[Migrant polyarthritis and EBV infection]. / Poliartrite migrante ed infezione da EBV.

A twelve-years-old boy developed fever, pharyngitis and acute migrant polyarthralgia. An increasing ASO titre was observed, so that rheumatic fever was firstly diagnosed. Finally splenomegaly and positive IgG and IgM against Epstein Barr virus led to the diagnosis of acute EBV infection with polyarthritis. EBV infection should be considered into the differential diagnosis of migrant polyarthritis.

Cricoarytenoid arthritis as an early sign of juvenile chronic arthritis.

A 14-month-old girl developed chronic stridor and dyspnoea. Four months later she presented arthritis, anterior uveitis and positive ANA. Juvenile chronic arthritis (JCA) was diagnosed. Laryngoscopy demonstrated the presence of cricoarytenoid arthritis (CA). The left vocal cord was adducted and immobile, while the right vocal cord had decreased mobility. Erythema and swelling of the arytenoid cartilage on both sides was seen. Steroid treatment resulted in the resolution of these symptoms and made airway control unnecessary. This case demonstrates that CA may be the first sign of JCA, preceding peripheral arthritis. CA should be considered in every child with chronic stridor and laryngeal obstruction.

[Continuous intraesophageal pH monitoring in the study of gastroesophageal reflux (GER) in children. Influence of age on the considered parameters]. / La pH-metria intraesofagea di lunga durata nello studio del reflusso gastroesofageo (RGE) del bambino. Influenza dell'età sui parametri considerati.

Gastroesophageal reflux is a very common event in children; it is studied using 24-hour intraesophageal pH-monitoring, which has a large sensitivity and specificity, but in the literature is not clear if the age of the children could have influence on the parameters considered in the pH-monitoring. The aim of our study is to assess if the age of our small patients could modify the results of pH-monitoring. During 3-year period from 1991-1993 continuous intraesophageal pH-monitoring of 45 children (29 males and 16 females), divided in three groups on the bases of age, homogeneous for number, sex and clinical symptoms, with pathologic reflux time (> 4% of 24 hours) has been evaluated. In our cases the pathologic total reflux time in 24 hours doesn't seem change with age. It has been noted that under two years of age the pH-monitoring measures are homogeneous with a tendency of reflux longer than children over two years. This older group has more after lunch refluxes; that is the number of total refluxes is larger in older children but the number of refluxes with length higher than five minutes is more in younger. These data are discussed in relation to the anatomical and functional gastroesophageal characteristics of the different age of the child.