Clinical quiz.
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Diagnosis, Differential↗
Biomedical subjects
J Amil Dias
Publications and source records attributed to J Amil Dias.
Does umbilical vein catheterization to exchange transfusion lead to portal vein thrombosis?
UNLABELLED: The aetiopathology of extrahepatic portal vein obstruction is unknown. In retrospective studies, umbilical vein cannulation and sepsis have been alleged to cause portal thrombosis. This prospective study was undertaken to detect whether thrombosis and consequent obstruction of the splenoportal venous system develops after umbilical vein catheterization for exchange transfusion in newborns using Doppler ultrasound. Forty children (M = 24; F = 16) who had undergone exchange transfusion for hyperbilirubinaemia were studied at school age. Maximal duration of the venous umbilical cannulation was 120 min and sepsis did not occur. Clinical, biological and sonographic examinations were normal, except in 3 children. In 2 the left branch of portal vein could not be identified (normal variant). CONCLUSION: Our results show that, in these children, umbilical vein catheterization did not lead to development of portal vein thrombosis. However, when other risk factors such as umbilical infection, traumatic catheterization are associated, children should be screened for obstruction of the portal vein.
Child↗
[Bullous pemphigoid in an infant].
Bullous pemphigoid is an acquired auto-immune blistering disease, which affects predominantly the elderly. It is rare in children and exceptional in infant. To our knowledge only ten cases were previously reported. We report a new case of a previously healthy six months old infant who presented with erythemato-vesico-bullous cutaneous lesions over a period of six days. Histology and immunofluorescence led to the diagnosis of bullous pemphigoid. Therapy with systemic and topic corticosteroids resulted in a good outcome.
Female↗