Reflex sympathetic dystrophy in a teenaged girl.

A patient had pain, a cold feeling, and absent pulses in the lower part of the right leg. Minimal change was present on Doppler artery examination. She was diagnosed as having reflex sympathetic dystrophy and was treated with nifedipine (Adalat, Procardia). Symptoms gradually diminished, and after three months the results of physical examination were normal, although she still had an occasional cool feeling in the right foot. Reflex sympathetic dystrophy seems to be a common condition, but it is not widely understood and is probably underdiagnosed. It may be seen by primary care physicians as well as by specialists. Treatment is fairly simple. When pain with vasospasm is the presenting manifestation, use of a calcium channel blocker or prazosin (Minipress) in addition to physical therapy should be considered.

Splenomegaly in Hmong refugees.

We review asymptomatic splenomegaly in Indochinese refugees and provide recommendations for evaluation of the problem. Prevalence of splenomegaly in newly arrived Indochinese refugees was 2.5%, three times more prevalent in the Hmong than in the non-Hmong refugees. Male Hmong refugees aged 15 to 29 years had the highest prevalence (10%). For the 50 Hmong refugees studied, there was no evidence that their splenomegaly was caused by clonorchiasis, schistosomiasis, tuberculosis, syphillis, lymphoma, tropical splenomegaly syndrome, or clinical malaria. Cases were more likely to have hepatomegaly, hepatitis B surface antigen positivity, and a low mean corpuscular volume than a reference population of Hmong refugees. Malaria antibody titers were elevated in all but one of the 41 cases (98%) tested.