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  • 1
    ISSN: 1432-0584
    Keywords: High-dose ARA-C ; Asparaginase ; Childhood leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Seventeen children and two adolescents, aged 6 months to 20 9/12 years, with poor risk leukemia were treated with a total of 38 sequential high-dose ARA-C-Asparaginase courses (HIDAC-ASNase). Each course was followed by profound myelosuppression. Fever occurred in 13.2% and infectious complications in 7.9% of courses. Other side effects were vomiting (81.6%), drug fever (55.3%), mucositis and diarrhoea (28.9%), mild hepatotoxicity (26.3%), exanthemas (18.4%), conjunctivitis (15.8%), local ASNasehypersensitivity (7.9%), athropathy (5.3%). One patient developed generalized seizures followed by coma and death. The possible association between ARA-C, the CNS symptoms and death could neither be demonstrated nor excluded. Except for the possible ARA-C related CNS toxicity, toxic effects were reversible. We consider this treatment a tolerable chemotherapeutic contribution in childhood.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Posttransfusion purpura ; Thrombocytopenia ; Blood transfusion ; Platelet antibodies ; HLA antigens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thirteen cases of posttransfusion purpura (PTP) which were diagnosed in Germany and Austria from 1977–1985 are described. All patients were women with a mean age of 58.6 years (range, 36–77 years). All but one had been pregnant and received blood transfusions 2 to 12 days prior to the onset of PTP. The thrombocytopenic purpura was always severe with a nadir of platelet counts below 10×109/l and lasted between 3 and 60 days. All patients recovered from PTP. Optimal therapy consisted of administration of high-dose IgG. Twelve of the 13 patients had developed platelet-specific Zwa antibodies (eight of them together with HLA antibodies), in one Zwa positive individual only HLA antibodies were detectable. Five of six HLA-DR typed patients carried DR3 which is considered an immunogenetic risk factor in PTP. Clinical awareness of this rare, but serious iatrogenic transfusion complication is prerequisite for prompt diagnosis and improved therapy.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 148 (2000), S. 1087-1091 
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Narkolepsie ; Hypersomnie ; Schlaflatenz ; Antidepressiva ; Kindes- und Jugendalter ; Keywords Narcolepsy ; Sleep latency ; Antidepressive drugs ; Childhood and adolescence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Introduction. Narcolepsy is a chronic disease which is characterised by excessive daytime sleepiness and cataplectic attacks. It is diagnosed mostly in the 2nd decade. Only a few reports are found in the literature on early childhood manifestations of narcolepsy. The first symptoms are often seen several years prior a definite diagnoses is made. The slow development of narcoleptic symptoms in a 13 year old boy is discribed. The diagnostic problems and the severe impairment of the child are worked out. The treatment requires day stucturing and stimulating drugs, antidepressive drugs are given additionally. Discussion. Daytime sleepiness and impaired night sleep which are often associated with behavioural disturbances should lead to polysomnography. The measurement of sleep latency has to be performed in order to establish the diagnosis of narcolepsy. On this basis early treatment is possible, thereby reducing the psychosocial impairment of narcoleptic patients.
    Notes: Zusammenfassung Hintergrund. Die Narkolepsie ist eine chronische Erkrankung, die durch exzessive Tagesschläfrigkeit sowie kataplektische Attacken gekennzeichnet ist. Häufigstes Erstmanifestationsalter ist das 2. Lebensjahrzehnt, nur vereinzelt wird in der Literatur von Narkolepsien im Kindesalter berichtet. Allerdings treten meist schon Jahre vor der Diagnosestellung erste Symptome auf, die zu erheblichen Beeinträchtigungen der Patienten führen können. Die langsame Entwicklung narkoleptischer Symptome eines 13-jährigen Jungen wird aufgezeigt, und die diagnostischen Probleme werden dargestellt. In der Therapie werden neben einer konsequenten Tagesstrukturierung Stimulanzien und Antidepressiva eingesetzt. Diskussion. Bei Verhaltensstörungen ist die Schlafanamnese nicht nur bezüglich der Narkolepsie von Bedeutung. Tagesschläfrigkeit und Durchschlafstörungen sollten polysomnographisch abgeklärt werden. Mit der Messung der Schlaflatenzen ist die frühzeitige Diagnose einer Narkolepsie möglich. Eine rasche medikamentöse Therapie und Veränderung der Lebensführung können die weitreichenden psychosozialen Konsequenzen gerade bei jungen Patienten reduzieren.
    Type of Medium: Electronic Resource
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