Biomedical subjects
A Trehan
Publications and source records attributed to A Trehan.
Long term survival in a young girl with renal cell carcinoma.
A young girl with an uncommon renal tumour is the subject of this communication. A diagnosis of renal cell carcinoma was established post-operatively. Combined modality treatment including chemotherapy and radiotherapy has helped achieve a disease free survival of nearly 5 years.
Retro-peritoneal cystic lymphangioma in association with fetal hydantoin syndrome.
Antiepileptic drugs are known to be teratogenic. Use of phenytoin during pregnancy can cause various congenital malformations leading to 'fetal hydantoin syndrome'. One such case reported is unique in the sense that it occurred with retroperitoneal cystic lymphangioma, itself a rare condition. Such an association is not described elsewhere.
Urinoma--an unusual complication following kidney biopsy.
Development of urinoma is an unusual complication following kidney biopsy. We describe one such case who was managed successfully by ultrasound guided percutaneous catheter drainage.
Human immunodeficiency virus infection transmitted through breast milk.
Perinatal acquisition of human immunodeficiency virus is responsible for most cases of pediatric AIDS. Breast feeding has been found to carry a higher risk of transmission of HIV and is not recommended to HIV infected mothers in the western world. In our country we have to be aware of the increasing incidence of pediatric AIDS and the varied constellation of symptoms it can present with. Also, we have to ensure that safe blood is available to avoid transfusion acquired diseases.
Accelerated phase at initial presentation: an uncommon occurrence in Chédiak-Higashi syndrome.
The authors describe an Indian child, who presented in the accelerated phase of the Chédiak-Higashi syndrome. The disease usually presents in early childhood with recurrent skin and mucosal infections. This patient had subtle pigmentary abnormalities and no family history of the disease, which made the clinical diagnosis difficult. The cytopenias, hepatosplenomegaly, lymphohistiocytic infiltrate in the bone marrow, and the characteristic granules in the leucocytes clinched the diagnosis. This case underscores the importance of a bone marrow examination in patients with unusual presentations of rare disorders.
The psuedo-Chediak-Higashi anomaly: an unusual staining pattern in an Indian child with acute myeloid leukemia.
The authors describe the psuedo-Chediak-Higashi anomaly in a 12-year-old boy with acute myeloid leukemia (AML-M2). There were large purple granules in the blasts, promyelocytes, and myelocytes. Instead of the previously described patterns, the authors observed a unique rim pattern staining of the granules in both the May-Grunwald-Giemsa and the myeloperoxidase stains. Moreover, many of the granules had central vacuoles with strong myeloperoxidase positivity at the periphery. The bone marrow had a much higher positivity for these mega-granules as compared to the peripheral blood. On remission, these granules were no longer seen. To the best of the authors' knowledge, this pattern of staining has not been previously reported in the literature.
Facial nerve palsy in an infant with hemophilia A.
A 5-month-old infant with hitherto undiagnosed hemophilia A, who developed a unilateral lower motor neurone type of facial palsy, is described. A high-resolution CT scan confirmed the nerve palsy to be a consequence of a hemotympanum. The patient recovered completely in 7-10 days after therapy with factor VIII concentrate.
Blue rubber bleb nevus syndrome: a cause for recurrent episodic severe anemia.
A 7-year-old boy had several episodes of severe anemia, requiring hospitalizations and blood transfusions. Skin hemangiomas characteristic of blue rubber bleb nevus syndrome were present since infancy, but were not recognized as being indicative of simultaneous existence of bowel hemangiomas, resulting in a delay of several years before an accurate diagnosis could be made.
Portal hypertension secondary to Langerhans cell histiocytosis.
We report two children, aged 2 and 2 1/2 years, with multisystem Langerhans cell histiocytosis (LCH). Both were administered chemotherapy, with apparently good response. However, hepatic fibrosis and portal hypertension were detected 5 and 1 1/2 years after therapy, respectively. The first child died after a bout of hematemesis. Hepatic fibrosis can proceed despite apparently successful chemotherapy in LCH.