[Panophthalmia caused by Pseudomonas in a newborn infant--indication for ophthalmologic-pediatric cooperation].
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Blindness↗
Biomedical subjects
K Rieske
Publications and source records attributed to K Rieske.
[Alpha 2-antiplasmin in childhood].
In 119 children, predominantly newborns and babies with sepsis, alpha 2-Antiplasmin was determined by the use of the chromogenic substrate S-2251. In healthy newborns, the inhibitor level averaged 65 per cent of the adult level. Already in the initial phase of sepsis, enhanced alpha 2-antiplasmin values were observed. During the further course, they increased markedly. Thus, alpha 2-antiplasmin proved to be an acute phase reactant together with fibrinogen, factors II and X, and alpha 1-antitrypsin measured as trypsin inhibitor capacity. The correlation analysis in all subgroups showed moderately tight binding to fibrin. In patients with shock or in those who decreased, lower levels were measured. The overproduction is assumed to be caused by disseminated intravascular coagulation processes. In other diseases such as respiratory distress, alpha 2-antiplasmin was reduced. In case of disseminated intravascular coagulation that was not caused by sepsis consumption of components dominated. In the probability paper, distribution of the values of the subgroups was found to differ markedly. Thus, the inhibitor proved to be of diagnostic value.
Blood Coagulation Factors↗
[Chlamydia pneumonia in infancy].
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Age Factors↗
[Sepsis due to E. coli in newborns with galactose intolerance (author's transl)].
The authors report on a case of sepsis due to E. coli in a newborn baby with galactose intolerance. The immature immunological state of the newborn child in combination with a disorder of galactose metabolism obviously favour the development of bacterial infections. Galactose-free formulas should be applied quickly together with an adequate antibiotic therapy in the case of newborn babies with suspected bacterial infection. The prognosis may be influenced favourably by early clarification of the cause of severe impairment including jaundice, vomiting, loss of weight and somnolence in the first three weeks of life.
Anti-Bacterial Agents↗
[Incipient spinal cord compression syndrome due to a herniation of calcified intervertebral disk in a young girl].
Intervertebral disc calcification in childhood is rare. Calcifications are discovered by occasion during routine examinations of healthy children or evoke symptoms like neck and shoulder pain or discrete neurological symptoms. The prognosis of nearly all patients is excellent. We report on a 11-year-old girl, who suffered from acute pain in the neck and the left shoulder with increasing paresthesias of her left extremities which led to hospitalisation. Intervertebral disc calcifications were found between several cervical and thoracic vertebra. The only paraclinical finding was an elevated erythrocyte sedimentation rate. After 12 days of conservative and analgetic treatment the clinical condition deteriorated with acute worsening of the neck pain. The MRI revealed a posterior herniation of a calcified disc between the lower cervical spine with spinal cord compression. Immediate neurosurgical intervention led to decompression and disappearance of the symptoms. After 14 months the clinically healthy child only showed the persistence of one intervertebral disc calcification and a complete resolution of the former findings.
Calcinosis↗
[Improved results in the treatment of acute myeloid leukemia - Results of study AML-BFM-93 in East Germany with comparisons to the preceding studies AML-I-82 and AML-II-87].
BACKGROUND: Three multicenter studies were conducted in East Germany on the treatment of acute myeloid leukaemia in children. The latest of the three studies (AML-BFM-93-OST) was part of the common German study AML-BFM-93. PATIENTS AND METHODS: The total number of registered patients was 262. The number and dosage of administered chemotherapeutic agents was elevated with each new study. RESULTS: Both the remission rate (85 %) and the likelihood of an event free survival (52 % after 5 years) could be improved significantly in study AML-BFM-93-OST. The results of the common German study AML-BFM-93 were identical to those of the East German part AML-BFM-93-OST. Compared with international studies it was one of the most successful treatment strategies in children with AML. Patients who showed toxic side effects to heart, liver, kidneys, skin or nervous system during the chemotherapy had a significantly lower risk of relapse, once they overcame the intensive therapy. During the five years of study AML-BFM-93-OST, treatment results could be improved despite an unchanged therapy strategy. This may partly be due to the modernisations and restorations that were carried out in many East German hospitals in this time. CONCLUSIONS: The therapy regimen of study AML-BFM-93 allowed a substantial improvement in the treatment of children with AML. Further intensification of chemotherapy should only be undertaken in accordance to the individual sensitivity of each patient.
Acute Disease↗
[Clinical aspects and epidemiology of hepatitis C in immunosuppressed children with mostly oncologic diseases].
Between July and October 1996 hepatitis C virus infection was diagnosed in 21 children who underwent immunosuppressive therapy mainly for malignant diseases. We report on the clinical signs and symptoms, diagnostic procedures and the clinical course of the disease in these patients. Epidemiological, diagnostic and clinical aspects of the outbreak are discussed. Analysis of all available data led to the conclusion that these infections were of nosocomial origin. This requires consequences in the hygienic regimen. In addition to the routinely used antibody-test the HCV-PCR should be the diagnostic method of first choice concerning the HCV-diagnostics in immunocompromised patients.
Adolescent↗
Impaired renal function and tumor lysis syndrome in pediatric patients with non-Hodgkin's lymphoma and B-ALL. Observations from the BFM-trials.
OBJECTIVE: Tumor lysis syndrome and renal failure remain important complications early in the course of therapy for pediatric Non-Hodgkin's lymphoma (NHL), frequently leading to therapeutic alterations. In the presented series, children with NHL and tumor lysis syndrome are retrospectively analysed regarding clinical features of acute renal failure and its implications on therapy. PATIENTS AND METHODS: From 4/1990 to 10/1997, 1192 patients diagnosed of any form of NHL have been registered in the NHL-BFM trials. 63 of these patients were reported to have suffered from impaired renal function and/or tumor lysis syndrome before or during initial treatment. Clinical data of these patients were analysed regarding diagnosis, stage, tumor mass, therapy and complications. RESULTS: 62 of 63 patients with impaired renal function and/or tumor lysis syndrome were diagnosed of Burkitt's lymphoma or B-ALL; 58 (92%) of these patients had advanced stages of disease and high LDH-levels (> 500 U/l). 43 of 63 patients had already signs of impaired renal function at admission. Hyperuricemia was the commonest cause of impaired renal function. Renal infiltration or enlargement was observed in 27 of 63 patients. 6 patients were diagnosed of urinary tract obstruction. 25 patients required hemodialysis. Despite improved renal function before administration of MTX, 21 of 63 patients suffered from protracted MTX-elimination during the first course of therapy. 7 of 63 patients (11%) with tumor lysis syndrome died of sepsis after the first course of therapy, another two patients died within 48 hours of therapy due to electrolyte imbalances. CONCLUSIONS: In pediatric NHL-patients, Burkitt's lymphoma and B-ALL appear to be the commonest cause of metabolic complications early in chemotherapy. Patients with advanced stages and large tumor mass are at high risk for renal failure. Impaired renal function predisposes patients to further complications and toxic death. Prophylactic use of urate-oxidase in all patients with advanced stage NHL might limit the incidence of tumor lysis syndrome. Prospective studies on renal function prior to and during therapy are required in order to develop a clinical profile reliably detecting patients at risk for developing renal failure and subsequent complications.
Acute Kidney Injury↗
[Multiplication of chromosomes and primary leucocyte number in childhood ALL and hyperdiploid karyotype].
In the blast cells of children with acute lymphoblastic leukemia (ALL) more than 50 chromosomes can be observed in a quarter of cases. As a rule these children have a good prognosis. However, some of these patients develop a relapse of their basic disease. There is only poor information about the significance of distinct additional chromosomes for the prognosis. The white blood cell count (WBC) at the time of diagnosis is a further very important prognostic factor in childhood ALL. Therefore we compared the relation between trisomy of distinct chromosomes and the initial white blood cell count of 41 children with common ALL and hyperdiploid karyotype. The modal chromosome number ranged from 50 to 60 chromosomes. Most frequently, the chromosomes X, 4, 6, 8, 10, 17, 18 and 21 were multiplied. Additionally, in 25 of the 41 cases structural chromosome aberrations were observed. The average WBC was estimated as 9.6 Gpt/l with a range from 1.8 to 41.5 Gpt/l. The initial WBC was slightly increased in patients with the additional chromosome X, 6, 11, 12 or 19 and distinctly decreased in children with the additional chromosome 8 or 9 in their hyperdiploid blast cells. No patient with an additional Chromosome 9 showed a WBC higher than 10 Gpt/l and only 2 out of the 12 children with an additional chromosome 8 revealed an initial WBC higher than 10 Gpt/l. Additional structural chromosome aberrations were without influence on the WBC.
Adolescent↗
[Infection caused by viridans streptococci in children with malignant hematologic diseases].
This is a review of the symptoms and signs of children with malignant diseases and septicemia due to viridans streptococci, treated during a 6-year-period (1990-1995) in the Departments of Pediatrics or Pediatric Surgery, University of Leipzig. All 11 children suffered from leukemia. Streptococcus mitis was the most frequently isolated streptococcal species. All patients had fever and malaise, in most cases we could find inflammatory signs of the respiratory tract. In two children we saw a severe course of the disease, one child had symptoms and signs of ARDS, the other died on septicemic shock. All 11 patients had neutropenia and a central venous line, 10 of them were treated by cytarabine before the streptococcal infection was diagnosed. Like others we could note during the last years an increase of systemic infections due to viridans streptococci in neutropenic patients with malignant diseases. Possibly there is an association between streptococcal infection and cytarabine therapy. The empiric antibiotic therapy in neutropenic patients with malignant diseases should cover also streptococcal infections.
Adolescent↗
Therapy of sinuorbital aspergillosis with amphotericin B colloidal dispersion.
Invasive aspergillosis is a feared complication in the management of patients with malignancies. We report a 13-year-old boy with acute myelogenous leukaemia and chronic sinusitis who developed a sinuorbital fungal infection during cytostatic and prolonged antibiotic treatment. The clinical findings, diagnostic measures and treatment and its adverse effects are described and discussed. Special emphasis is given to our experience of the use of colloidal dispersed amphotericin B (Amphocil).
Adolescent↗