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Norwegian scabies in Bloom's syndrome.

Norwegian scabies is an unusual Sarcoptes scabiei infestation. It has been reported often in patients who are either severely debilitated or who have congenital or iatrogenic suppression of their immune responses. We report the occurence of Norwegian scabies in a 13-year-old boy with Bloom's syndrome who had impaired humoral and cell-mediated immunity.

Adolescent↗

Telangiectasia.

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Adolescent↗

The 'CREST' syndrome. Comparison with systemic sclerosis (scleroderma).

The CREST syndrome refers to a disorder comprising the manifestations of calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia. Thirteen CREST patients (two with CRST) were compared with 26 patients with systemic sclerosis but without the full manifestations of the CRST syndrome. No significant difference was found between the groups in the age of onset of Raynaud's phenomenon, degree of multiphasic digital color changes, ulcerations of fingers, sclerodactyly, or in the frequency of abnormal esophageal peristalsis or dysphagia. Laboratory results were similar, including the frequency of an elevated ESR. However, the CREST patients had a significantly lower frequency of arthralgia (54%) and arthritis (15%) than did those with scleroderma (88% and 65%, respectively). All but one of the CREST patients were women, which was a greater proportion than found among scleroderma cases (69%), and all were white (P less than .05). Most patients with the CREST syndrome had rather severe acrosclerosis. At last evaluation, four patients were chronically ill and three had died. The CREST and CRST syndromes are closely related disorders that seem to be part of the spectrum of systemic sclerosis.

Adult↗

Gastrointestinal telangiectasias. A source of bleeding in patients receiving hemodialysis.

Endoscopy was used over a five-year period to determine the cause of acute or chronic gastrointestinal (GI) tract bleeding in 46 patients receiving long-term hemodialysis. Nine (19%) of the patients were found to be bleeding from telangiectasias. We observed the occurrence of such lesions in the stomach, the small bowel, and the colon. Endoscopic cauterization of the lesions in three patients and jejunal resection in another stopped previously recurrent GI tract bleeding.

Aged↗

Arteriovenous malformations of the brain. I: Current concepts and treatment.

Arteriovenous malformations (AVMs) of the brain are uncommon congenital lesions, causing symptoms in the middle decades of life. Neurosurgical and neuroradiological techniques have been developed to deal effectively with these lesions, in many instances resulting in a cure. This first part of a two-part article details the important anatomic aspects of these lesions, symptoms, and radiographic considerations. The largest group of lesions discussed here, the AVMs, vary in size but are usually large, involving important areas of the cortex and white matter with a complex array of arterial to venous shunts. Their most common initial symptoms are due to hemorrhage or seizure. The use of the computerized tomographic scan has often resulted in the unexpected diagnosis of these lesions. However, angiography remains the paramount method of defining these lesions.

Brain Neoplasms↗

Acute cerebellar hemorrhage secondary to capillary telangiectasia in an infant. A case report.

We encountered an unusual case of an acute cerebellar hemorrhage secondary to a capillary telangiectasia in a 4-month-old infant. Prompt surgical evacuation of the cerebellar hematoma resulted in an excellent neurologic outcome. To the best of our knowledge, ours represents the only clinical case report of massive cerebellar bleed due to a capillary telangiectasia.

Acute Disease↗