Maria Serenella Scotta

MEMBRANOUS GLOMERULOPATHY AND CHRONIC SMALL‐INTESTINAL ENTEROPATHY ASSOCIATED WITH AUTOANTIBODIES DIRECTED AGAINST RENAL TUBULAR BASEMENT MEMBRANE AND THE CYTOPLASM OF INTESTINAL EPITHELIAL CELLS

ABSTRACT. A child with an immune‐mediated disease is described, who presented two very rare clinical manifestations, a membranous glomerulopathy with circulating anti‐renal tubular basement membrane antibody and a small‐intestinal enteropathy with circulating antibody directed against the cytoplasm of intestinal epithelial cells. Steroid treatment was followed by complete resolution of the renal but not the intestinal manifestations.

Cell-mediated immunity in children with chronic cholestasis

Cell-mediated immune response was evaluated in 14 children with long-lasting intra- or extrahepatic cholestasis. Cell-mediated immunity was clearly depressed in children with intrahepatic cholestasis while children with extrahepatic biliary obstruction had a more modest and variable degree of impairment. This finding may be related to the longer duration of cholestasis and the higher total bile acid level in the intrahepatic compared to the extrahepatic group. In particular, in children with Byler disease, long-lasting, severe intrahepatic cholestasis was associated with depressed cell-mediated immunity and recurrent severe infections.

Chronic viral hepatitis B in infancy

REFERENCES 1. Schwartz RH, Rodriquez W J, Gundfast KM: Pharmacologic compliance with antibiotic therapy for acute otltis media: Influence on subsequent middle ear effusion. Pediatrics 68:619, 1981. 2. Buchanan GR, Siegel JD, Smith S J, et al: Oral penicillin prophylaxis in children with impaired splenic function: A study of compliance. Pediatrics 70:926, 1982. 3. Chretien JH, McGarvey M, Destwolinski A, Esswein JG: Abuse of antibiotics: A study of patients attending a university clinic. Arch Intern Med 135:1063, 1975. 4. Haggerty R J, Roghman K J: Noncompliance and self medication: Two neglected aspects of pediatric pharmacology. Pediatr Clin North Am 19:101, 1972.

Exocrine pancreatic function in children and adolescents with insulin-dependent diabetes mellitus

Exocrine pancreatic function was evaluated in 21 diabetic children on the basis of a p-aminobenzoic acid (PABA) test and a determination of fasting serum amylase, pancreatic isoamylase, lipase, trypsin and elastase levels. Fecal chymotrypsin was also measured. Compared to the controls, the diabetic children had significantly lower levels of trypsin (P less than 0.001) and elastase (P less than 0.02). Fecal chymotrypsin appeared to be significantly lower (P less than 0.01) in diabetic children than in controls but in all patients fecal chymotrypsin values registered above the limit considered to be normal. No significant correlation was observed between pancreatic enzyme concentrations, serum and urinary PABA values, and chronologic age, HbA1 and insulin requirement. Only for serum PABA a significant negative correlation with duration of disease (P less than 0.01) has been observed. These data show that exocrine pancreatic function may be abnormal in children with IDDM.

A new faecal chymotrypsin method for evaluating the exocrine pancreatic function in patients with different pancreatic diseases.

SummaryUsing a new colorimetric method we measured the faecal chymotrypsin in 407 subjects, divided as follows: 252 adult subjects with a normal exocrine pancreatic function as shown by duodenal intubation, 24 adult patients with a mild to moderate pancreatic insufficiency, and 26 adult patients with severe pancreatic insufficiency. In addition, 40 healthy children, 50 children with chronic diarrhoea, and 15 with cystic fibrosis were studied before and after substituting enzyme therapy. Faecal chymotrypsin was found to be useful in evaluating the degree of exocrine functional insufficiency in subjects with diseases of the pancreas that had, already been clinically ascertained. The same cannot be said for its ability to provide an early diagnosis of subjects with a slight-moderate insufficiency in exocrine pancreatic function.

HLA in Graves' disease coexistent with coeliac disease.

Lactase 0.0 24.7 8.7 2.3 26.0 5.5 5.3 27.4 19.3 14.7 13.5 20.6 22.042.5 Maltase 30.0 308.0 106.3 82.0 536.0 337.0 170.4 518.0 375.1 193.8 284.0 265.4 280.0-580.0 Sucrase 2.4 36.2 14.4 9.6 37.4 29.0 34.1 65.8 39.3 29.6 42.5 37.3 38.065.0 Gluco-amylase 2.2 25.3 8.5 26.0 23.0 17.9 33.9 27.2 22.3 27.5 23.4 26.038.0 Alkalinephosphatases 4.2 19.6 12.3 4.4 22.2 11.9 9.5 22.3 16.6 8.3 10.9 12.0 15.525.0 Histology (0 to V) V 0/I II V I III III 0 I/II III/IV II I/II 0 Lymphocytes 8 42 10 28 25 10 33 22 18 20 512% (intra-epithelial)

Malignant small cell tumor of the thoracopulmonary region in childhood: a case report

A case of malignant small cell tumor of the thoracopulmonary region in a 3-year-old boy is presented. The rarity of this tumor in children justifies the presentation of a new case. Differential diagnosis with other childhood neoplasms is discussed.

A FOLLOW-UP STUDY OF CHILDREN WITH COW'S MILK INTOLERANCE. DEVELOPMENT OF MULTIPLE FOOD INTOLENCE

The aim of this study is to investigate the outcome of cows milk intolerance and the possible development of multiple food intolerance. 43 children with C.M.I, were followed for periods varying from 7 to 72 months (mean 34 months). The age at onset of symptoms varied from 1 to 6 months. 14 presented immediate reactions to cows milk and 29 delayed reactions. They were evaluated clinically and using skin prick test and RAST to milk and 15 other food allergens. The diagnosis of acquired C.M. tolerance or the development of multiple food intolerance was based on tests of elimination and challenge of milk and other proteins. To evaluate the outcome of C.M.I, we used the method employed for actuarial analysis of survival data. This revealed that the probability percentage of recovery from C.M.I. is 28% at 1 year from diagnosis, 79% at 2 years, 84% at 3 years and 95% at 4 years. After the third year from the diagnosis all Intolerant children presented multiple food intolerance.