Renal artery stenosis: An unusual etiology of hypertensive encephalopathy in a child with fanconi anemia.

A 9-year-old girl, diagnosed case of Fanconi anemia, presented with generalized convulsion with altered sensorium. She had fever, severe pallor, sinus tachycardia, blood pressure of 180/120 mmHg in both upper and lower limb, pan-systolic murmur of grade 2/6, abdominal bruit and bilateral papilledema. A provisional diagnosis of hypertensive encephalopathy was made and managed with continuous labetalol infusion. Detailed evaluation including magnetic resonance angiography of renal artery detected underlying atrophic and non-functioning right kidney secondary to severe renal artery stenosis on the same side. She was started with multiple antihypertensives, but her blood pressure was maintained poorly. Later on, she underwent rightsided nephrectomy. Following surgery, she was doing well and maintaining normal blood pressure without any antihypertensives. Our child is the second reported case of Fanconi anemia associated with renal artery stenosis presenting with hypertensive encephalopathy.

An unusual presentation of a mesenteric lymphangioma.

Lymphatic malformations are the second most common benign vascular tumour in children, after haemangioma. They may be localised or generalised and commonly occur in the cervicofacial region, axilla and thorax. They appear early in life with almost all cases evident by the age of 3 years. Lymphangioma or cystic hygroma is a mass of dilated lymphatics. The following case in a 4-year-old boy of intraabdominal cystic lymphangioma is being reported due to its rarity and its confusing presentation. The boy presented with progressive swelling of abdomen and respiratory distress. A repeat USG after second episode of rapid increase of abdomen showed a huge cystic swelling of whole abdomen and pelvis. CT scan of abdomen suggested mesenteric lymphangioma. The cyst was excided and histopathology confirmed the diagnosis of lymphangioma.

Myelomeningocele with hydrocephalus and agenesis of corpus callosum.

A 45-day-old male baby presented with a leaking myelomeningocele and signs of meningitis. A computerised tomographic scan of brain revealed gross supratentorial ventriculomegaly with inflammatory exudates suggestive of intracranial infection. An unexpected association of complete agenesis of corpus callosum was discovered, however it is an incidental finding, a rare combination indeed.