The Journal of pediatrics
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The Journal of pediatrics · Apr 1997
Case ReportsIntravenous ribavirin therapy in a neonate with disseminated adenovirus infection undergoing extracorporeal membrane oxygenation: pharmacokinetics and clearance by hemofiltration.
Intravenously administered ribavirin (20 mg/kg per day) was given to a neonate with disseminated adenovirus infection requiring extracorporeal membrane oxygenation and hemofiltration. Plasma concentrations at steady state were 4.81 to 8.47 micrograms/ml, hemofiltration sieving-coefficient was 0.85, and hemofiltration clearance (0.046 L/kg per hour) was similar to the renal clearance reported with normal kidney function. Despite low plasma concentrations, results of viral cultures were negative within 48 hours of initiation of ribavirin therapy, suggesting that plasma concentrations may not adequately predict inhibition of adenovirus replication in vivo.
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The Journal of pediatrics · Apr 1997
Progressive and fluctuating sensorineural hearing loss in children with asymptomatic congenital cytomegalovirus infection.
To determine the prevalence and temporal changes of sensorineural hearing loss (SNHL) among children with clinically inapparent (asymptomatic) congenital cytomegalovirus (CMV) infection identified from a cohort of newborn infants screened for congenital CMV infection. ⋯ Asymptomatic congenital CMV infection is likely a leading cause of SNHL in young children. The continued deterioration of hearing and delayed onset of SNHL in these children emphasizes the need for continued monitoring of their hearing status.
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The Journal of pediatrics · Apr 1997
Infants with Kasabach-Merritt syndrome do not have "true" hemangiomas.
In 1940 Kasabach and Merritt described an infant with a vascular anomaly, extensive purpura, and thrombocytopenia; they called his lesion "capillary hemangioma." Hemangioma is a benign tumor that grows in infancy and is characterized by proliferation of endothelial cells and regression during childhood. Although Kasabach-Merritt syndrome (KMS) is frequently mentioned as a possible complication of hemangioma, our experience suggests that the anatomic vascular lesion underlying the thrombocytopenia is not a "true," classic, involuting type of hemangioma of infancy and childhood. ⋯ KMS is a distinctive disease of infancy, but the underlying vascular lesion is not a "true," classic, involuting type of hemangioma of infancy. This is a different vascular tumor with a resemblance pathologically to either tufted angioma or kaposiform hemangioendothelioma in association with lymphatic-like vessels. Whether the underlying lesion in KMS is a single anatomic entity or heterogeneous cannot be definitely concluded from this study. We need a better understanding of the pathogenesis of KMS to improve our therapeutic management.