Hyperimmunoglobulinemia E syndrome of neonatal onset.

A case of hyperimmunoglobulinemia IgE with recurrent infections of neonatal onset and unfavourable evolution is described. The first clinical finding was the appearance of maculopapular rash in the skin when the child was fifteen days old. From this period onwards, respiratory and cutaneous infections were continuous, leading to a progressive deterioration of the general condition, and malnutrition, which ended fatally at the age of three years. IgE levels were measured on several occasions, this being 17 IU/ml at the onset of the symptoms; afterwards, the mean value was 17.680 IU/ml (Range: 14.9-32.710 IU/ml).

[Lactose-free formula versus adapted formula in acute infantile diarrhea]. / Fórmula sin lactosa versus fórmula adaptada en la diarrea aguda del lactante.

We have studied a population of 60 children with acute diarrhea. In order to evaluate the benefit of lactose suppression from the diet on the clinical course of the disease, these children were randomly assigned to either the control group or the experimental group. No differences were found in respects to the duration of the illness (lactose containing formula 4.8 +/- 2 days vs lactose free formula 4.4 +/- 3.1 days). Similarly, body weight change did not change significantly (12.5 +/- 235.8 gr vs 55.9 +/- 238.0 gr, t-test non-significant). Children fed with the lactose free diet voided less frequently than did children in the control group (12.8 +/- 10.5 vs 19.8 +/- 9.5 times; p < 0.01). This difference disappeared when only invasive diarrheas were considered (26.6 +/- 12 vs 21.5 +/- 9.5 voidings; t-test nonsignificant). Finally, only 2 of the 32 cases fed with lactose containing formula showed clinical intolerance to lactose. Therefore, we conclude that in patients with mild-to-moderate acute diarrhea, the resumption of feeding should be undertaken with the same formula that they were previously fed, restricting the use of lactose free formulas to selected cases and to those children in whom a standard milk made symptoms reappear.

[Kala-azar. Is it possible to treat it with aminoglucosides?]. / Kala-azar. Es posible el tratamiento con aminoglucósidos?

We report the case of a 13 month old male infant with visceral leishmanisis. The clinical picture was suggestive of kala-azar, but a bone marrow aspirate was negative, so treatment was not started. During the course of the process an urinary infection was documented and therapy with aminoglycosides was begun. At this time we observed that hepato--and spleno--megaly diminished and then disappeared and clinical manifestations improved. We later received a positive serology for Leishmania donovani. We review the medical literature in respect to this therapeutic possibility.