[Unusual relapse for neuroblastoma. Case of an intracranial relapse]. / Rechute inhabituelle de neuroblastome. A propos d'une récidive intracrânienne.

The usual sites of initial metastatic deposits in neuroblastoma are osteo-medullary. With modern therapies including megatherapy and hematopoietic rescue, prolonged survival is obtained. However, unusual metastatic sites are more and more often described during the prolonged evolution of these patients such as brain metastases. A case of isolated intracerebral metastatic relapse is reported here in a patient who had received 4 months before a megatherapy in first complete remission. Pathogeny and therapeutical implications are discussed.

[Post-anesthetic hepatitis. The role of halothane and antimitotic combinations]. / Hépatite postanesthésique. Responsabilité de l'association halothane-antimitotiques.

A 12 year old boy with Burkitt's lymphoma developed severe hepatitis with hepatomegaly, subclinical jaundice, and a small rise in body temperature, associated with an important rise in SGPT and fall in prothrombin titres, 6 days after anticancer chemotherapy and 24 hours after halothane anaesthesia. Hepatitis A and B serology remained negative. This hepatic failure explained perhaps the unusually severe vincristine toxicity which gave rise to a polyneuritis with important sequelae. The association of halothane hepatitis with antimitotic drugs appeared particularly dangerous, and halothane should probably be avoided in all patients been given or about to be given anticancer chemotherapy.

[Deficiency rickets in older children. Apropos of 2 cases]. / Rachitisme carentiel chez le grand enfant. A propos de 2 observations.

Typical rickets were observed in a 13 year old Turkish girl and in a 14 year old Moroccan girl. Hypocalcaemia was present in one case. Symptoms have easily regressed with vitamin D2. Seric 25 OH D3 was very low; seric 1-25 OH D3 was normal before treatment and increased very much with vitamin D. In the second case vitamin D deficiency was familial. Study of 15 immigrant children living in or near Saint-Etienne has shown low seric concentrations of 25 OH D3 in 9 (8 undetectable).

[Rare nutritional deficiency anemia: deficiency of copper and vitamin E]. / Anémies carentielles nutritionnelles de cause rare: déficit en cuivre, en vitamine E.

Copper deficiency anemia occurs in some specific situations if supplemental copper is not given: low birth-weight premature infants fed milk only, protracted total parenteral nutrition, chronic diarrhea with severe malnutrition. Severe neutropenia precedes the onset of sideroblastic anemia. Iron therapy is ineffective. Diagnosis is established by the low serum copper concentrations, the delayed osseous anomalies, and the dramatic response to copper therapy. Low serum vitamin E concentrations may be found in low birth-weight premature infants aged six to ten weeks with hemolytic anemia. In such cases, vitamin E therapy is effective. This condition occurs more often in infants fed milk formulas without supplemental copper and in infants given high doses of iron. Whether vitamin E deficiency causes anemia is still an open question. Preventive vitamin E supplementation is only partly effective.