ABSTRACT
UNLABELLED: Neonates with Down's syndrome have an increased risk for congenital leukaemia, particularly acute megakaryoblastic leukaemia (FAB, M7) which most often resolves spontaneously and is called transient leukaemia. It can be observed in non-constitutional trisomy 21 infants then presenting trisomy 21 on blasts cells. OBSERVATION: We report a transient leukaemia with an isolated pericardial effusion in a phenotypically normal neonate. Trisomy 21 was found on blasts cells. Complete remission remains after 32 months. DISCUSSION: Congenital leukaemias, with trisomy 21 on blasts cells have a good prognosis that justifies observation before using chemotherapy.
Subject(s)
Down Syndrome/complications , Leukemia, Megakaryoblastic, Acute/congenital , Antigens, CD/analysis , Down Syndrome/pathology , Humans , Infant , Leukemia, Megakaryoblastic, Acute/pathology , Male , Remission, SpontaneousABSTRACT
UNLABELLED: Tachycardia-induced cardiomyopathy is a reversible left ventricular dysfunction caused by cardiac arrhythmia. Because of its reversibility, a correct diagnosis and treatment are necessary. The aim of our study was to precise the diagnostic procedures of the tachycardia-induced cardiomyopathy and to study the left ventricular function after the correction of the arrhythmia. PATIENTS AND METHODS: A retrospective study done between 1992 and 2001. Children studied were followed-up for: an idiopathic form of cardiomyopathy, in which the etiological research showed a cardiac arrhythmia; a cardiac arrhythmia associated to a cardiomyopathy. An electrocardiogram recorded the cardiac arrhythmia. The left ventricular function was evaluated by an echocardiography before and every month after the correction of the cardiac arrhythmia. RESULTS: Twelve children were included, ages ranged from 2 months to 15 years (median 11 years). Four patients presented a cardiac insufficiency associated to arrhythmia; three followed-up for an arrhythmia developed a cardiomyopathy; five whose cardiac arrhythmia was not easy to demonstrate had an idiopathic form of cardiomyopathy. The Wilcoxon test showed a significant amelioration (P < 0.01) of the left ventricular function after the correction of the cardiac arrhythmia. CONCLUSIONS: Tachycardia-induced cardiomyopathy in children is curable and the diagnosis is quite difficult. Pediatricians and family doctors should try to look for specific signs of cardiac insufficiency or arrhythmia. Pediatric cardiologists should search a tachycardia-induced cardiomyopathy in every idiopathic form of cardiomyopathy.
Subject(s)
Tachycardia/complications , Ventricular Dysfunction, Left/diagnosis , Adolescent , Child , Child, Preschool , Diagnosis, Differential , Echocardiography , Female , Follow-Up Studies , Humans , Infant , Male , Retrospective Studies , Ventricular Dysfunction, Left/therapyABSTRACT
Two cases of myocarditis and congestive heart failure in immunocompetent patients with seroconversion for toxoplasmosis are reported. Serological tests showed that in the first case the cardiac manifestations occurred at the time of seroconversion (low IgG, raised IgM and IgA), whereas in the second case they occurred several months after the initial infection when IgM was decreasing, IgG levels were very high (>1000 IU/ml) and IgG had high affinity for the antigen. The pathophysiological mechanisms underlying cardiac involvement in acute or chronic toxoplasmosis are discussed.
Subject(s)
Antibodies, Protozoan/blood , Heart Failure/etiology , Myocarditis/etiology , Toxoplasma/immunology , Toxoplasmosis/complications , Adult , Animals , Child , Female , Heart Failure/parasitology , Heart Failure/physiopathology , Humans , Immunocompetence , Myocarditis/parasitology , Myocarditis/physiopathology , Toxoplasmosis/parasitologyABSTRACT
The modalities of left ventricular (LV) adaptation (dilatation and/or hypertrophy) to exercise are not as well known in children as in adults. Therefore, the authors followed up 11 national ice hockey players, initially aged 10, following an eight hour per week training schedule for a period of 5 years. M mode echocardiographic studies were carried out each year during the training period to measure LV internal dimensions, wall thickness, myocardial mass and contractility (fractional shortening and systolic stress index). The evolution of these parameters was evaluated (Student's test) by two year peripubertal periods (10-12 years: 12-14 years) and compared in absolute values and in rate of growth with the standardised values indexed to body surface area reported by Henry. Between 10 and 12 years of age, the LV internal dimensions (a good indicator of LV volume in healthy children) increased significantly (p less than 0.05) and LV mass increased very significantly (p less than 0.01). The LV internal dimensions were normal at the outset and remained in the upper limits of normality reported by Henry with a normal rate of growth. Myocardial mass was normal at the age of 10 and its rate of growth was also normal. Between 12 and 14 years of age, the increase in LV internal dimensions was not statistically significant but myocardial mass increased very significantly (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
