Abraham Abrahamov

Bloody diarrhea--a possible complication of sulfasalazine transferred through human breast milk.

Sulfasalazine very rarely causes bloody diarrhea. A 3-month-old infant had bloody diarrhea that could be related to sulfasalazine that had been taken by his mother and was transferred through his mothers breast milk. The patient was exclusively breast fed, and no other known etiological factors could be detected for the infants bloody diarrhea.

Natural course of atrial septal aneurysm in children and the potential for spontaneous closure of associated septal defect

Atrial septum aneurysm (ASA), usually involving the region of the fossa ovalis, has rarely been described in children. In this study, the incidence and natural course of this anomaly were prospectively evaluated in 3,500 children referred for echocardiographic examination. ASA was found in 35 patients, 19 female and 16 male (1.0%). Patients were 6 years of age or younger at the time of diagnosis and 18 were neonates. None of the 750 children with normal echocardiograms had ASA. The most common associated lesion was atrial septal defect (ASD), which occurred in 24 of the 35 patients (69%). Other associated cardiac lesions were ventricular septal defect in 10, pulmonary stenosis in 5, patient ductus arteriosus in 4 and coarctation or interruption of the aorta with subaortic membrane in 2. No clinical complications were associated with ASA. Six patients with complex heart disease died. When associated with ASD, the direction of the ASA motion and that of the shunt found by Doppler echocardiography were similar. Fourteen patients with ASD were followed for 0.5 to 4 years. In 8 the ASD closed and in 6 the ASA disappeared. In 6 patients the ASD and ASA persisted until the end of the follow-up (p less than 0.01). Thus, the incidence of ASA in children in this series was higher than previously presumed and usually was associated with other cardiac anomalies, mainly ASD. In children, ASA tends to disappear with age and may have a role in spontaneous closure of associated ASD.

Pancreatitis as a complication of Henoch--Schonlein purpura.

A 5-year-old girl suffering from Henoch--Schonlein purpura developed severe abdominal pain accompanied by vomiting and fever. Concomitantly, the serum amylase level became elevated and leukocytosis developed, with a shift to the left. A diagnosis of pancreatitis complicating Henoch--Schonlein purpura was made. This rare complication is presented, along with a review of the literature.

Prostaglandins in small intestinal mucosa of children with celiac disease.

Diarrhea is one of the important clinical symptoms in patients suffering from celiac disease and is attributed mainly to malabsorption. We determined prostanoid content in small intestinal mucosa of five patients with active celiac disease and in a control group consisting of six patients. Prostaglandin E2 and thromboxane B2 content in duodenal mucosa of patients with active celiac disease was 1,581 +/- 161 and 118 +/- 40 pg/mg wet wt, respectively, significantly higher than their content in duodenal mucosa of the control group, 378 +/- 86 and 8 +/- 8, p less than 0.001 and p less than 0.02, respectively. 6-Ketoprostaglandin F1 alpha content in celiac patients was not significantly different from its content in the control group: 908 +/- 437 and 124 +/- 53 pg/mg wet wt, respectively. It is possible that, in celiac disease, increased mucosal prostanoid content may contribute, at least in part, to intestinal electrolyte and fluid secretion and consequent diarrhea.

Chronic Pigmented Purpura: A Case Report of Schamberg's Disease

The syndrome of chronic pigmented purpura (CPP) consists of pigmented macular lesions, predominantly involving the lower extremities. An 11-year-old girl was diagnosed initially as suffering from vasculitic purpura, but the clinical course and the skin histology proved to be consistent with CPP. This syndrome should be included in the differential diagnosis of childhood purpura.

AN OUTBREAK AMONG CHILDREN OF ASEPTIC MENINGITIS CAUSED BY ECHOVIRUS TYPE 9 A Clinical and Serological Study

An outbreak of aseptic meningitis broke out in a limited residential area of Jerusalem, Israel, in the early summer of 1967. The patients, whose ages varied from 15 months to 10 years, presented a clinical picture of acute meningitis. Nuchal rigidity, positive Kernigs and Brudzinskis signs and high temperature were noted in all cases.

Usefulness of echocardiography and radionuclide ventriculography for diagnosing buckling of the innominate artery in children

Abstract Buckling of the brachiocephalic arteries is a relatively common anomaly. 1–4 Until now, this anomaly has been diagnosed during life only by angiography or as a postmortem finding. 1–4 To the best of our knowledge, involvement of the innominate artery in pediatric patients has not yet been reported. We present 14 patients with buckling of the innominate artery who were diagnosed by 2-dimensional (2-D) echocardiography and nuclear angiography. In 4 patients angiography was also performed and the diagnosis was confirmed in all.