[Behçet's disease in children: cortical calcifications]. / Enfermedad de Behçet en la infancia: calcificaciones corticoencefálicas.

INTRODUCTION: Between 5 and 48% of the patients with Behçet s disease have neurological abnormalities. In children, meningoencephalitis as an initial manifestation of the disease is not frequent. CASE REPORT: We present a four years old girl with a Behçet s disease. When she was six months of age, during an hospitalization caused by malnutrition and respiratory infection, she had developed an aseptic meningoencephalitis and laboratory test showed hypergammaglobulinemia. When she was 21 months old, she had seizures as epilepticus status, and good response was achieve treating with anticonvulsive drugs. She did not repeat episodes of epileptic seizures, but the patient showed language and neuromotor problems. CT was abnormal with asymmetric ventricular dilatation and increased subarachnoides cortical sulci with multiple calcifications in those areas. She also suffered respiratory and gastrointestinal infections that required hospitalization. At the age of 3 years and 6 months, she had occular affection with uveitis, oral and genital ulceration. The clinical history of the girl consisting of meningoencephalitis, gastrointestinal and respiratory disorders, later presentation of uveitis and oral and genital ulcers confirmed the Behçet s disease diagnosis. CONCLUSION: We present a girl with multisystemic disorders characteristic of the Behçet s disease. Initially she had an aseptic meningoencephalitis developing cortical calcifications.

Enfermedad de Behçet en la infancia:calcificaciones corticoencefálicas / Behçet's disease in children: cortical calcifications

Introducción. Entre el 5 y el 48 por ciento de los pacientes con enfermedad de Behçet, presentan alteraciones neurológicas. La meningoencefalitis en la lactancia es infrecuente como manifestación inicial. Caso clínico. Presentamos una niña de 4 años y 10 meses de edad, que a los 6 meses de vida padecía meningoencefalitis aséptica, después de una prolongada internación por un cuadro de desnutrición moderada y neumopatía. Se constató hipergammaglobulinemia. Al año y 9 meses de vida presentó status convulsivo. Posteriormente las crisis epilépticas se controlaron. La paciente presenta un retraso neuromotor y lingüístico. La tomografía axial computarizada demuestra una dilatación ventricular asimétrica, con un aumento de los espacios subaracnoideos corticales que presentaban calcificaciones múltiples. Fue internada en numerosas ocasiones por intercurrencias respiratorias y gastrointestinales. A los 3 años y 6 meses de vida presentaba una afección ocular, uveítis, lesiones bucales y genitales. La historia previa de la niña, su cuadro de meningoencefalitis, trastornos gastrointestinales y respiratorios, la aparición de uveítis, úlceras perianales y bucales e hipergammaglobulinemia corresponden a las características clínicas de la enfermedad de Behçet. Conclusión. Se presenta una niña con alteraciones multisistémicas características de la enfermedad de Behçet, afectada de meningoencefalitis precoz con aparición de calcificaciones corticales (AU)

Antibody response to group A streptococci in an epidemic of streptococcal pharyngitis.

An epidemic of acute pharyngitis involving 280 cases occurred in a kibbutz in Israel during the fall and winter of 1972-1973. Group M and/or T type 12 streptococci was associated with the outbreak. No cases of rheumatic fever and no acute nephritis appeared in spite of the vigorous immune response to both cellular and extracellular antigens of group A streptococci documented in 50% to 80% of patients, suggesting that strain variation may be a feature of rheumatogenicity as well as nephritogenicity of group A streptococcal pharyngitis.

Evaluation of streptozyme and antistreptolysin O tests in streptococcal pyodermal nephritis.

The evaluation of the streptozyme test in sera from 34 patients with streptococcal pyodermal nephritis was studied. Ninety-seven percent of the patients developed high titers of antistreptozyme antibodies on the first bleeding after hospitalization, in contrast to only 40% of patients who developed elevated antistreptolysin O titers. The high antistreptozyme titers declined during convalescence and reached normal levels in the sixth month after onset of the disease. The most significant fall in titers occurred between 1 and 2 months from the onset of disease. The streptozyme test may be particularly helpful as a rapid screening test for antibodies in streptococcal pyodermal nephritis.

Application of enzyme production properties in subtyping of group A streptococci according to T type.

The production of extracellular nicotinamide adenine dinucleotide glycohydrolase (NADG) and the cell-bound lipoproteinase (serum opacity reaction, SOR) by strains of different serological types of group A streptococci, in relation to the T typing, was studied. The production of both NADG and SOR, or only one of them, was found to be characteristic of serotypes, as determined by M and T antigen. No difference in the production of these enzymes was found in relation to M-positive and M-negative variants. Investigation into NADG and SOR production as related to the T type enabled the division of a single agglutination pattern into four main groups, each of which corresponds to one specific M type or more. Of the 370 strains belonging to 12 different T-agglutination patterns, 21% produced both enzymes and 42.5% failed to produce any of them, whereas the remaining 36.5% produced only one out of the two enzymes. Five streptococcal types which did not produce NADG and SOR also failed to synthesize streptolysin S at the early logarithmic phase of growth, indicating that streptolysin S production by young cultures may be also related to serotype. No correlation was found between the production of NADG-SOR as related to serotype and the production of streptolysin O, acid phosphotase, esterase, N-acetylglucosaminidase, hyaluronidase, streptokinase, and the cell-sensitizing factor. The practical and potential usefulness of NADG and SOR production in epidemiological studies is discussed.