in the posterior fossa. The association between arachnoid cyst and leukemia as described in the literature appear to be quite rare. The clinical and radiologic features of arachnoid cyst as well as cytogenetic abnormalities of the leukemic clones are described in the present article.
Subject(s)
Arachnoid Cysts/etiology , Cranial Fossa, Posterior/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Child, Preschool , Female , Humans , Magnetic Resonance ImagingABSTRACT
BACKGROUND: We report on the experience of retinopathy of prematurity (ROP) at Chang Gang Memorial Hospital (CGMH), Keelung, Taiwan over a 10-year period. METHODS: A retrospective review was made of data of all premature infants with a diagnosis of ROP at Keelung CGMH between 1994 and 2003. Data on certain characteristics including gender, gestational age (GA), birth body weight (BBW), stage of ROP, and treatment modalities were collected and analyzed. RESULTS: Among the 458 infants screened for ROP, 148 eyes of 74 premature infants were diagnosed as having ROP. Threshold ROP occurred in 24 eyes of 12 infants. The average BBW and GA were significantly lower in the threshold than in the non-threshold ROP group (p < 0.05). According to medical records of the 24 eyes of the 12 patients receiving transscleral cryotherapy, anatomical success was attained in 13 (81.3%) of 16 eyes. CONCLUSIONS: This review found low GA and BBW to be major risk factors for ROP. This review shows that transscleral cryotherapy for treating threshold ROP achieved anatomical success in about 80% of eyes. However, myopia, amblyopia, and strabismus remain major sequelae. Laser therapy is now believed to be less damaging to ocular structures and just as effective as cryotherapy in treating ROP.
Subject(s)
Retinopathy of Prematurity/etiology , Birth Weight , Cryotherapy , Female , Gestational Age , Humans , Incidence , Infant, Newborn , Male , Retinopathy of Prematurity/epidemiology , Retinopathy of Prematurity/therapy , Retrospective Studies , Risk FactorsABSTRACT
Although magnetic resonance imaging (MRI) is not performed routinely in the diagnostic work-up of children with leukemia, patients may present with a normal peripheral blood cell count and osteological manifestations. For such cases, MRI may be requested in the early workup for a diagnosis. This situation illustrates that a delay in appropriate diagnosis may occur, with the classic features of the disease being uniformly absent. We present a child illustrating the salient features of acute leukemia upon MRI with limb pain and an initial normal peripheral blood cell count.
Subject(s)
Bone Marrow/pathology , Magnetic Resonance Imaging , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Child, Preschool , HumansABSTRACT
Hepatoblastoma is a rare childhood embryonal malignancy. Recent reports suggested a linkage between premature birth and later development of hepatoblastoma. In August 2000, we encountered a 24-month-old boy with extremely low birth weight who developed hepatoblastoma with an unfavorable histology. His birth weight was only 584 g. Radiological evaluation of the liver revealed a hypoattenuated tumor occupying the left lobe. His initial serum alpha-fetoprotein level was 4032 ng/mL. The patient underwent successful left hepatectomy. The histological examination showed that the tumor, weighing 210 g, was a hepatoblastoma of epithelial type in two different patterns. One was composed purely of fetal type of tumor cells, whereas another was made up of embryonal type of cells in a macrotrabecular pattern. Four courses of adjuvant chemotherapy were given after surgery and were well tolerated. The patient remained in clinical remission 18 months after diagnosis.
