Pédiatrie
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Case Reports
[Diagnostic and therapeutic strategy of bilateral nephroblastoma (apropos of 4 cases)].
Four cases of bilateral nephroblastoma out of a total number of 99 cases have been observed during a period of 18 years at the INSE of Tunis (4%). The frequency of associated anomalies, the familial incidence, the young age of the patients are underlined. The main therapeutic modalities are discussed. Based on the most recent studies published in the literature, the prognosis of bilateral nephroblastoma has been improved in recent years with a possibility of survival at 2 years exceeding two thirds of the cases.
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A familial observation of hypophosphatemic rickets with unusual inheritance and evolution, different from that of X linked hypophosphatemia, is reported. The mode of inheritance was autosomal dominant, a father and his son being affected. Severe early signs of rickets and delayed growth were present in both cases. ⋯ Complete cure of rickets and catch-up growth were obtained with the only treatment of vitamin D (40,000 U/day) in the father and of 1 alpha hydroxyvitamin D (1 microgram/day) in the son. This observation is quite similar to the 'autosomal hypophosphatemic bone disease' described by Scriver et al. It illustrates the heterogeneity of familial hypophosphatemia which presently includes 4 different physiopathological entities.
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Near drowning in a bathtub occurred to a 3 years 7 months old boy. He was resuscitated at home by the firemen before admission in hospital, where he presented coma, convulsions and a massive distension of the abdomen. ⋯ The stomach is filled with air because inadequate position of the catheter. It also may be related to relaxation of crico-pharyngeal sphincter during anesthesia or coma.