ABSTRACT
Multiple sclerosis is a rare finding in pediatric age. The onset of the disease may be in adolescence or pre-adolescence. It is important that pediatricians know the diagnostic criteria and clinical course of multiple sclerosis in childhood. We describe the case reports of two children, a 11- and a 14-years-old girls and review the literature of the last 5 years on multiple sclerosis in childhood.
Subject(s)
Multiple Sclerosis/diagnosis , Adolescent , Child , Female , Humans , Multiple Sclerosis/drug therapy , Prednisone/administration & dosageABSTRACT
The therapeutic index of antineoplastic agents is generally low, therefore, errors in administration can cause severe, life-threatening toxicity. The publication of cases of overdoses may provide useful information on the causes of the mistakes, on drug-induced toxic effects, and on salvage therapy. We report a case of vinblastine overdose in a child affected by Langerhans' cell histiocytosis, Hand-Schüller-Christian syndrome according with the previous classification of histiocytosis X. To our knowledge this is the highest dose of vinblastine ever administered. The child was given salvage therapy with steroids and citrovorum factor. Major side effects were neurologic toxicity (seizures, coma) and marrow aplasia, which improved and gradually resolved beginning day 12.
Subject(s)
Bone Marrow Diseases/chemically induced , Coma/chemically induced , Histiocytosis, Langerhans-Cell/drug therapy , Medication Errors , Seizures/chemically induced , Vinblastine/poisoning , Adrenal Cortex Hormones/therapeutic use , Bone Marrow Diseases/drug therapy , Coma/drug therapy , Female , Humans , Hypothalamo-Hypophyseal System/drug effects , Infant , Intestinal Pseudo-Obstruction/chemically induced , Leucovorin/therapeutic use , Osteolysis/drug therapy , Osteolysis/etiology , Poisoning/drug therapy , Prednisone/therapeutic use , Seizures/drug therapy , Vasopressins/metabolism , Vinblastine/administration & dosage , Vinblastine/pharmacologySubject(s)
Leucovorin/therapeutic use , Methotrexate/administration & dosage , Myelodysplastic Syndromes/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Bone Marrow/pathology , Child , Cytological Techniques , Humans , Infusions, Intravenous , Interphase/drug effects , Pilot ProjectsABSTRACT
About 5-10% of boys with acute lymphoblastic leukemia (ALL) present with isolated testicular relapse. Very frequently these relapses occur during treatment or in the following six months, and in these cases the prognosis is very severe. The patients are usually treated with radiotherapy and chemotherapy or bone marrow transplantation (BMT). Testicular relapses after BMT are relatively rare. We report the case of a child with ALL who presented testicular relapse during therapy and was treated with local radiotherapy (2000 cGy), chemotherapy and allogeneic matched BMT. The preparative regimen consisted of Cyclophosphamide (60 mg/kg/day x 2 days) and total body irradiation (200 cGy x 2/day x 3 days). Engraftment was documented at day + 14. The patient presented again with testicular relapse at day + 146, and was therefore treated with orchiectomy, local radiotherapy and systemic chemotherapy. A marrow relapse followed, however, at day + 284 and the patient died of progressive disease.
