Search

Congenital mesoblastic nephroma is a rare pediatric renal tumor and has been reported in patients presenting with palpable abdominal mass, arterial hypertension, hematuria, polyuria, or hypercalcemia. Here we present the case of a 1-month-old neonate with suspected parathyroid hormone (PTH)-related peptide (PTH-rp)-mediated severe hypercalcemia revealing congenital mesoblastic nephroma. Preoperatively, hypercalcemia was corrected with hydration, furosemide, pamidronate, and low-calcium infant formula. Unilateral nephrectomy led to the resolution of hypercalcemia, transient hyperparathyroidism, and transient vitamin D and mineral supplementation. We conclude that congenital mesoblastic nephroma can secrete PTH-rp that can cause severe hypercalcemia. [ABSTRACT FROM AUTHOR]

Elasticity of the child rib cortical bone is poorly known due to the difficulties in obtaining specimens to perform conventional tests. It was shown on the femoral cortical bone that elasticity is strongly correlated with density for both children and adults through a unique relationship. Thus, it is assumed that the relationships between the elasticity and density of adult rib cortical bones could be expanded to include that of children. This study estimated in vivo the elasticity of the child rib cortical bone using quantitative computed tomography (QCT). Twenty-eight children (from 1 to 18 y.o.) were considered. Calibrated QCT images were prescribed for various thoracic pathologies. The Hounsfield units were converted to bone mineral density (BMD). A relationship between the BMD and the elasticity of the rib cortical bone was applied to estimate the elasticity of children’s ribs in vivo. The estimated elasticity increases with growth (7.1 ± 2.5 GPa at 1 y.o. up to 11.6 ± 1.9 GPa at 18 y.o.). This data is in agreement with the few previous values obtained using direct measurements. This methodology paves the way for in vivo assessment of the elasticity of the child cortical bone based on calibrated QCT images. [ABSTRACT FROM AUTHOR]

Ninety five normal Caucasian subjects (51F, 44M) aged from 2 to 25 y were measured at the hand and wrist level with a small DXA system (pDEXA) in order to obtain the normal values of the bone mineral content (BMC), density (BMD) and projected area (A) of carpal (c) and metacarpal (m) bones. BMDc ranged from 0.065 +/- 0.007 g/cm2 to 0.365 +/- 0.035 g/cm2 in females and 0.425 +/- 0.040 g/cm2 in males. It presented a sharp change of increase rate at 15.5 and 17 y of age in girls and boys, respectively. Ac presented the same kind of evolution as BMDc, but had a larger value dispersion. The second metacarpal bone had the highest BMCm value in 85% of females and 90% of males. The sum of BMCmi or Ami values (i = 1-5) and the projected mean density of the 5 metacarpal bones was well correlated with BMCc, Ac and BMDc, respectively (r > 0.90). A volumetric mineral density, dmi, calculated for each of these bones, approximated to a cylinder, was correlated with age (r > 0.85). [ABSTRACT FROM AUTHOR]

Abstract: The 2000 French consensus conference for acute viral bronchiolitis management underlined the fundamental role of chest physiotherapy. According to Chalumeau and al., rib fractures were found out in 1/1000 children hospitalized for bronchiolitis or pneumonia. However, such complication of chest physiotherapy is exceptional. We report 2 cases with third to sixth lateral rib fractures after chest physiotherapy in infants with bronchiolitis. Despite the rarity of these complications, clinicians must keep in mind this etiology while facing rib fractures in infants. [Copyright &y& Elsevier]

Résumé: Les thromboses splanchniques surviennent chez 30 % des patients atteints de thrombocytémie essentielle, mais sont rarement présentes lors du diagnostic. Nous rapportons 2 cas pédiatriques ayant présenté une thrombocytémie essentielle révélée par une thrombose splanchnique atypique. Dans le premier cas, une jeune fille de 16ans avait présenté un syndrome de Budd-Chiari révélé par un choc hémorragique sur rupture de varices œsophagiennes. L’examen clinique avait mis en évidence une splénomégalie isolée. La recherche d’une thrombophilie avait permis de diagnostiquer une mutation homozygote du facteur V Leiden associée à une mutation de Jak2. La biopsie médullaire avait confirmé le diagnostic de syndrome myéloprolifératif. Dans le deuxième cas, une jeune fille de 17ans avait consulté son médecin traitant pour une visite de routine, et l’examen clinique avait révélé une splénomégalie isolée. L’échographie avait montré l’existence d’un thrombus des veines splénique et portale. Une mutation isolée de Jak2 avait été mise en évidence et le syndrome myéloprolifératif avait été confirmé sur la biopsie médullaire. Le diagnostic de syndrome myéloprolifératif a donc été évoqué chez ces deux jeunes-filles devant une thrombose veineuse atypique associée à une mutation de Jak2, et confirmé par la biopsie médullaire. Ces présentations initiales de syndrome myéloprolifératif sont rares chez l’enfant et probablement sous-diagnostiquées. [ABSTRACT FROM AUTHOR]

Background. – Rectal tumors are rare in childhood and among them malignant tumors are even less common. Only eight cases of primary rectal lymphomas were reported in children, with various presenting signs and histology. Burkitt’s lymphomas are among these cases.Case report. – A five-year-old child presented with hematochezia and unusual constipation. The rectal examination showed a voluminous intra rectal mass. Radiographic and pathologic examinations led to the diagnostic of Burkitt’s lymphoma with medullary involvement. Complete remission was obtained after initial chemotherapy but a local relapse occurred and the child died eight months later.Conclusion. – Hematochezia associated with unusual constipation impose a rectal examination. Early diagnosis of a rectal tumor may allow patients survival. [Copyright &y& Elsevier]