Acute nonspecific mesenteric lymphadenitis (ANML) is a common cause of acute abdominal pain in children with no specific treatment.A total of 13 patients (6 boys, 7 girls) aged 7.3 (5-13.5) years with severe acute abdominal pain were evaluated using ultrasonography and laboratory tests to establish the diagnosis of ANML. They were treated with prednisone 1 mg/kg (max 40 mg daily) for a maximum of 5 days. The intensity of abdominal pain was evaluated before and after treatment using a numeric rating scale.All patients had pain scores above 6/10 before, and below 4/10 after treatment with prednisone. Intensity of abdominal pain after treatment for 1-5 days decreased significantly (p < 0.001), with no recurrence at follow-up within 3 months. All other pre-existing signs and symptoms, such as nausea, vomiting, anorexia, fever, diarrhea, and constipation were found to disappear with no adverse effects of corticosteroid therapy.These results suggest that the treatment with prednisone in selective patients with ANML can reduce the duration of abdominal pain.
The authors present contemporary views on the pathogenesis, clinical picture and treatment of chronic renal failure. A comprehensive approach to the pathogenesis of renal failure revealed new therapeutic methods such as treatment with erythropoietin, vitamin D etc. The authors emphasize substantial changes in the quality and range of the clinical picture which developed due to the prolonged survival of patients with dialyzation treatment. New problems developed such as e.g. dialyzation amyloidosis, aluminium intoxication, endocrine changes, increased occurrence of malignities etc. These must be foreseen, diagnosed and treated. While during the first half of this century uraemia was a fatal disease, at the end of the nineties patients survive due to the dialyzation and transplantation programme.
Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercalcemia and hypercalciuria. We present the case of a 4.5-month old infant with signs of vitamin D intoxication, which occurred due to supplementation for the purpose of rickets prevention and diet with vitamin D-fortified milk. The clinical manifestations were constipation, vomiting and failure to thrive. After excluding hormonal, tumoral and malformative (Williams syndrome) causes, treatment included hyperhydration, loop diuretics and prednisone. This case highlights the need for proper informing of parents on the manners of vitamin D supplementation during the first year of life in order to avoid dangers of parental dosing errors.
The clinical and laboratory study of 80 patients (75 males, 5 females) with cholinergic urticaria (CHU), treated from 1971 to 1996 is presented. The mean age at CHU occurrence was 22.3 years (10-50). The disease lasted at the time of examination from 3 months to 14 years, on an average 2 years and 11 months. Among 30 studied patients, the disease ceased after 1-3 in 5 patients, and it lasted from 3 to 24 years, on an average 9 years, in the remaining 25 patients. Exercise-induced anaphylaxis occurred in 8 patients and simultaneously cold urticaria occurred in 7 patients. The increase of histamine level in blood, following the exercise and/or heat test was found in 12 examined patients. The higher increase was noticed after the exercise, than after the heat test, which was well correlated with the severity of clinical features and the duration of skin manifestations. Repeated heat and/or cold test, performed at the same day, showed the weaker or no reaction at all. The role of the sweat, acetylcholine and histamine in CHU occurrence was discussed.