Surgical Intervention in Pediatric Orbital Hemangioma: A Case Report

Infantile hemangiomas are common vascular tumors in infancy, typically affecting the skin. However, intraconal orbital hemangiomas are rare and present diagnostic challenges due to their impact on critical structures within the orbit. We present the case of a 1-year-old male with progressive orbital swelling and proptosis. Initial conservative management with propranolol was attempted, but due to the lack of response, surgical resection of the intraconal hemangioma was performed. Pediatric orbital hemangiomas, particularly intraconal variants, pose distinctive diagnostic challenges. While conservative approaches, such as propranolol, align with evolving strategies for infantile hemangiomas, surgical intervention may be necessary in cases with an inadequate response. This case underscores the importance of recognizing the need for timely surgical intervention in pediatric orbital hemangiomas, even after initial conservative measures. Successful surgical outcomes contribute to understanding pediatric orbital pathology and emphasize the ongoing evolution of management strategies in this challenging clinical scenario.

Fetal/neonatal alloimmune thrombocytopenia: a continuing challenge

Fetal/neonatal alloimmune thrombocytopenia is the platelet counterpart of the red cell disorder, haemolytic disease of the fetus and newborn. Unlike Rhesus pregnancies, first pregnancy is commonly affected. It is a progressive disease and can cause severe fetal damage, late fetal and neonatal loss and severe handicap. No screening programme is currently available and the diagnosis is often delayed. Testing for platelet antibodies in those mothers whose babies are thrombocytopaenic is necessary for early detection of this condition.

Effect of ammonia on in vivo and in vitro immune responses

The effects of exposure of animals to ammonia on their delayed type of dermal response, the mitogenic and antigenic responses of their lymphocytes, and the bactericidal and phagocytic activities of their alveolar macrophages were examined. Experimental guinea pigs vaccinated with Mycobacterium bovis BCG were exposed to 3.75 micrograms of ammonia per dl of air (50 ppm) or 6.75 micrograms of ammonia per dl of air (90 ppm), whereas control animals also vaccinated with BCG were maintained in the normal environment. The delayed type of dermal response to tuberculin injected 3 weeks later was significantly (P less than 0.05) less in experimental animals exposed to 6.75 micrograms of ammonia per dl than in control animals. In vitro, the response of blood lymphocytes and bronchial lymphocytes to phytohemagglutinin, concanavalin A, and tuberculin stimulation was significantly (P less than 0.01) less than the response of lymphocytes from control animals. The response of normal blood lymphocytes to phytohemagglutinin incubated in medium containing 1 or 10 mg of ammonia per dl was significantly (P less than 0.01) reduced as compared with the response of lymphocytes incubated without ammonia. The viability of lymphocytes incubated with these concentrations of ammonia was significantly (P less than 0.01) affected. There was no significant difference in the bactericidal or phagocytic activities of alveolar macrophages collected from animals exposed to ammonia and control animals. However, ammonia added to the culture of alveolar macrophages from normal animals significantly inhibited their bactericidal activity.