[Clinical and therapeutic aspects of dermatomyositis in childhood].
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Biomedical subjects
Publications and source records attributed to L R Garibaldi.
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Four boys, aged 2 years 5 months to 3 years 7 months, with large hepatomegaly due to phosphorylase-kinase deficiency glycogenosis, were given a trial of sodium dextrothyroxine (D-T4) at a mean dose of 0.165 mg/kg/day for an average period of 6 months. Phosphorylase-kinase was undetectable in the haemolysates of erythrocytes (3 patients) or in the liver (one patient) before, and still undetectable in the haemolysates of the four patients during treatment, thus pointing to X-linked phosphorylase-kinase deficiency glycogen storage disease (GSD IXb). D-T4 administration resulted in complete normalization of liver size, decrease of serum GOT (p less than 0.02), GPT (p less than 0.05) and triglycerides (p less than 0.01) to normal values, as well as correction of mild asymptomatic hypoglycemia (p less than 0.01). As long as the outcome of type IXb glycogenosis in adult life remains undefined, dextrothyroxine therapy seems an effective means of reducing liver size and correcting part of the biochemical abnormalities of the disease.
Clinical and biochemical evidence of oculocutaneous tyrosinosis, a rare disease due to hepatic soluble tyrosine aminotransferase (STAT) deficiency, was found in a 3 1/2-year-old girl and in her maternal aunt. Different expressivity of this disease, resulting in clinical heterogeneity, is shown to occur commonly according to the cases reported in this as well as in previous studies. The metabolic pathways leading to the unexpected excretion of phenolic acids in urine are reviewed, and the need for early diagnosis and dietary treatment, in order to prevent corneal clouding and brain damage is finally stressed.
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