[Chronic, infantile, neurologic, cutaneous and articular syndrome (CINCA) in an infant]

BACKGROUND

CINCA syndrome is a clinical syndrome of unclear etiology, characterized by a chronic multi-organ inflammatory process unsusceptible to treatment.

CASE REPORT

An 18-month-old boy was admitted because he suffered, since the age of 2 months, from cutaneous, articular and neurological changes, lymphadenopathy, hepatosplenomegaly, choroiditis and psychosomatic development retardation. These clinical symptoms were unsusceptible to anti-inflammatory and antihistaminic drugs. Rehabilitation was not effective either.

CONCLUSION

A long-term clinical observation is required before sustained multi-organ changes beginning in early childhood and exclusion of other chronic inflammatory diseases enable the diagnosis of CINCA syndrome.

Internal organ involvement in juvenile connective tissue disease

Using noninvasive investigative techniques, cardiac, pulmonary and gastrointestinal abnormalities were found in patients with all types of connective tissue diseases. Impedance rheography suggested impaired myocardial function. Abnormalities of pulmonary function included a decrease in diffusing lung capacity for CO (DL) values followed by restrictive ventilatory defects and mild alveolar hyperventilation. The results of endoscopic investigation of the gastrointestinal tract showed inflammatory changes. Ultrasonography revealed dyskinesis of the ducts of the gallbladder and some hepatic and pancreatic structural changes.

Pulmonary lesions in the course of rheumatoid arthritis in children

Pulmonary morphological lesions are described in 16 children who died of rheumatoid arthritis. In all of them the disease had a stormy course. Generalized amyloidosis was the most frequent cause of death. The majority of cases showed clinical and morphological lung lesions. The lung lesions were only rarely the chief cause of death. There were no formations of the type of rheumatoid nodule nor diffuse lung fibrosis. There was only peribronchial and perivascular fibrosis as well as thickening of interalveolar septa. The most frequent abnormalities, namely lung congestion and edema could result from extrapulmonary causes or agony. Although the observed lung lesions are nonspecific, they can reflect the generalization of the disease.