Acta paediatrica
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Review Case Reports
Linear IgA bullous dermatosis of neonatal onset: case report and review of the literature.
Several small blisters were noticed on the forehead and the trunk of a newborn boy on day 1. The blisters gradually enlarged and spread over the whole body including the oral mucosa. A skin biopsy was performed twice and subepidermal bullae with polymorphonuclear and mononuclear cell infiltration were demonstrated. Direct immunofluorescence showed linear IgA, IgG and C3 depositions along the basement membrane zone and this finding led to a diagnosis of linear IgA bullous dermatosis. So far, internationally, only one case has ever been reported on the disease at neonatal onset. The skin lesions spontaneously regressed and the mucosal lesions were controlled with diaminodiphenylsulfone. ⋯ In neonates with prolonged blistering, autoimmune disease such as linear IgA bullous dermatosis should be considered within the differential diagnosis and an immunofluorescence study must be performed.
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The prevalence of IgE-mediated food allergy (FA) in childhood varies from 6% to 8% in the first year of life compared to 1% to 2% in adults. In contrast to adults, FA in childhood, often part of the "allergic march", resolves in more than 85% of children, especially those with hypersensitivity to cow's milk and egg. ⋯ Prospective studies of non-selected children, optimally from birth cohorts, are needed to evaluate the effects of such management programmes regarding FA in childhood.
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Instrumental dead space (iDS) is a major part of total dead space in newborns, and thus significantly determines effective alveolar ventilation. Continuous tracheal gas insufflation (CTGI) is a method for reducing the role of iDS, allowing a reduction in respiratory support and secondary lung injury. The literature and authors' experience with the method are reviewed. Major attention is paid to the risks in providing CTGI, optimal equipment and optimal management of CTGI.
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Some of the complex factors that can affect growth in weight but especially in height are discussed. It is emphasized that although due attention needs to be paid to diet and the regular provision of the extra macro- and micro-nutrients needed during catch-up growth, other considerations are just as important. ⋯ As well as dealing with the problem of poor sanitation and consequent frequent infection in developing countries, social stimulation and the restoration of a feeling of well-being and general happiness can be just as important.
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Review Case Reports
Kikuchi-Fujimoto disease: a rare but important cause of lymphadenopathy.
Cervical lymphadenopathy is a common problem in children. Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis) is a rare condition that causes persistent lymphadenopathy and has a characteristic histological appearance. Kikuchi-Fujimoto disease is well recognized in Japan, where it was first described, but descriptions in the paediatric literature are sparse. Paediatricians may therefore be unaware of this rare but important condition. The case is described of a 14-y-old girl suffering from fatigue, weight loss, night sweats and lymphadenopathy. The predominance of systemic symptoms prompted an extensive investigation. The diagnosis of Kikuchi-Fujimoto disease was made after direct histological examination of a lymph node biopsy. The case illustrates the clinical features of this little-known condition and highlights the potential confusion with other diagnoses. The pathological features are discussed and the literature reviewed. ⋯ Kikuchi-Fujimoto disease should be considered in cases of persistent lymphadenopathy. An early biopsy can be instrumental in preventing unnecessary investigations and potentially harmful treatments.