[Late hemorrhagic disease in newborn infants. Is the current preventive treatment with oral vitamin K adequate?]. / Sen haemoragisk sygdom hos nyfødte. Er den nuvoerende perorale K-vitaminprofylakse tilstroekkelig?

During recent years, we have observed two cases of haemorrhage due to vitamin K deficiency which developed late in the neonatal period. One patient was a female infant aged six weeks with severe intracranial bleeding and the other was a female infant aged three weeks with marked haemorrhage from the umbilicus. Both of these infants were entirely breast-fed and had received vitamin K (1 mg fytomenadion) orally at birth. Both infants had unrecognized alfa-1-antitrypsin deficiency with liver involvement. In other European countries, many cases of late haemorrhagic disease of the newborn due to vitamin K deficiency have been registered in infants who had received oral vitamin K prophylaxis. On the basis of these observations and investigations which suggest that oral vitamin K prophylaxis is not so effective as intramuscular administration, it is suggested that the present oral vitamin K prophylaxis should be altered.

Screening for familial hypercholesterolaemia by measurement of apolipoproteins in capillary blood.

A total of 3025 families with schoolchildren aged 6-8 years were offered pilot screening for familial hypercholesterolaemia by measurement of the concentrations of apolipoproteins A-1 and B in the children's capillary blood and by analysis of their family histories of early ischaemic heart disease. The concentrations of the apolipoproteins were determined by double rocket immunoelectrophoresis of an eluate of blood spotted on filter paper. Results were available from 2085 children. Because their B:A-1 ratio was above the 97.5 centile and their concentration of B was above the 99th centile, 54 children (2.6%) were selected to have their apolipoprotein concentrations reassessed. The 17 children (0.8%) whose values were persistently above the chosen cut off points, and all of their available first and second degree relatives, had fasting determinations of serum lipid concentrations carried out. Raised serum concentrations of low density lipoprotein cholesterol and an autosomal dominant pattern of hypercholesterolaemia were found in 12 children and 10 families, respectively, suggesting a higher incidence of familial hypercholesterolaemia than the reported 1:500. Further investigations among family members disclosed hypercholesterolaemia in 29 relatives. A family history of early ischaemic heart disease was elicited by questionnaire, and was positive in only five of the 12 schoolchildren with hypercholesterolaemia. We conclude that analysis of apolipoproteins from capillary blood spotted on filter paper is suitable for screening for familial hypercholesterolaemia, and that this method is more efficient than screening based on family history.

[Congenital cystic adenomatoid malformation]. / Medfødt cystisk adenomatoid misdannelse.

Congenital cystic adenomatoid malformation (MCAM) is a rare disease which commences as a rule in the neonatal period with respiratory distress. The diagnosis is established radiologically but may also be established prenatally by ultrasound scanning. Treatment is surgical. Two cases of MCAM are described. One was a boy aged 5 1/2 months with failure to thrive and the other a 28 week foetus with hydrops foetalis.

[Infantile arterial calcification]. / Infantil arteriel kalcifikation.

A case of idiopathic infantile arterial calcification combined with hydrops foetalis is presented. The pathogenesis, symptomatology and diagnosis are reviewed.