Lee Cs

Fraternal hepatocellular carcinoma in young children in two families

Two pairs of young brothers from two families with histologically verified hepatocellular carcinoma (HCC) occurred with almost simultaneous onset in each family. In the first family, the boys were 5 and 7 years of age, respectively. Both of them, their parents, and a younger sister were hepatitis‐B‐surfaceantigen (HBsAg)‐positive. In the second family, the two brothers were 9 and 7 years of age, respectively. Both patients, their mother, and maternal grandmother were HBsAg‐positive. The fraternal occurrence of HCC in children under the age of 10 years has not been reported in the literature. The pattern of HBsAg on these families suggests the HCC cases were infected by their mothers, most possibly in the perinatal period, and is additional support for the important role of hepatitis‐B virus in the etiology of HCC. The very early and almost simultaneous onset, however, suggests that additional genetic and/or environmental factors are also important.

Lactose malabsorption and small-intestinal lactase in normal Chinese children.

A total of 852 healthy Chinese children from 1 month to 14 years of age were investigated for lactose malabsorption using the breath hydrogen test. A lactose load of 2 g/kg was administered to 528 children and 1 g/kg to another 324 children. The incidence of lactose malabsorption was significantly different among various age groups and between the two different lactose dosages. While the incidence of malabsorption increased strikingly from the age of 3 to the age of 5 years, the age effect remained constant after the age of 6 years. The lactose load of 2 g/kg induced a higher incidence of malabsorption in study subjects than 1 g/kg did, and the dose effect increased for those aged below 5 years and decreased above 5 years. Small-intestinal lactase was also studied in 34 children aged from 2 months to 15 years. The lactase activity was highest in children 2 years old or younger, gradually decreasing with increasing age. In conclusion, lactase activity in Chinese children decreases gradually after 3 years of age, a finding that correlates well with the results of the breath hydrogen test.