Assuntos
Encefalopatias/diagnóstico , Síndrome de Reye/diagnóstico , Adolescente , Encéfalo/patologia , Criança , Pré-Escolar , Craniotomia , Descompressão , Transfusão Total , Ácidos Graxos não Esterificados/sangue , Humanos , Lactente , Recém-Nascido , Fígado/patologia , Síndrome de Reye/etiologia , Síndrome de Reye/patologia , Síndrome de Reye/fisiopatologia , Síndrome de Reye/terapia , Ureia/biossínteseRESUMO
The lipid content of the proximal jejunum, as studied by light microscopy with lipid histochemical staining methods, is determined in 14 fasting children with juvenile-onset diabetes mellitus. The results show that four children had greatly increased amounts of lipid, while six others had a mildly to moderately increased amounts of lipid present. The amount of lipid present appears to correlate most closely with the quality of control of the diabetes. These results indicate either that the clearance of exogenous lipid is impaired or that there is an increased endogenous synthesis of lipid within the intestine of the diabetic child, especially in those under poor control.
Assuntos
Diabetes Mellitus Tipo 1/metabolismo , Mucosa Intestinal/metabolismo , Intestino Delgado/metabolismo , Metabolismo dos Lipídeos , Adolescente , Glicemia/metabolismo , Pré-Escolar , Colesterol/sangue , Diabetes Mellitus Tipo 1/patologia , Feminino , Humanos , Mucosa Intestinal/patologia , Intestino Delgado/patologia , Masculino , Triglicerídeos/sangueRESUMO
The treatment of 66 children with Reye syndrome proved by hepatic biopsy or autopsy is described. Prior to the utilization of exchange transfusion early in the course of the disease, our case fatality rate was 100% of nine patients. With early diagnosis and early exchange transfusion, the case fatality rate was reduced to 27% of 44 patients. During the 1974 epidemic of Reye syndrome, 26 children were treated. In 18 children the diagnosis was established by hepatic biopsy; 16 received one or more exchange transfusions. There were no deaths among these 26 patients. In the 1974 epidemic, the national case fatality rate was estimated to be 40%. Exchange transfusion appears to have been an important factor in the reduction of the case fatality rate among our patients.
Assuntos
Encefalopatias/terapia , Transfusão Total , Síndrome de Reye/terapia , Biópsia por Agulha , Encefalopatias/etiologia , Criança , Pré-Escolar , Transfusão Total/efeitos adversos , Humanos , Fígado/patologia , Ohio , Síndrome de Reye/diagnóstico , Síndrome de Reye/tratamento farmacológico , Síndrome de Reye/epidemiologiaRESUMO
We describe three patients with seizure disorders in whom pancreatitis or pancreatic injury was probably caused by valproic acid, a widely used anticonvulsant drug. Trivial or no increases of serum amylase (EC 3.2.1.1) but striking increases of serum lipase (EC 3.1.1.3) were common to all patients, as assayed in the Kodak Ektachem. In vitro, valproic acid does not cause any change in serum lipase. In patients with symptoms suggestive of pancreatitis and abnormal values for amylase and (or) lipase, treatment with valproic acid should be discontinued.