Sarcomatoid Renal Cell Carcinoma in an Adolescent with Sickle Cell Anaemia.

Malignancies have been reported to occur in people with sickle cell disease. Renal medullary carcinoma (RMC), also tagged seventh sickle cell nephropathy, is an aggressive cancer seen almost exclusively in people with sickle cell disease with more than 160 cases reported worldwide, but only few cases were reported in patients with sickle cell anaemia (HBSS) and from Nigeria. Sarcomatoid renal cell carcinoma is a renal tumour of any histologic variant containing foci of high-grade malignant spindle cells. We report an adolescent girl with sickle cell anaemia (HBSS) who presented with left renal tumour, histology of which confirmed a diagnosis of sarcomatoid renal cell carcinoma (sRCC). Surgical debulking and palliative care with chemotherapy were given, and she demised 10 months after. The rarity of the case and challenges of managing a cancer in the background of a chronic haematologic disorder are highlighted.

Seroprevalence of IgG antibodies to herpes simplex virus type-1 in Nigerian children.

BACKGROUND: Herpes simplex virus type-1 (HSV-1) can cause chronic ulcerative infection in immunosuppressed children leading to latency with subsequent reactivate in the conjunctiva resulting in scarring, thickening of the cornea and blindness. They are also common cause of fatal sporadic encephalitis in 70% of paediatric patients. This cross sectional study determined the prevalence of HSV-1 in children in Kaduna State, Nigeria. METHOD: A total of 377 blood samples were collected from children less than five years old attending some selected hospitals in Kaduna State and analyzed for HSV-1 IgG antibodies employing Enzyme immune assaytechnique by using commercially available ELISA Kits. RESULTS: Sero-prevalence rate of 57.8% (218/377) was obtained. The highest prevalence of HSV-1 infection was obtained in children in age group 49-60 months (85.2%) and lowest in children in age group 13-24 months (44.8%). Further analysis of the result of children less than one year old showed that children 9-16 weeks old were more susceptible to HSV-1 infection. HSV-1 infection was significantly associated with age (X2 = 37.92, df = 4, p = 0.001). Though a higher prevalence was obtained in female children (61.5%) than male children (54.5%), the difference observed in the prevalence was not statistically significant (X2 = 1.84, df = 1, P = 0.105). HSV-1 infection was significantly associated with children who were in school (X2 = 15.28, df = 1, P = 0.001) with a higher prevalence of 74.3%. CONCLUSION: Over half of the children sampled were protected from HSV-1 infection while 42.2% were susceptible to the infection and were at risk of developing severe HSV-1 manifestation which includes keratitis, encephalitis and Keratoconjunctivitis.

Gangrene of the limb complicating Salmonella typhi septicaemia in a Nigerian child.

We report an unusual case of lower limb gangrene in a pubertal boy following a typical clinical presentation of septicaemia due to Salmonella typhi. After an initial response to presumed appropriate antibiotic and supportive therapy, the patient developed tissue ischaemia in both feet. There were no clinical or laboratory evidence suggestive of DIC or coagulopathy. Following conservative management which included oral administration of vitamin C, there was gradual regression of ischaemic changes, progressive healing and recovery of function of the left foot while the condition of the right foot deteriorated with extensive tissue necrosis and dry gangrene that extended to the distal one third of the foot. This necessitated surgical disarticulation of the metatarsophalangeal joints two months after admission. This report is to alert clinicians about this rare complication of a common curable disease with a view to anticipating the possibility of it occurring as well as considering appropriate preventive measures.