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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 8 (1998), S. 588-591 
    ISSN: 1432-1084
    Keywords: Key words: Pasteurella ; Hepatitis ; Liver granuloma ; Lymph nodes ; Child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Numerous diseases can lead to multilocular lesions of the liver. The authors report a rare pediatric case of hepatic granulomas due to Pasteurella multocida: a 7-year-old girl with chronic fever was investigated by sonography and CT scan, demonstrating mesenteric lymph node enlargement and numerous small hepatic lesions. After surgical biopsy, histopathology of the liver specimens showed pyogenic granuloma, with serologic testing positive for Pasteurella multocida. Treatment with a tetracycline and corticosteroids was successful. Pasteurella multocida infection, despite its habitual benign course, should be suspected among differential diagnoses of lymphogranulomatous affections with hepatic involvement. No case of liver and lymph node foci in a child has been previously described.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1084
    Keywords: Key words: Child ; gastrointestinal tract ; Gallbladder ; wall thickening ; Liver ; US ; Histiocytosis ; Hepatitis ; Hemophagocytic lymphohistiocytosis ; Hemophagocytic syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Hemophagocytic lymphohistiocytosis, a variant of histiocytosis, is characterized by an uncontrolled activation of the cellular immune system, including hepatic mononuclear phagocytic cells. Abdominal ultrasound findings in children are evaluated in this disease. We present six pediatric cases, two with familial and four with sporadic hemophagocytic lymphohistiocytosis, examined by abdominal sonography. Three signs were frequently observed: thickening of the gallbladder wall (all cases), increased periportal echogenicity (four cases), and enlarged lymph nodes in the porta hepatis (four cases). Hepatomegaly, splenomegaly, and ascitic fluid may also be found. These imaging findings are not specific and may be seen in viral hepatitis. However, once hepatitis is excluded, they may suggest the diagnosis of hemophagocytic lymphohistiocytosis in a critically ill child. A bone smear must be done to establish the diagnosis.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1076
    Keywords: Key words Nephrotic syndrome  ;  Hodgkin disease  ;   Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  This report documents the occurrence of a nephrotic syndrome in five children with Hodgkin disease. In two cases the nephrotic syndrome predated the diagnosis of lymphoma by 6 months and 12 months respectively , while in the other three, the two disorders occurred simultaneously. The nephrotic syndrome resolved in four cases during effective treatment for active Hodgkin disease, while proteinuria remained unchanged in the fifth case with partial control of the lymphoma. The occurrence of a nephrotic syndrome as a manifestation of active Hodgkin disease suggests that some immunological abnormalities play a role in the pathogenesis of the association. Conclusion The possibility of glomerular dysfunction although rare must be considered and actively looked for in all cases of Hodgkin disease. Similarly, any unusual sign or symptom noted in patients with nephrotic syndrome, particularly receiving or having received immunosuppressants, requires thorough investigation to determine the presence or absence of lymphoma.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1076
    Keywords: Keywords Thrombosis ; Portal vein ; Stomatocytosis ; Splenectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Portal vein thrombosis is a rare but potentially lethal complication in children requiring splenectomy. We report on a 15-year-old boy with a dehydrated hereditary stomatocytosis, who underwent splenectomy and presented a postoperative partial portal vein thrombosis. With prompt heparin therapy, neither propagation of the thrombus nor further cavernous transformation in the following occurred 6 years. Conclusion Recent data suggest that hereditary stomatocytosis carries a high risk of thrombotic complications, especially after splenectomy. This procedure, the benefit of which is limited in this condition, should therefore be strongly avoided.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1279-8509
    Keywords: Acute myeloblastic leukemia ; Child ; Bone marrow transplantation ; Chemotherapy ; Cytarabine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the LAME89/91 protocol, children with acute myeloid leukemia (AML) who achieved complete remission (CR) after induction chemotherapy, were treated either with allogeneic bone marrow transplantation (BMT) if they had an HLA-compatible related donor or with chemotherapy including high-dose cytarabine. The objectives of this study were to describe the overall results of this strategy and to compare the two post-remission arms. Two hundred and thirty-one children were enrolled in the protocol. Induction chemotherapy consisted of a combination of cytarabine and mitoxantrone. A CR was achieved in 204 children (88%). Fifty-one of them had an HLA-identical sibling donor and were eligible for BMT. These 51 patients, as well as two additional children who had a one antigen HLA-mismatched father, received BMT during first CR. Consequently, 53 patients were analysed in the BMT group and 151 in the chemotherapy group. With a mean follow up duration in the study of 38 ± 2 months, overall event-free survival (EFS) was 47 ± 7% at 4 years for the 231 patients entered into the protocol. The 4-year disease-free survival (DFS) was 53 ± 8% for the 204 patients who achieved complete remission after induction therapy. The 4-year probability of relapse was 28 ± 14% in the BMT group and 47 ± 9% in the chemotherapy group (p = 0.02). The risk of therapy-related death was 6.2% for BMT and 8.1% for chemotherapy. DFS was 68 ± 14% in the BMT group and 48 ± 9% in the chemotherapy group (p = 0.02). We conclude that allogeneic BMT from a matched sibling donor is the treatment of choice for reducing the relapse risk and for increasing DFS in children with AML in first CR.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1998
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Capillary haemangiomas are frequent benign tumours in infancy. The authors report a case of capillary haemangioma of the greater omentum, discovered in a child of 5 months of age and studied with US, CT and MRI. The localization of such a lesion in the greater omentum is exceptional. Abdominal US revealed a heterogeneous, multinodular intraperitoneal mass. Doppler study demonstrated hypervascularity of the lesion. CT localized the mass to the greater omentum. The mass was hypodense on the unenhanced scan and enhanced massively after injection. The infant suffered a reaction to contrast medium during the CT. MRI demonstrated a mass which was hypointense on T1-weighted images and hyperintense on T2-weighted images. Laparotomy confirmed the location of the mass within the greater omentum and allowed resection of the tumour.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1569-8041
    Keywords: ABMT ; anaplastic large-cell lymphoma ; children ; relapse ; vinblastine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose:to study response to chemotherapy and the outcome ofchildren treated for a relapsed anaplastic large-cell lymphoma (ALCL) and toevaluate the role of bone marrow transplantation (BMT) in these patients. Patients and methods:Clinical data concerning the 41 relapsesthat occurred in 119 patients with ALCL enrolled in 3 consecutive studiessince 1975 were analysed. First-line treatment consisted of intensivechemotherapy according to the COPAD protocol for the first series of 12patients treated between 1975 and 1989 and to the SFOP (French Society ofPediatric Oncology) HM protocols for the 30 patients treated between 1989 and1997. Twenty-eight patients were treated with CV(B)A (CCNU, vinblastine, ara-Cwith or without bleomycin), and the others with miscellaneous protocols forrecurrent disease. Fifteen patients underwent autologous BMT and 1 allogeneicBMT while in CR2. Results:Thirty-six of forty-one (88%) patients achievedCR2. With a median follow-up of 5 years, 12 patients died, 9 of their diseaseand 29 patients are alive in CR2 (20 patients), CR3 (5 patients), CR4 (2patients), CR5 (1 patient) or CR6 (1 patient). Overall and disease-freesurvival are respectively 69% (53%–82%) and44% (29%–61%) at three years. In univariateanalysis, patients treated with ABMT while in CR2 did not appear to have abetter outcome than the other. Remarkably, a long-lasting remission wasobtained in 8 of 13 patients treated with weekly vinblastine for a relapseincluding 6 relapses occurring after ABMT. Conclusions:Relapsed ALCL are highly chemosensitive but over40% of the patients experience several relapses. Prolonged conventionalchemotherapy based on vinblastine might, in some cases, be as efficient asshort intensive treatment with ABMT.
    Type of Medium: Electronic Resource
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