[Pathological hoarding by children and adolescents]. / Pathologisch verzamelen bij kinderen en jeugdigen.

BACKGROUND: There is a dearth of knowledge and understanding concerning hoarding by children and adolescents. Psychiatrists need to know more about the phenomenon of hoarding since it can be a marker of psychopathology and it sometimes is symptomatic of a psychiatric disorder. AIM: To review hoarding from an epidemiological and psychopathological perspective and to discuss it in relation to the developmental aspect of the first object acquisition: the transitional object. METHOD: We conducted a literature search in PubMed, Medline, PsycINFO and the Cochranedatabase using primarily the search term 'hoarding', but also in combination with the terms: primates, child, adolescent, psych*, klepto*, transitional object, obsessive-compulsive disorder, collecting and attachment. RESULTS: Both animals and humans engage frequently in collecting and hoarding. Up to 60% of normally functioning children and adolescents are involved in collecting. A strong emotional attachment to possessions may be a response to an attachment problem. Hoarding combined with psychopathology is seen in persons of all ages but the prevalence rates for children and adults are unknown. CONCLUSION: Hoarding is a worrisome type of behaviour which must be regarded as an indication of serious comorbid psychopathology. It can occur either as a symptom of an existing disorder or as a separate disorder. Finally we recommend that hoarding be included in the diagnostic criteria of the dsm and icd.

[Purpura fulminans: a rare complication of chickenpox]. / Purpura fulminans, een zeldzame complicatie van waterpokken.

A 3.5-year-old boy presented with purpura on the buttocks extending towards both legs. Two weeks earlier, he had had chickenpox. Because of the rapidly progressing purpura with clinical signs of hypovolaemic shock, he was treated with fresh frozen plasma, packed red blood cells, intravenous immunoglobulins, prednisolone, acyclovir and ceftriaxone. The purpura stopped spreading. In the next few days, the skin at the site of the purpura became necrotic and was excised, as was the subcutis and part of the fascia on both legs and flanks. The right lower leg was amputated and a temporary colostomy was created to prevent faecal contamination of the wounds. The patient recovered and was discharged after three months. Purpura fulminans is a rare complication after a primary infection with varicella zoster virus. A varicella infection may lead to protein S deficiency resulting in diffuse intravascular coagulation and severe skin defects.

[Myosotis in children with flu; a rare complication of influenza]. / Myositis bij grieperige kinderen.

Influenza is a common viral infection, which occurs in yearly endemics during the winter period. Complications are mostly seen amongst the elderly, but may also be seen in previously healthy children; the airways and central nervous system, in particular, may be affected. Another complication of influenza, first described in 1957 and only sporadically discussed, is influenza associated myositis (IAM). In this article we describe three patients with IAM. IAM is mainly seen in children, and boys are more often affected than girls. It is most commonly seen in influenza type B. The pathogenesis is largely unknown, but the clinical presentation and laboratory results for IAM are quite typical. Clinical presentation may be very severe, and when the clinical symptoms are not recognized, invasive tests will often follow. Most cases of IAM are self-limiting, but a minority of the patients might experience life-threatening complications.