Effect of discontinuing of laronidase in a patient with mucopolysaccharidosis type I.

We present a patient on enzyme replacement therapy who showed rapid deterioration when laronidase was discontinued owing to pregnancy.

Use of the gonadal vein in children with difficult central venous access: a novel technique.

In children who require multiple central venous catheterization, the commonly used veins can become thrombosed making central venous access a challenging problem. The authors report on a patient with a rare metabolic disorder who had extensive thrombosis of the superior vena cava and iliofemoral veins, in whom the right ovarian vein was cannulated using a retroperitoneal approach for the placement of a SILASTIC((R)) (Dow Corning, Midland, MI) catheter with an implantable port. This is a useful and reliable technique in children who have difficult venous access.