[Preeclampsia increases the risk of hyaline membrane disease in premature infant: a retrospective controlled study]

OBJECTIVES

Relation between preeclampsia (PE) and hyaline membrane disease (HMD) is still controversial. We found interesting to contribute to the study of this relation by comparing a HMD group to a control group with the aim to know if the risk to develop HMD was more important in case of PE.

MATERIAL AND METHODS

Two groups of premature infants (HMD group and control group) weighing less than 2000g and hospitalized between 1st January 2004 and 31st December 2005, were compared for data concerning mother (age, parity, diabetes, corticotherapy), PE (severity, complications, type and treatment), delivery (mode, infectious context, perinatal asphyxia) and neonatal stay (gestational age, birth, weight, sex). A multivariate analysis by logistic regression was used to control the effect of potential confounding variables that were considered risk factors for HMD.

RESULTS

Ninety-seven neonates were retained and were compared to 97 control. PE was present in 71 cases in HMD group and in 51 cases of control group. This difference was statistically very significant (p=0.003). When we controlled for confounding variables, there was a significant increase in risk to develop HMD (odds ratio, 1.3; 95% confidence interval, 0.7-1.8).

CONCLUSION

The risk to develop HMD, in premature infant weighing less than 2000g, is increased in case of PE. These finding support that fetal lung maturity is not accelerated in PE, in the opposite, it is delayed.

[Vein of Galen aneurysmal malformation: a neonatal case with unusual evolution]

We report on a neonatal patient case with a cerebral vascular dilation consistent with a vein of Galen malformation diagnosed on an antenatal doppler ultrasound examination. Antenatal diagnosis was confirmed by fetal MRI scan. After delivery, cerebral MRI scan found the same dilatation and showed no cerebral parenchymal damage. The infant's condition was stable and particularly there was no congestive cardiac failure. Before discharge at ten days of age, clinical examination and particularly cardiac examination was normal. At 14 days of age, symptoms in relation to a congestive cardiac failure appeared. Echocardiography showed a high output cardiac failure with no cardiac malformation. Infectious laboratory tests were normal. Evolution was initially favourable after digitalo-diuretic treatment. Unfortunately, death occurred at 36 days of age due to intractable cardiac failure. This case highlights that, unusually, heart failure can occur long after the first days of life in cases of Galen vein aneurysmal malformation. The optimal time for vascular embolization in neonatal cases of Galen vein aneurysmal malformation is discussed.

The Antley-Bixler syndrome. A new case without radiohumeral synostosis

The author report a new case of the syndrome described by Antley and Bixler. It concerns a female new-born who presents a craniosynostosis with brachycephaly, midface hypoplasia, unilateral choanal atresia, multiple joint contractures and arachnodactyly. There was no bowing of the femora and only the radius and the ulna were bowed. The absence of radiohumeral synostosis reported in all observations of the literature represents the main particularity of this observation.

[Neurologic Behçet disease]

BACKGROUND

Behçet's disease is very occasionally revealed by neurological abnormalities. This report describes such a case.

CASE REPORT

A 13 year-old girl was admitted because of status epilepticus and fever. Clinical examination showed horizontal nystagmus, cerebellar syndrome, right hemiplegia, ophthalmoplegia and meningitis. Her CSF contained 80 lymphocytes/mm3, 0.75 milligram proteins and 0.5 milligram glucose. CT scan showed a hypodense area in the internal capsule. Two similar episodes occurred 4 and 6 months later, but all attempts at determining the etiology were negative. A diagnosis of neurological Behçet's disease was considered 10 months after the first episode when the patient developed oral ulcers followed by pseudofolliculitis of the scalp. The disease recurred several times despite treatment with prednisone, colchicine and antiaggregant drugs.

CONCLUSION

Recurrent aseptic meningitis is a classic manifestation of neurological Behçet's disease. It usually appears 2 months to 27 years after the first extraneurological signs and not, as in this case, several months before.