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Introduction: Kabuki syndrome (KS) is a genetic disorder with characteristic facial dysmorphisms, short stature, hypertension, and obesity later in life. The aim of this study was to evaluate catch-up growth and cardiovascular markers before and during growth hormone (rhGH) treatment in KS children., Methods: This prospective study included 18 children whose KS was genetically established. Each KS subject received rhGH for a period of 2 years. Several measurements were performed before and during treatment: anthropometry, glucose metabolism, lipid profile, markers for endothelial function, and low-grade inflammation., Results: This study found an increase in delta height standard deviation score (SDS) for the whole group of 1.1 SDS after 2 years of rhGH treatment. Baseline metabolic profiles showed no cardiometabolic abnormalities in these children. Although 4 out of 18 children were obese, there were no signs of the metabolic syndrome. During rhGH treatment, serum low-density lipoprotein cholesterol concentrations decreased significantly (2.16-1.91 mmol/L, p = 0.04). Apolipoprotein B100 concentrations also showed a reduction after 24 months of treatment, but the other lipid and (apo)lipoprotein parameters did not change. While other endothelial function markers were stable, only vascular cell-adhesion molecule-1 concentrations increased (1,084-1,161 pg/mL, p < 0.01) during rhGH therapy. Furthermore, BMI and waist circumference improved during treatment. There were no signs of hypertension., Conclusions: At baseline and during rhGH therapy, there were no signs of the metabolic syndrome. This is the first study demonstrating that rhGH treatment in KS children is a safe and effective therapy and that it positively influences linear height without exerting adverse effects on a wide array of cardiovascular risk markers., (© 2021 The Author(s) Published by S. Karger AG, Basel.)

A boy withthoracicpain A 15-year-old Iraqi boy who had been living in the Netherlands for 4 years was referred to a paediatric clinic due to malaise, thoracic pain and weight loss since 3 months. Imaging revealed multiple large cystic lesions in the right lung and liver, highly suggestive of echinococcosis, which was serologically confirmed. He was treated with albendazole and underwent lung surgery successfully.

Background: Genetic evaluation is recommended in patients with unexplained dilated cardiomyopathy (DCM), but its diagnostic yield and prognostic relevance in unexplained isolated left ventricular dysfunction (LVdys) is unknown., Methods and Results: A total of 127 LVdys and 262 DCM patients underwent genetic screening. Long-term outcome consisted of a combined end point of life-threatening arrhythmia, heart transplantation, and death. At baseline, LVdys patients were younger and had less frequently New York Heart Association class ≥3 when compared with DCM (55±13 versus 58±12; P =0.019 and 21% versus 36%; P =0.003, respectively). The prevalence of familial disease and pathogenic mutations was similar in LVdys and DCM (45% versus 40%; P =0.37 and 19% versus 17%; P =0.61, respectively). After a follow-up of 56 (31-82) months, outcome did not differ in LVdys compared with DCM patients (hazard ratio, 0.83; 95% confidence interval, 0.47-1.45; P =0.51). Overall, outcome was less favorable in patients with a genetic mutation or familial disease when compared with those without (hazard ratio, 2.7; 95% confidence interval, 1.07-7.7; P =0.048 and hazard ratio, 2.2; 95% confidence interval, 1.2-4.2; P =0.013, respectively). Thus, the diagnostic yield of genetic testing in LVdys and DCM is similarly high. The presence of a gene mutation or familial predisposition results in an equally worse prognosis., Conclusions: Genetic evaluation is advised in LVdys patients and should not merely be restricted to DCM., (© 2018 American Heart Association, Inc.)

An interactive morphometry system (Leitz T.A.S.) was used to extract 39 parameters from 1506 cells of five normal WBC classes. The data set was split in a learning set and a test set, and the value of each single parameter and of combinations of parameters was assessed with the interactive pattern recognition system ISPAHAN. A combination of nine densitogram parameters gave a correct classification in 92.6%; adding four geometrical and seven counting densitogram parameters improved this to 98.5%. It appeared that simple measurements are sufficient for a correct differentiation into the normal white blood cell types. In a pilot study fo 40 normal myeloid bone marrow cells of four classes a correct discrimination between mature and immature cells was reached in 93%. Extraction of parameters with the T.A.S. and their subsequent evaluation with ISPAHAN appeared to be an efficient method of white blood cell classification probably including immature cell types.