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El Chehadeh S, Touraine R, Prieur F, Reardon W, Bienvenu T, Chantot-Bastaraud S, Doco-Fenzy M, Landais E, Philippe C, Marle N, Callier P, Mosca-Boidron AL, Mugneret F, Le Meur N, Goldenberg A, Guerrot AM, Chambon P, Satre V, Coutton C, Jouk PS, Devillard F, Dieterich K, Afenjar A, Burglen L, Moutard ML, Addor MC, Lebon S, Martinet D, Alessandri JL, Doray B, Miguet M, Devys D, Saugier-Veber P, Drunat S, Aral B, Kremer V, Rondeau S, Tabet AC, Thevenon J, Thauvin-Robinet C, Perreton N, Des Portes V, Faivre L. Xq28 duplication includingMECP2in six unreported affected females: what can we learn for diagnosis and genetic counselling? Clin Genet 2017; 91:576-588. [DOI: 10.1111/cge.12898] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/14/2016] [Accepted: 10/17/2016] [Indexed: 11/27/2022]
Affiliation(s)
- S. El Chehadeh
- FHU TRANSLAD, Centre de Référence Maladies Rares «Anomalies du Développement et Syndromes Malformatifs» de l'Est; Centre de Génétique, CHU de Dijon; Dijon France
- Service de Génétique Médicale, Institut de Génétique Médicale d'Alsace (IGMA), Centre de Référence Maladies Rares «Anomalies du Développement et Syndromes Malformatifs» de l'Est; Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre; Strasbourg France
| | - R. Touraine
- Service de Génétique Clinique Chromosomique et Moléculaire; CHU de Saint-Etienne; Saint-Étienne France
| | - F. Prieur
- Service de Génétique Clinique Chromosomique et Moléculaire; CHU de Saint-Etienne; Saint-Étienne France
| | - W. Reardon
- Clinical Genetics, Division National Centre for Medical Genetics; Our Lady's Children's Hospital; Dublin Ireland
| | - T. Bienvenu
- AP-HP, Laboratoire de Génétique et Biologie Moléculaires, HU Paris Centre, Site Cochin, France; Université Paris Descartes; Institut Cochin, INSERM U1016; Paris France
| | - S. Chantot-Bastaraud
- Service de Génétique et Embryologie Médicales; CHU Paris Est - Hôpital d'Enfants Armand-Trousseau; Paris France
| | - M. Doco-Fenzy
- Service de Génétique, EA3801; SFR-CAP Santé, CHU de Reims; Reims France
| | - E. Landais
- PRBI, Pôle de Biologie Médicale; CHU de Reims; Reims France
| | - C. Philippe
- Laboratoire de Génétique Médicale; Hôpitaux de Brabois CHRU; Vandoeuvre les Nancy France
| | - N. Marle
- Service de Cytogénétique; CHU de Dijon; Dijon France
| | - P. Callier
- Service de Cytogénétique; CHU de Dijon; Dijon France
| | | | - F. Mugneret
- Service de Cytogénétique; CHU de Dijon; Dijon France
| | - N. Le Meur
- Etablissement Français du Sang; CHU de Rouen; Rouen France
| | - A. Goldenberg
- Service de Génétique et Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée, CHU de Rouen; Inserm et Université de Rouen; Rouen France
| | - A.-M. Guerrot
- Service de Génétique et Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée, CHU de Rouen; Inserm et Université de Rouen; Rouen France
| | - P. Chambon
- Laboratoire D'histologie, Cytogénétique et Biologie de la Reproduction; CHU de Rouen; Rouen France
| | - V. Satre
- Département de Génétique et Procréation, CHU Grenoble Alpes; Université Grenoble Alpes; Grenoble France
| | - C. Coutton
- Département de Génétique et Procréation, CHU Grenoble Alpes; Université Grenoble Alpes; Grenoble France
| | - P.-S. Jouk
- Département de Génétique et Procréation, CHU Grenoble Alpes; Université Grenoble Alpes; Grenoble France
| | - F. Devillard
- Département de Génétique et Procréation, CHU Grenoble Alpes; Université Grenoble Alpes; Grenoble France
| | - K. Dieterich
- Département de Génétique et Procréation, CHU Grenoble Alpes; Université Grenoble Alpes; Grenoble France
| | - A. Afenjar
- Service de Génétique; CHU Paris Est - Hôpital d'Enfants Armand-Trousseau; Paris France
| | - L. Burglen
- Service de Génétique; CHU Paris Est - Hôpital d'Enfants Armand-Trousseau; Paris France
| | - M.-L. Moutard
- Unité de neuropédiatrie et pathologie du développement; CHU Paris Est - Hôpital d'Enfants Armand-Trousseau; Paris France
| | - M.-C. Addor
- Service de Génétique Médicale; Centre Hospitalier Universitaire Vaudois CHUV; Lausanne Switzerland
| | - S. Lebon
- Unité de Neuropédiatrie; Centre Hospitalier Universitaire Vaudois CHUV; Lausanne Switzerland
| | - D. Martinet
- Laboratoire de Cytogénétique Constitutionnelle et Prénatale; Centre Hospitalier Universitaire Vaudois CHUV; Lausanne Switzerland
| | - J.-L. Alessandri
- Pôle Enfants; CHU de la Réunion - Hôpital Félix Guyon; Saint-Denis France
| | - B. Doray
- Service de Génétique; CHU de la Réunion - Hôpital Félix Guyon; Saint-Denis France
| | - M. Miguet
- Service de Génétique Médicale, Institut de Génétique Médicale d'Alsace (IGMA), Centre de Référence Maladies Rares «Anomalies du Développement et Syndromes Malformatifs» de l'Est; Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre; Strasbourg France
| | - D. Devys
- Laboratoire de Diagnostic Génétique; CHU de Strasbourg - Hôpital Civil; Strasbourg France
| | - P. Saugier-Veber
- Laboratoire de Génétique Moléculaire; Faculté de Médecine et de Pharmacie; Rouen France
| | - S. Drunat
- Laboratoire de Biologie Moléculaire; Hôpital Robert Debré; Paris France
| | - B. Aral
- Service de Biologie Moléculaire; CHU de Dijon; Dijon France
| | - V. Kremer
- Laboratoire de Cytogénétique, Hôpitaux Universitaires de Strasbourg; Hôpital de Hautepierre; Strasbourg France
| | - S. Rondeau
- Service de Pédiatrie Néonatale et Réanimation; CHU de Rouen; Rouen France
| | - A.-C. Tabet
- Laboratoire de Cytogénétique; Hôpital Robert Debré; Paris France
| | - J. Thevenon
- FHU TRANSLAD, Centre de Référence Maladies Rares «Anomalies du Développement et Syndromes Malformatifs» de l'Est; Centre de Génétique, CHU de Dijon; Dijon France
- GAD, EA4271, Génétique et Anomalies du Développement; Université de Bourgogne; Dijon France
| | - C. Thauvin-Robinet
- FHU TRANSLAD, Centre de Référence Maladies Rares «Anomalies du Développement et Syndromes Malformatifs» de l'Est; Centre de Génétique, CHU de Dijon; Dijon France
- GAD, EA4271, Génétique et Anomalies du Développement; Université de Bourgogne; Dijon France
| | - N. Perreton
- EPICIME-CIC 1407 de Lyon, Inserm; Service de Pharmacologie Clinique, CHU-Lyon; Bron France
| | - V. Des Portes
- Service de Neurologie Pédiatrique; CHU de Lyon-GH Est; Bron France
| | - L. Faivre
- FHU TRANSLAD, Centre de Référence Maladies Rares «Anomalies du Développement et Syndromes Malformatifs» de l'Est; Centre de Génétique, CHU de Dijon; Dijon France
- GAD, EA4271, Génétique et Anomalies du Développement; Université de Bourgogne; Dijon France
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2
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Grampa V, Delous M, Silbermann F, Oyde G, Krug P, Filhol E, Alessandri JL, Sigaudy S, Bouvier R, Zabot MT, Antignac C, Gubler M, Attié-Bitach T, Benmerah A, Jeanpierre C, Saunier S. A study of new NEK8 mutations in patients with severe renal cystic hypodysplasia and ciliopathy-associated defects. Cilia 2015. [PMCID: PMC4519170 DOI: 10.1186/2046-2530-4-s1-p54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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3
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Boudon E, Levy Y, Abossolo T, Cartault F, Brouillard P, Vikkula M, Kieffer-Traversier M, Ramful D, Alessandri J. Antenatal presentation of hereditary lymphedema type I. Eur J Med Genet 2015; 58:329-31. [DOI: 10.1016/j.ejmg.2015.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/29/2015] [Indexed: 11/15/2022]
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4
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Collet C, Alessandri JL, Arnaud E, Balu M, Daire V, Di Rocco F. Crouzon syndrome and Bent bone dysplasia associated with mutations at the same Tyr-381 residue inFGFR2gene. Clin Genet 2013; 85:598-9. [DOI: 10.1111/cge.12213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 05/17/2013] [Accepted: 05/30/2013] [Indexed: 11/30/2022]
Affiliation(s)
- C. Collet
- Service de Biochimie et Biologie Moléculaire; Hôpital Lariboisière; Paris France
| | - J.-L. Alessandri
- Service de Réanimation Pédiatrique; Hôpital Felix Guyon, CHU de la réunion; Saint Denis-La Réunion France
| | - E. Arnaud
- Unité de Chirurgie Craniofaciale, Service de Neurochirurgie; Centre de Référence National Dysostoses Crâniofaciales, Hôpital Necker; Paris France
| | - M. Balu
- Service de Radiologie Pédiatrique; Hôpital Felix Guyon, CHU de la réunion; Saint Denis-La Réunion France
| | - V.C. Daire
- Génétique Clinique, INSERM U781; Université Paris-Descartes-Sorbonne Paris cité, Institut Imagine, Hôpital Necker; Paris France
| | - F. Di Rocco
- Unité de Chirurgie Craniofaciale, Service de Neurochirurgie; Centre de Référence National Dysostoses Crâniofaciales, Hôpital Necker; Paris France
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5
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Pellot AS, Alessandri JL, Robin S, Sampériz S, Attali T, Brayer C, Pasquet M, Jaffar-Bandjee MC, Benhamou LS, Tiran-Rajaofera I, Ramful D. [Severe forms of chikungunya virus infection in a pediatric intensive care unit on Reunion Island]. Med Trop (Mars) 2012; 72 Spec No:88-93. [PMID: 22693937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED In 2005-2006, an unexpected, massive outbreak of chikungunya occurred on Reunion Island, a French overseas territory in the Indian Ocean. This arboviral infection transmitted by a mosquito of the Aedes genus is usually benign. A surprising feature of the Reunion Island epidemic was the occurrence of rare severe forms involving adults as well as children. OBJECTIVES The purpose of this report is to describe severe forms of chikungunya observed in children hospitalized in a pediatric intensive care unit. PATIENTS AND METHODS This retrospective single-center study was conducted from January 1st to April 30th, 2006. Children between 1 month and 15 years admitted to the pediatric intensive care unit with proven chikungunya infection were included. RESULTS A total of 9 children were included. The main manifestations were extensive skin blisters in 5 cases, neurological symptoms (encephalopathy) in 4, cardiac complications (myocarditis, hemodynamic disorders) in 5 and bleeding in 1. Two children died. The causes of death were circulatory failure associated with coma and massive hemorrhage in one case and post-infectious encephalitis in the other. Three survivors present long-term neurologic or dermatologic sequels. DISCUSSION Severe cases of chikungunya in children provide a stark reminder of the cardiac and neurological tropism of the virus and its hemorrhagic forms with high potential mortality and morbidity. These cases underline the need for personal protection measures and for research to develop specific antiviral therapy and vaccines to prevent potentially lethal forms of the disease.
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Affiliation(s)
- A S Pellot
- Service de Réanimation Néonatale et Pédiatrique, CHR Félix Guyon, 97405 Saint-Denis, La Réunion
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6
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Alessandri J, Isidor B, David A, Martin-Coignard D, Ghazouani J, Ramful D, Laville J, Le Caignec C. Tibial developmental field defect in valproic acid embryopathy: Report on three cases. Am J Med Genet A 2010; 152A:2805-9. [DOI: 10.1002/ajmg.a.33633] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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7
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Ramful D, Fourmaintraux A, Rollot O, Alessandri J, Boumahni B, Noormahomed T, Robillard P, Fritel X, Sampériz S, Gérardin P. CL060 - Pronostic neurodéveloppemental à 2 ans de l’infection materno-néonatale à virus Chikungunya. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70276-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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8
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Cuillier F, Alessandri JL, Lemaire P, Fritel X, Harper L. Bruck Syndrome: Second Antenatal Diagnosis. Fetal Diagn Ther 2006; 22:23-8. [PMID: 17003551 DOI: 10.1159/000095838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2005] [Accepted: 02/16/2006] [Indexed: 11/19/2022]
Abstract
Bruck syndrome is characterized by the association of arthrogryposis and osteogenesis imperfecta. It is a distinct autosomal recessive disorder associated with normal collagen I. The main features are osteoporosis, long bone bowing and scoliosis due to vertebral deformities and congenital joint contractures. We describe a French girl who was born with ankle and wrist contractures (second antenatal discovery).
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Affiliation(s)
- F Cuillier
- Department of Gynecology, Hôpital Felix Guyon, Saint-Denis, Réunion, France.
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9
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Cuillier F, Cartault F, Lemaire P, Alessandri JL. Maxillo-nasal dysplasia (binder syndrome): antenatal discovery and implications. Fetal Diagn Ther 2005; 20:301-5. [PMID: 15980645 DOI: 10.1159/000085090] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2004] [Accepted: 06/14/2004] [Indexed: 11/19/2022]
Abstract
Binder syndrome (BS) or maxillo-nasal dysplasia is an uncommon developmental anomaly affecting primarily the anterior part of the maxilla and nasal complex. The characteristic findings are a failure of development in the premaxillary area with associated deformities of the nasal skeleton and the overlying soft tissues. Affected individuals typically have an unusually flat, underdeveloped midface (midfacial hypoplasia), with an abnormally short nose and flat nasal bridge, underdeveloped upper jaw, relatively protruding lower jaw and/or a 'reverse overbite' (or class III malocclusion). A case of BS was diagnosed at 24 weeks of gestation using two- and three-dimensional ultrasound. The first sign was an isolated flattened fetal nose in the mid-sagittal plane. Further ultrasound imaging showed the absence of the naso-frontal angle, giving impression of flat forehead and small fetal nose. We discuss about this entity.
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Affiliation(s)
- F Cuillier
- Department of Gynecology, Hôpital Félix Guyon, Saint-Denis, Ile de la Réunion, France.
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10
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Jaffar-Bandjee MC, Alessandri JL, Molet B, Clouzeau J, Jacquemot L, Sampériz S, Saly JC. [Primary amebic meningoencephalitis: 1st case observed in Madagascar]. Bull Soc Pathol Exot 2005; 98:11-3. [PMID: 15915965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The primary amebic meningoencephalitis is an acute suppurative infection that involves both the brain and the meninges. It is caused by Naegleria fowleri and is a very rare and fulminating condition, so far nearly always fatal. We report the first case in the area of Southern part of Indian Ocean that occured in a 7-year old French boy living in Madagascar. It is assumed that the disease was contracted by swimming in warm fresh water in a lake of the Madagascar east coast. Clinical signs began 10-12 days after exposure, associating headache, vomiting and pyrexia (39-40 degrees C). Upon admission in a Madagascar hospital, the patient was started on antibiotics, that did not control the disease and soon presented with a loss of consciousness and a delirium. He was transferred to Reunion island (Centre Hospitalier Départemental Félix-Guyon), where the diagnosis of primary amebic meningoencephalitis was confirmed. Therefore, he was started on high-dose of intraspinal amphotericin B, IV amphotericin B lipid complex and tetracycline. He developed myocarditis, diabetes insipidus, deep coma and subsequently died a week later. The diagnosis of amebic meningoencephalitis was based on: -- the cerebrospinal fluid examination that confirmed the diagnosis of purulent meningitis: 420 leucocytes (76% polynuclears, 14% lymphocytes), 90 red blood cells, and showed 50 ameboid trophozoites per 100 leucocytes, approximately 20 microm in size. -- the flagellate transformation test in distilled water showed two anterior flagellas that confirmed the genus Naegleria.
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Affiliation(s)
- M C Jaffar-Bandjee
- Laboratoire de biologie, Centre hospitalier départemental Félix-Guyon Saint-Denis, La Réunion, France.
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Brayer C, Micheau P, Bony C, Tauzin L, Pilorget H, Sampériz S, Alessandri JL. Brûlure néonatale accidentelle à l'isopropanol. Arch Pediatr 2004; 11:932-5. [PMID: 15288085 DOI: 10.1016/j.arcped.2004.04.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2003] [Accepted: 04/19/2004] [Indexed: 11/20/2022]
Abstract
Antiseptic solutions are commonly used for skin care but are not always safe. In preterm infants, application of antiseptic solutions can lead to serious burns. We report the case of a premature newborn who developed severe burns at 35 weeks post-conceptional age, after his mother used disposable antiseptic towels containing isopropyl alcohol for his skin care. Burns outcome led to diffuse skin burn and death of the baby. Several cases of isopropyl alcohol poisoning through skin absorption have been reported in neonate and infants. Because of its neonatal toxicity, isopropyl alcohol has been excluded from composition of antiseptic solutions commonly used in neonatology. However, isopropyl alcohol is still available in many housecleaning and cosmetic products, while its toxic effects in children are not clearly mentioned. A specific mention "toxic for infants and children" should appear on mass consumption products containing isopropyl alcohol. Moreover, health workers may individually inform parents about possible hazards of poisoning through skin absorption.
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MESH Headings
- 2-Propanol/poisoning
- Accidents, Home
- Bacteremia/complications
- Burns, Chemical/etiology
- Burns, Chemical/therapy
- Enterococcus faecalis
- Fatal Outcome
- Gram-Positive Bacterial Infections/complications
- Humans
- Infant, Newborn
- Infant, Premature, Diseases/chemically induced
- Infant, Premature, Diseases/microbiology
- Infant, Premature, Diseases/therapy
- Male
- Multiple Organ Failure/chemically induced
- Multiple Organ Failure/microbiology
- Parents/education
- Product Labeling
- Pseudomonas Infections/complications
- Skin Absorption
- Skin Care/adverse effects
- Skin Care/instrumentation
- Skin Diseases, Bacterial/complications
- Staphylococcal Infections/complications
- Staphylococcus epidermidis
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Affiliation(s)
- C Brayer
- Service de réanimation néonatale, CHD Félix-Guyon, Bellepierre, 97405 Saint-Denis de la Réunion cedex, France.
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Michel JL, Harper L, Alessandri JL, Jacquemot L, De Napoli-Cocci S, Pilorget H, Samperiz S. Peritoneal needle suction for intestinal perforation in the preterm neonate. Eur J Pediatr Surg 2004; 14:85-8. [PMID: 15185152 DOI: 10.1055/s-2004-815853] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED A few years ago, most intestinal perforations in the premature newborn appeared within the clinical context of necrotising enterocolitis (NEC). Since then, we have observed an increase in the number of isolated perforations appearing outside typical NEC. The fact that the perforations are more often isolated, and the healing capabilities of the premature intestine, led us to propose peritoneal needle suction (PNS) alone as first treatment for intestinal perforations in the premature neonate. MATERIALS AND METHOD The charts of 6 consecutive premature infants presenting with intestinal perforations treated initially by PNS alone were reviewed. RESULTS The patients' median birth weight was 1030 g, with a median gestational age of 27 weeks. In 5 out of 6 infants (83 %), PNS achieved complete exsufflation without recurrence of the pneumoperitoneum and complete intestinal healing, allowing complete enteral feeding 30 to 71 days after perforation. One infant with recurrent pneumoperitoneum after 3 PNS and peritoneal drainage was operated. All infants survived. CONCLUSION We believe that for early perforations of the premature neonate, the poor diffusion of the infection and the frequent capacity of the perforation to close and subsequently heal without scars, favour a minimally invasive management using PNS.
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Affiliation(s)
- J L Michel
- Department of Paediatric Surgery, Felix Guyon Hospital, Saint-Denis, Reunion Island, France. jl-michel.@chd-fguyon.fr
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13
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Brayer C, Bony C, Salles M, Sampériz S, Pilorget H, Attali T, Alessandri JL. Dysplasie bronchopulmonaire et pneumopathie à cytomégalovirus. Arch Pediatr 2004; 11:223-5. [PMID: 14992770 DOI: 10.1016/j.arcped.2003.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2003] [Accepted: 12/06/2003] [Indexed: 11/16/2022]
Abstract
Hyaline membrane disease (HMD) of premature newborn can lead to bronchopulmonary dysplasia (BPD). We report the observation of a 33 weeks premature newborn with HMD, treated with exogenous surfactant and mechanical ventilation. The patient developed respiratory distress with oxygen dependency initially related to BPD. Because of worsening of respiratory condition after 2 months, despite corticosteroid therapy, further investigation was performed. Cytomegalovirus (CMV) was found in urine and in the pharynx and CMV-pneumonia was diagnosed. Treatment with gancyclovir allowed a rapid regression of symptoms. Association between BPD and CMV-pneumonia has been previously reported but the causal relationship is controversial. In premature newborn, CMV-pneumonia can appear clinically and radiologically like a BPD. When evolution is atypical, with persistence of respiratory distress despite BPD treatment, CMV-pneumonia must be considered as a specific antiviral therapy may be discussed.
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Affiliation(s)
- C Brayer
- Service de réanimation néonatale, CHD Félix-Guyon, Bellepierre, 97405 Saint-Denis de la Réunion cedex, France.
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14
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Abstract
UNLABELLED We report a case of warfarin embryopathy. This disease affects more than 6% of fetuses exposed in utero to a vitamin K antagonist. OBSERVATION A child whose mother was treated with acenocoumarol because of a mechanical heart valve presented with signs of warfarin embryopathy. He showed chondrodysplasia punctata with telebrachydactyly, facial dysmorphism with nasal hypoplasia, a cataract, and a bilateral pyeloureteral junction syndrome. COMMENTS Characteristics of this drug induced embryopathy are reminded, while bearing in mind the conflict of interests between the mother and the fetus. The mechanisms of this embryopathy are debated in light of the recent knowledge concerning fetal metabolism of vitamin K.
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Affiliation(s)
- C Bony
- Service de réanimation néonatale, CHD Félix-Guyon, 97405 Saint-Denis, La Réunion, France
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15
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Tiran-Rajaofera I, Sampériz S, Trouilloud C, Pilorget H, Montbrun A, Attali T, Alessandri JL. [27-gauge percutaneous catheters: use in nutritional management of very-low-birth-weight and severely premature newborns in a neonatal intensive care unit]. Arch Pediatr 2001; 8:816-23. [PMID: 11524911 DOI: 10.1016/s0929-693x(01)00540-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
UNLABELLED Percutaneous central venous catheterization for parenteral feeding is a permanent problem in the management of very low birth weight neonates. Usually, 23-gauge catheters (diameter: 0.6 mm) are used. In our unit, we have started to use 27-gauge catheters (diameter 0.35 mm) since 1995. The aim of this study was to report our experience with this materiel. SUBJECT AND METHODS Between September 1, 1997 and January 30, 2000, 352 catheter implantations were performed using 27-gauge infusing sets in 200 premature infants (gestational age less than or equal to 33 weeks [mean 29.2], weight less than or equal to 1,500 g [mean: 1, 152.5 g]). Data were reviewed retrospectively with the view to determine the modality of use and complications. Peculiar insertion modalities were prospectively evaluated in the 50 last included infants (92 catheters). RESULTS In 97% of cases, the physician needed no help to insert the catheter. In 99.5% of cases (199 neonates), the insertion was successful (the procedure failed in one case). The mean duration procedure was 26 min (range 10 to 85 min). The mean age at insertion of the first catheter was 29 hours (range 0 to 216). Mean catheter maintenance duration was 15 days (range 1 to 53). In 31 cases, documented sepsis related to the catheter were noted (8.8% or 5.8 infections for 1,000 catheter-days). Endocarditis was observed in one case. A pericardial effusion was diagnosed in two cases. No death related to the catheter was noted. CONCLUSION In our experience, 27-gauge catheter implantation is an easy and safe procedure. We noted no major maintenance problems. Complications were not observed more frequently than those usually encountered with 23-gauge catheters. We conclude that 27-gauge catheter utilization is an attractive alternative for percutaneous central venous catheterization, in very low birth weight neonates.
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Affiliation(s)
- I Tiran-Rajaofera
- Service de réanimation néonatale, centre hospitalier départemental Félix-Guyon, 97400 Saint-Denis, La Réunion, France.
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Abstract
BACKGROUND Feingold syndrome is a combination of hand and foot anomalies, microcephaly, tracheo-esophageal fistula, esophageal/duodenal atresia, short palpebral fissures and developmental delay. The most frequent physical findings are clinodactyly of the second and fifth fingers with absent or hypoplastic middle phalanges, and syndactyly of the toes. Inheritance is autosomal dominant (MIM number 164280) with full penetrance concerning hand anomalies, variable expressivity and great intrafamilial variability. CASE REPORT We report the case of an African boy with duodenal atresia, microcephaly, brachymesophalangy of the second and fifth fingers, unilateral thumb hypoplasia, bilateral syndactyly of toes 2-3 and amesophalangy of the toes. Karyotype was normal. No other member of the family was affected. A fresh mutation is possible. CONCLUSION Brachymesophalangy affecting mainly the second and fifth fingers and amesophalangy of the lateral toes are cardinal clinical findings in Feingold syndrome. These clinical findings define the syndrome of brachydactyly A4-Temtamy type (MIM 112800), suggesting that brachydactyly A4 would be a partially expressed Feingold syndrome. The incidence of esophageal/duodenal atresia is 29%, including all the known cases. All karyotypes of reported patients were normal.
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Affiliation(s)
- J L Alessandri
- Service de réanimation néonatale et pédiatrique, centre hospitalier départemental Félix-Guyon, Saint-Denis, France
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Montbrun A, Attali T, Sampériz S, Tiran I, Pilorget H, Alessandri JL. [Electrocardiographic signs compatible with subendocardial ischemia in a newborn after maternal electric injury during pregnancy]. Arch Pediatr 1999; 6:1347-8. [PMID: 10627909 DOI: 10.1016/s0929-693x(00)88901-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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18
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Marlin S, Blanchard S, Slim R, Lacombe D, Denoyelle F, Alessandri JL, Calzolari E, Drouin-Garraud V, Ferraz FG, Fourmaintraux A, Philip N, Toublanc JE, Petit C. Townes-Brocks syndrome: detection of a SALL1 mutation hot spot and evidence for a position effect in one patient. Hum Mutat 1999; 14:377-86. [PMID: 10533063 DOI: 10.1002/(sici)1098-1004(199911)14:5<377::aid-humu3>3.0.co;2-a] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Townes-Brocks syndrome (TBS) is an autosomal dominant developmental disorder characterized by anal and thumb malformations and by ear anomalies that can affect the three compartments and usually lead to hearing loss. The gene underlying TBS, SALL1, is a human homolog of the Drosophila spalt gene which encodes a transcription factor. A search for SALL1 mutations undertaken in 11 unrelated affected individuals (five familial and six sporadic cases) led to the detection of mutations in nine of them. One nonsense and six different novel frameshift mutations, all located in the second exon, were identified. Together with the previously reported mutations [Kohlhase et al., 1999], they establish that TBS results from haploinsufficiency. The finding of de novo mutations in the sporadic cases is consistent with the proposed complete penetrance of the disease. Moreover, the occurrence of the same 826C>T transition in a CG dimer, in three sporadic cases from the present series and three sporadic cases from the other series [Kohlhase et al., 1999] (i.e., six of the eight mutations identified in sporadic cases), reveals the existence of a mutation hotspot. Six different SALL1 polymorphisms were identified in the course of the present study, three of which are clustered in a particular region of the gene that encodes a stretch of serine residues. Finally, the chromosome 16 breakpoint of a t(5;16)(p15.3;q12.1) translocation carried by a TBS-affected individual was mapped at least 180 kb telomeric to SALL1, thus indicating that a position effect underlies the disease in this individual.
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Affiliation(s)
- S Marlin
- Unité de Génétique des Déficits Sensoriels, Institut Pasteur, Paris, France
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19
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Marlin S, Blanchard S, Slim R, Lacombe D, Denoyelle F, Alessandri JL, Calzolari E, Drouin-Garraud V, Ferraz FG, Fourmaintraux A, Philip N, Toublanc JE, Petit C. Townes-Brocks syndrome: detection of a SALL1 mutation hot spot and evidence for a position effect in one patient. Hum Mutat 1999. [PMID: 10533063 DOI: 10.1002/(sici)1098-1004(199911)14:5<377::aid-humu3>3.0.co;2-a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Townes-Brocks syndrome (TBS) is an autosomal dominant developmental disorder characterized by anal and thumb malformations and by ear anomalies that can affect the three compartments and usually lead to hearing loss. The gene underlying TBS, SALL1, is a human homolog of the Drosophila spalt gene which encodes a transcription factor. A search for SALL1 mutations undertaken in 11 unrelated affected individuals (five familial and six sporadic cases) led to the detection of mutations in nine of them. One nonsense and six different novel frameshift mutations, all located in the second exon, were identified. Together with the previously reported mutations [Kohlhase et al., 1999], they establish that TBS results from haploinsufficiency. The finding of de novo mutations in the sporadic cases is consistent with the proposed complete penetrance of the disease. Moreover, the occurrence of the same 826C>T transition in a CG dimer, in three sporadic cases from the present series and three sporadic cases from the other series [Kohlhase et al., 1999] (i.e., six of the eight mutations identified in sporadic cases), reveals the existence of a mutation hotspot. Six different SALL1 polymorphisms were identified in the course of the present study, three of which are clustered in a particular region of the gene that encodes a stretch of serine residues. Finally, the chromosome 16 breakpoint of a t(5;16)(p15.3;q12.1) translocation carried by a TBS-affected individual was mapped at least 180 kb telomeric to SALL1, thus indicating that a position effect underlies the disease in this individual.
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Affiliation(s)
- S Marlin
- Unité de Génétique des Déficits Sensoriels, Institut Pasteur, Paris, France
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20
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Graber D, Hebert JC, Jaffar-Bandjee MC, Alessandri JL, Combes JC. [Severe forms of eosinophilic meningitis in infants of Mayotte. Apropos of 3 cases]. Bull Soc Pathol Exot 1999; 92:164-6. [PMID: 10472441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND Eosinophilic meningitis caused by Angiostrongylus cantonensis is widespread in Southeast Asia and the Pacific islands. Adults develop transient meningitis with a benign course, whilst severe or fatal disease may occur in pediatric patients. CASE REPORTS Three infant girls, aged 8 to 11 months, living on the island of Mayotte, developed fever, hypotonia, coma (2 cases), and, for one of them, seizures. Eosinophilia was detected in the peripheral blood and cerebrospinal fluid. Secondary, flaccid quadraplegia (1 case) or paraplegia (2 cases) with absence of deep tendon reflexes, urinary retention and anal incontinence were noted. Three patients had autonomic dysfunction. Computerized tomography showed enlarged ventricles and cerebral subarachnoid spaces. One patient had sequelae. Two patients could not be followed. Retrospectively, the diagnosis of angiostrongylus infection was established for two infants by a serological study. CONCLUSION We report three new cases of infants with severe Angiostrongylus cantonensis infection in the French island of Mayotte (Comoro Islands). In this Indian Ocean area, eosinophilic meningitis seems to occur exclusively in infants and with severe radiculomyeloencephalitic forms.
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Affiliation(s)
- D Graber
- Service de pédiatrie, CHD F. Guyon, St Denis, La Réunion
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21
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Montbrun A, Sampériz S, Tiran I, Pilorget H, Attali T, Alessandri J. Hepatite aigue mortelle chez un enfant de 5 ans revelatrice d'un syndrome lymphoproliferatif lie a l'x (syndrome de purtilo). Arch Pediatr 1999. [DOI: 10.1016/s0929-693x(99)81666-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Abstract
Mutations in exon 5 of the ROMK1 gene (KCNJ1) have recently been observed in antenatal Bartter syndrome patients. This study describes a homozygous deletion removing KCNJ1 exons 1 and 2 observed in a consanguineous family with antenatal Bartter syndrome. Absence of the untranslated exon 1 led to the deletion of transcription elements located in this exon that may cause the disease. Deletion of exon 1 transcription elements should lead to the absence of hROMK2-K5 transcripts, whereas hROMK1 transcripts should normally be transcripted. Consequently, probably only hROMK2-K5 transcripts are expressed in the medullary thick ascending limb of Henle.
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Affiliation(s)
- D Feldmann
- Laboratory of Biochemistry, Armand Trousseau Hospital, Paris, France
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23
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Graber D, Antignac C, Fite A, Deschenes G, Alessandri JL, Combes JC, Ponsot G. Hypoplasie vermienne et néphronophtise juvénile avec délétion du gène NPH1: à propos d'une observation. Arch Pediatr 1998. [DOI: 10.1016/s0929-693x(99)80033-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Montbrun A, Samperiz S, Rivière JP, Attali T, Pilorget H, Alessandri JL. [Secondary fatal acute pancreatitis in ascaridiasis in a 4-year-old child]. Arch Pediatr 1998; 5:928-9. [PMID: 9759302 DOI: 10.1016/s0929-693x(98)80203-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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25
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Graber D, Jaffar MC, Attali T, Poisson J, Renouil M, Alessandri JL, Combes JC. [Angiostrongylus in the infant at Reunion and Mayotte. Apropos of 3 cases of eosinophilic meningitis including 1 fatal radiculomyeloencephalitis with hydrocephalus]. Bull Soc Pathol Exot 1998; 90:331-2. [PMID: 9507763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Eosinophilic meningitis caused by Angiostrongylus cantonensis is widespread in Southeast Asia and Pacific islands. Adults develop a transient meningitis with a benign course but severe or fatal disease may occur in pediatric patients. CASE REPORT 1: A 11 months old boy living in Mayotte island was hospitalized some days after fever and skin rash with seizure status, coma, flaccid quadriplegia, absence of deep tendon reflexes, urinary retention and anal incontinence. Eosinophilia was observed in peripheral blood and in the cerebrospinal fluid. Secondary, he developed a triventricular hydrocephalus treated by a ventriculoperitoneal shunt. After 3 weeks, the child died. Retrospectively, the diagnosis of angiostrongylus infection was established with the help of serology. CASE REPORTS 2 AND 3: Two infants, 10 and 11 months old boys, living in Reunion island, developed fever and vomitings, irritability and, for one of them, a unilateral sixth cranial nerve palsy. There was eosinophilia in the peripheral blood and in the cerebrospinal fluid. All symptoms progressively disappeared with complete recovery. The suspected diagnosis of angiostrongylus infection was confirmed by the serology. CONCLUSION We report the first case of Angiostrongylus cantonensis infection in the French island of Mayotte (Comoro Islands) and we confirm the presence of this disease in Reunion island. In this Indian Ocean area, eosinophilic meningitis occurs most of the time in infants with sometimes severe radiculomyeloencephalitic forms. The origin of these occasionally massive infections is the giant African snail Achatina fulica. For a child with meningitis living in Reunion or Mayotte, or coming back from these 2 islands, Angiostrongylus cantonensis infection must be evoked, especially if there is a blood eosinophilia. Since efficiency of antiparasitic treatment is nowadays not proved, information must be given to people living in exposed areas in view to limit incidence of this disease.
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Affiliation(s)
- D Graber
- Service de pédiatrie, Centre hospitalier départemental F. Guyon, St. Denis, France
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26
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Dubern B, Alessandri JL, Montbrun A, Attali T, Pilorget H, Samperiz S. [Reye syndrome in a child having received chemotherapy]. Arch Pediatr 1998; 5:342-3. [PMID: 10328010 DOI: 10.1016/s0929-693x(97)89384-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
MESH Headings
- Abdominal Neoplasms/drug therapy
- Antibiotics, Antineoplastic/administration & dosage
- Antibiotics, Antineoplastic/adverse effects
- Antimetabolites, Antineoplastic/administration & dosage
- Antimetabolites, Antineoplastic/adverse effects
- Antineoplastic Agents, Alkylating/administration & dosage
- Antineoplastic Agents, Alkylating/adverse effects
- Antineoplastic Agents, Hormonal/administration & dosage
- Antineoplastic Agents, Hormonal/adverse effects
- Antineoplastic Agents, Phytogenic/administration & dosage
- Antineoplastic Agents, Phytogenic/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Burkitt Lymphoma/drug therapy
- Child
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Cytarabine/administration & dosage
- Cytarabine/adverse effects
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Etoposide/administration & dosage
- Etoposide/adverse effects
- Humans
- Male
- Methotrexate/administration & dosage
- Methotrexate/adverse effects
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Reye Syndrome/chemically induced
- Vincristine/administration & dosage
- Vincristine/adverse effects
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27
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Graber D, Alessandri JL, Combes JC, Ponsot G. Les anorexies graves du nourrisson réunionnais: huit observations pour une même maladie ? Arch Pediatr 1998. [DOI: 10.1016/s0929-693x(97)83475-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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28
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Graber D, Alessandri JL, Combes JC, Ponsot G. [Severe anorexia in infants from Reunion Island: eight cases of the same disease?]. Arch Pediatr 1998; 5:90-2. [PMID: 10223120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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29
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Graber D, Jaffar-Bandjee MC, Attali T, Poisson J, Renouil M, Alessandri JL, Combes JC. [Angiostrongylosis in infants in Reunion and Mayotte. Apropos of 3 cases of eosinophilic meningitis including 1 fatal radiculo-myeloencephalitis with hydrocephalus]. Arch Pediatr 1997; 4:424-9. [PMID: 9230991 DOI: 10.1016/s0929-693x(97)86666-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Eosinophilic meningitis caused by Angiostrongylus cantonensis is widespread in Southeast Asia and Pacific islands. Adults develop a transient meningitis with a benign course but severe or fatal disease may occur in pediatric patients. CASE REPORT Case 1. A 11-month-old boy living in Mayotte island was hospitalized a few days with fever and skin rash following by seizure, coma, flaccid quadraplegia, absence of deep tendon reflexes, urinary retention and anal incontinence. Eosinophilia was observed in peripheral blood and cerebrospinal fluid. He further developed a triventricular hydrocephalus treated by ventriculoperitoneal shunt. The child died 3 weeks later. A serodiagnosis of angiostrongylus infestation was restrospectively established. Case reports 2 and 3.-Two infants, 10 and 11-month-old-boys, living in Reunion island, developed fever and vomitings, irritability and, for one of them, unilateral sixth cranial nerve palsy. There was eosinophilia in the peripheral blood and in the cerebrospinal fluid. All symptoms progressively disappeared with complete recovery. The suspected diagnosis of angiostrongylus infestation was confirmed by the serology. CONCLUSION We report the first case of Angiostrongylus cantonensis infection in the French island of Mayone (Comoro Islands) and we confirm the presence of this disease in Reunion island. In this Indian Ocean area, eosinophilic meningitis occurs most of the time in infants with sometimes severe radiculomyeloencephalitic forms.
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Affiliation(s)
- D Graber
- Service de pédiatrie, centre hospitalier départemental F-Guyon, Saint-Denis, la Réunion, France
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30
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Abstract
BACKGROUND Viruses, such as those of congenital rubella and cytomegalovirus infection, have been associated with bone lesions of rarefaction. CASE REPORT A full-term neonate was admitted at bith (birth weight: 1,630 mg; head circumference: 29 cm) for hypotrophy. A severe growth retardation had been diagnosed at 32 weeks of gestation. The fetal karyotype was normal. Search for maternal toxoplasmosis, syphilis and rubella was negative. The neonate had a complex heart defect; skeletal X-ray films showed metaphyseal transverse bands of rarefaction of the long bones and longitudinally streaked band of sclerosis and rarefaction at the ends of the femora. Urine culture was highly positive for CMV while CMV IgM were negative and CMV IgG highly positive in serum. CONCLUSIONS Neonatal bone changes usually seen in congenital rubella infection may also be observed in CMV infection.
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Affiliation(s)
- J L Alessandri
- Service de réanimation néonatale et infantile, CHD Félix-Guyon, Saint-Denis, La Réunion, France
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31
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Tilmont P, Rogé-Wolter M, Alessandri JL, Bratzlawsky C. [Mortality and short-term outcome of low birth-weight infants 1500 g or less in Reunion]. Arch Pediatr 1995; 2:598-600. [PMID: 7640765 DOI: 10.1016/0929-693x(96)81209-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Alessandri JL, Guionnet N, Serres H, Montbrun A, Tilmont P, Combes JC. [Myxedematous pericarditis in a child]. Arch Pediatr 1995; 2:382-3. [PMID: 7780549 DOI: 10.1016/0929-693x(96)81163-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Pilorget H, Alessandri JL, Montbrun A, Ah-Hot M, Orvain E, Tilmont P. [Isotretinoin (RoAccutane) embryopathy. A case report]. J Gynecol Obstet Biol Reprod (Paris) 1995; 24:511-515. [PMID: 7499738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Retinoids are synthetic vitamin A derivatives, particularly used in dermatology. Their prescription in women of childbearing age can cause, if pregnancy occurs, a serious malformative embryopathy, mainly involving external ear, brain and heart. A neonatal case caused by isotretinoin (RoAccutane) emphasizes the clinical and epidemiological data concerning this embryopathy. The aetiopathological hypothesis of an interaction between isotretinoin and Hox genes is advanced. Prophylactic measures are difficult since neonatal reported cases are uncommon, but antenatal exposition to this strong teratogenic agent results in multiple spontaneous abortions or pregnancy interruptions.
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Affiliation(s)
- H Pilorget
- Service de Néonatologie et Réanimation Néonatale et Pédiatrique, Centre Hospitalier, Saint-Denis, La Réunion
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Tilmont P, Alessandri JL, Duthoit G, Rossi-Farrer C, Roge-Wolter M. [Chylous effusion and surgical treatment of diaphragmatic hernia in 2 newborn infants]. Arch Fr Pediatr 1993; 50:783-6. [PMID: 8060209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND. Post-operative chylous effusion is rare in infants. It may result from venous thrombosis, thoracic duct injury or lymphatic vessel obstruction. This paper describes 2 cases of diaphragm hernia with post-operative chylous effusion. CASE REPORTS Case 1: A newborn developed chylous ascites two weeks after repair of a left posterolateral diaphragm hernia. Abdominal paracentesis showed milky fluid containing numerous lymphocytes (98%). Ascites was rapidly reduced by feeding with medium-chain triglyceride-rich (MCT) formula. Case 2: A chylothorax was seen 7 days after surgery to repair a left posterolateral diaphragm hernia. Thoracocentesis showed serous fluid containing numerous lymphocytes (93%). The chylothorax was resolved after two thoracocenteses, parenteral nutrition and feeding with MCT formula. CONCLUSION. These cases are the third report of chylothorax and the second report of chylous ascites after surgical repair of a diaphragm hernia. The exact cause of the chylous effusion is not clear.
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Affiliation(s)
- P Tilmont
- Service de Réanimation Néonatale et Infantile et de Chirurgie Infantile, Centre Hospitalier Félix-Guyon
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