[Tonsillar and erythrocyte levels of superoxide dismutase in children with and without recurrent tonsillitis]. / Niveles de superóxido dismutasa amigdalar y eritrocitaria en niños con y sin amigdalitis de repetición.

BACKGROUND AND OBJECTIVES: Oxidative stress secondary to infant tonsillar infection produces the expression of local and systemic antioxidants. Its determination seems to be useful as a marker of tonsillar suffering before tonsillectomy but is currently unknown. The aim of this study was to determine the evolution of this parameter in tonsillectomized children during a long-term follow-up. METHODS: One hundred thirty-six children underwent tonsillectomy, 46 for tonsillar hypertrophy without infection and 90 for recurrent tonsillitis. Superoxide dismutase (SOD) concentrations were measured before tonsillectomy and at 6, 12, 24 and 36 months post-tonsillectomy. RESULTS: Infection provoked significantly higher SOD concentrations than tonsillar hypertrophy in tonsillar tissue (223.06 30.46 vs 156.39 54.05 U/l, p < 0.001) and in blood (1124.91 141.73 vs 1007.19 97.03 U/gr Hb, p < 0.001). There was a strong correlation between tonsillar and erythrocyte concentrations. During the 3-year follow-up, SOD concentrations in blood progressively decreased until stabilizing in all patients. Stabilization was reached at 6 months post-tonsillectomy in the group with tonsillar hypertrophy and at 2 years in the group with infection. Children with recurrent tonsillitis consistently showed higher SOD concentrations in blood throughout the follow-up. CONCLUSIONS: Oxidative damage in tonsillar tissue results from the incidence and severity of focal infections. Tonsillectomy reduces SOD levels but, as a consequence of oxidative stress, these do not return to normal.

[Inner ear autoimmune disorder. Cogan's syndrome]. / Un caso pediátrico de trastorno autoinmune del oído interno (síndrome de Cogan).

We present a case of Cogan's syndrome (interstitial keratitis, rapidly evolving sensorineural hearing loss and vestibular dysfunction) in a 12-year-old girl. Diagnosis was made by clinical and audiologic examination as well as by nonspecific laboratory findings (increased erythrosedimentation rate and positive IgA and IgM rheumatoid factor titers and antineutrophil cytoplasmic autoantibodies). Detection of specific autoantibodies against cochlear antigenic epitopes with a molecular weight of 68 kDa by Western-blot assay confirmed an organ-specific autoimmune mechanism. Therapy with deflazacort 1 mg/kg per day 3 three weeks decreasing progressively thereafter was successful and the patient remains symptom-free.