ABSTRACT
Patients with profound sensorimotor deficits following spinal trauma/post spinal surgery are vulnerable to develop pressure ulceration. Here we present an unusual case of multiple pressure ulcers in an 11-year-old paraplegic child, with histiocytoma of the spine at the T1-T3 level. Although multiplicity of ulcers is not uncommon, this was the first case, in our institute, in which such a large number of pressure ulcers were encountered in a child. Successful management, using a multidisciplinary approach, led to improved quality of life and, at follow-up of more than 1 year, the child has not developed any new pressure ulcers, and neither is there any recurrence.
Subject(s)
Histiocytosis, Langerhans-Cell/surgery , Laminectomy/rehabilitation , Paraplegia/complications , Pressure Ulcer/etiology , Pressure Ulcer/surgery , Skin Transplantation , Spinal Diseases/surgery , Child , Histiocytosis, Langerhans-Cell/rehabilitation , Humans , Male , Paraplegia/rehabilitation , Spinal Diseases/rehabilitationABSTRACT
Two patients with retinal vascular disease also had antiphospholipid antibodies, defined by the presence of the circulating lupus anticoagulant (LAC), anticardiolipin antibodies, or both. One had retinal arterial occlusions and the other had a nonischemic central retinal vein occlusion. The association of thrombotic vascular disease, including both retinal and cerebral vessels, with the presence of these antibodies should be investigated in otherwise normal individuals or in patients presenting with a lupuslike syndrome and retinal vascular occlusive disease. Low-dose aspirin administration could be of therapeutic value in managing thrombotic events in this group of patients.
Subject(s)
Autoantibodies/metabolism , Phospholipids/immunology , Retinal Diseases/immunology , Adult , Arterial Occlusive Diseases/immunology , Blood Coagulation Factors/immunology , Blood Coagulation Factors/metabolism , Cardiolipins/immunology , Female , Humans , Lupus Coagulation Inhibitor , Male , Retinal Artery , Retinal Vein Occlusion/immunologyABSTRACT
Chronic idiopathic neutrophilia is a rarely recognized finding in otherwise healthy subjects. Described here is a case, not previously reported; in which the patient also had congenital asplenia. Studies carried out to determine the mechanism for the neutrophilia are also described. The results show that the patient's neutrophilia was associated with an enlarged circulating pool of neutrophils, increased production and utilization of neutrophils and a short blood granulocyte survival. The findings differ completely from those observed in patients with chronic idiopathic neutrophilia and intact spleens. The results suggest that (1) the mechanism for neutrophilia in patients with chronic idiopathic neutrophilia varies and depends upon the presence or absence of the spleen, and (2) the spleen has a role in the control of neutrophil production, distribution and utilization.
