Katsuji Kato

Fatal agranulocytosis following sulfathiazoletherapy

Summary A case of acute and fatal agranulocytosis with toxic dermal lesionsproduced by therapeutic doses of sulfathiazole, occurring in an infant 8 weeks old, is reported. At the time of this writing, no other cases of agranulocytosis following sulfathiazole medication in infants have been recorded, although instances of extreme granulocytopenia in children due to other members of the sulfonamide group have been observed. An experience of this sort re-emphasizes the necessity of exercising the utmost care in the therapeutic use of sulfathiazole in infants and children and of making frequent blood examinations as well as of determining the concentration of the drug in the blood. Despite the fact that absolute proof of this sulfonamide being the sole cause of agranulocytosis is lacking, the circumstantial evidence in our case strongly suggests that both intoxication by and sensitization to this drug played significant roles in the production of the toxicodermatosis as well as of the agranulocytosis which resulted in the death of the patient.

Primary carcinoma of the liver, with Banti's syndrome

Summary A case of primary carcinoma of the liver is reported which occurred in a 6-year-old female child and was characterized by the pronounced cirrhotic changes in the organ, resulting in the development of collateral circulation (caput medusae), esophageal and gastric varices (hematemesis), splenomegaly, ascites, and a hypoplastic blood picture. Analysis of the train of symptoms in this case suggests the advisability of regarding the symptom complex seen in neoplastic diseases of the liver, in Bantis disease proper, and in the Smith-Howard-Wallgren syndrome as indistinguishable from one another, even though each may differ in its fundamental etiology. Clinically, however, all these conditions are typified by their common manifestations resulting from similar sequences of events, all of which may be conveniently designated as “Bantis syndrome.”