ABSTRACT
Lymphomas are the third most frequent type of childhood cancer after acute leukemias and brain tumors. Symptoms at diagnosis are extremely different depending on several factors such as histological subtype, disease extent, and site of tumor. We report an unusual presentation describing a case of epistaxis of the posterior nasal fossa with severe hematemesis.
Subject(s)
Hematemesis/etiology , Lymphoma, B-Cell/diagnosis , Nasopharyngeal Neoplasms/diagnosis , Child, Preschool , Humans , Magnetic Resonance Imaging , MaleABSTRACT
We report the 1 year follow-up of 3 children affected by non-paraneoplastic Opsoclonus-Myoclonus Syndrome (OMS) resistant to conventional therapies (steroids, ACTH and intravenous immunoglobulins) who were treated with an anti CD20 monoclonal antibody (rituximab). Treatment response was recorded on the basis of an international score at 0, 3, 6, 9 and 12 months. Despite the long disease duration and the numerous previously administered treatments, all patients underwent rapid and persistent neurological recovery following rituximab administration, thus suggesting a potential role of this drug even in pre-treated patients.
Subject(s)
Antibodies, Monoclonal, Murine-Derived/therapeutic use , Opsoclonus-Myoclonus Syndrome/drug therapy , Adrenocorticotropic Hormone/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Ataxia/drug therapy , Ataxia/etiology , Child Behavior Disorders/etiology , Child Behavior Disorders/psychology , Dexamethasone/therapeutic use , Drug Resistance , Electroencephalography , Gait Disorders, Neurologic/drug therapy , Gait Disorders, Neurologic/etiology , Humans , Immunoglobulins, Intravenous/therapeutic use , Infant , Magnetic Resonance Imaging , Male , Prednisone/therapeutic use , Rituximab , Speech Disorders/drug therapy , Speech Disorders/etiology , Treatment Outcome , Tremor/drug therapy , Tremor/etiology , Virus Diseases/complicationsABSTRACT
GOALS OF WORK: The goal of this study was to describe the incidence of Clostridium difficile-associated disease (CDAD) in children with solid tumours. PATIENTS AND METHODS: After documentation of a case of C. difficile-associated pseudomembranous colitis in a patient with neuroblastoma, the presence of C. difficile toxins A and B was prospectively tested in all children undergoing antineoplastic chemotherapy for solid tumours or lymphomas at the "G. Gaslini" Children Hospital in Genoa who presented abdominal pain. MAIN RESULTS: From January 2005 to December 2006, nine (6%) out of 141 patients treated for solid tumours had C. difficile toxin A detected in their stools in the presence of abdominal symptoms including vomit, abdominal pain and diarrhoea. The majority of patients had a normal neutrophil count at onset of gastrointestinal disease No patient developed pseudomembranous colitis, and none died. All patients received antibiotics and/or antineoplastic drugs previously associated with CDAD. CONCLUSIONS: CDAD may be a complication of children with solid tumours. Since this disease may be life threatening and cause epidemic clusters, this possibility must be kept in mind for the differential diagnosis of abdominal diseases in children with cancer, especially in absence of neutropenia.