Biomedical subjects
Publications and source records attributed to C M F Kneepkens.
Refraining from smoking during pregnancy and giving exclusively breast feeding for 4-6 months reduce the chance of allergic manifestations during the first 6 years of life and possibly longer. Hypoallergenic baby foods have a comparable effect on food allergy and atopic eczema, but their long-term effects remain uncertain. The prevention of allergy is therefore both possible and useful.
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Three children, two boys aged 5 years and one 2-year-old girl, who were referred because of abdominal pain of variable duration, were found to have cystic malformations that arose from the pancreas. In the first boy, a traumatic pseudocyst was found that eventually turned out to have been caused by child abuse. The second boy had pseudocysts complicating chronic pancreatitis of presumably hereditary origin. In the girl, a congenital pancreatic cyst was found. Pancreatic disease, although rare, should be considered in the differential diagnosis of abdominal pain in children.
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A 2-month-old, prematurely-born boy suffered from vomiting and failure to thrive due to the combination of a large hiatal hernia and malrotation of the intestine.
To date, microvillus inclusion disease (MID) has been diagnosed in six Dutch patients. It is a rare autosomal recessive hereditary intestinal disorder mostly presenting with malabsorption and severe secretory diarrhoea from birth. The diagnosis is confirmed by electron microscopy of intestinal mucosal biopsies, which show characteristic intracytoplasmic vesicles containing clearly recognisable microvilli and irregularly distributed microvilli in the brush border. The two clinical forms of the disease that have been recognised internationally, a 'congenital' and a 'late-onset' form of MID, have also been observed in the Dutch patients. At the last follow-up five patients had died, the sixth was 17 years old and alive. The pathogenesis and genetics of MID are, as yet, unknown. Eventually, all patients die from complications of the disease, notably from the total parenteral nutrition. The only chance of survival is intestinal or combined liver-intestinal transplantation.
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