RESUMO
We report an adolescent who developed anemia, leukopenia, and neutropenia after prolonged use of over-the-counter zinc for treatment of acne. Hypocupremia and sideroblastic anemia may result from long-term or excessive exposure to zinc.
Assuntos
Anemia/induzido quimicamente , Leucopenia/induzido quimicamente , Neutropenia/induzido quimicamente , Medicamentos sem Prescrição/efeitos adversos , Zinco/efeitos adversos , Acne Vulgar/tratamento farmacológico , Adolescente , Contagem de Células Sanguíneas , Cobre/deficiência , Humanos , Masculino , Medicamentos sem Prescrição/uso terapêutico , Automedicação , Zinco/uso terapêuticoRESUMO
OBJECTIVE: To catalog and evaluate patterns of disease in families of children with pleuropulmonary blastoma (PPB). METHODS: Data have been collected since 1988 on 45 children with PPB and their families. All pathologic materials were centrally reviewed. Preliminary molecular genetic analyses were performed when possible. RESULTS: In 12 of 45 patients, an association was found between PPB and other dysplasias, neoplasias, or malignancies in the patients with or in their young relatives. The diseases found to be associated with PPB include other cases of PPB, pulmonary cysts, cystic nephromas, sarcomas, medulloblastomas, thyroid dysplasias and neoplasias, malignant germ cell tumors, Hodgkin disease, leukemia, and Langerhans cell histiocytosis. Abnormalities of the p53 tumor suppressor gene, Wilms tumor suppressor gene (WT1), and the putative second genetic locus for Wilms tumor (WT2) were not found in preliminary investigations. CONCLUSIONS: The occurrence of PPB appears to herald a constitutional and heritable predisposition to dysplastic or neoplastic disease in approximately 25% of cases. All patients with PPB and their families should be investigated carefully. Further research of this new family cancer syndrome may provide insight into the genetic basis of these diseases.
Assuntos
Neoplasias Pulmonares/genética , Pulmão/patologia , Blastoma Pulmonar/genética , Adulto , Criança , Pré-Escolar , Cromossomos Humanos Par 11 , Éxons , Genes Supressores de Tumor , Humanos , Cariotipagem , Neoplasias Pulmonares/patologia , Linhagem , Blastoma Pulmonar/patologiaRESUMO
To determine the immunogenicity of Haemophilus influenzae type b polysaccharide-tetanus protein conjugate vaccine in specific populations at risk, we administered vaccine to children with sickle cell anemia (n = 19; mean age, 18.3 months, malignancies (n = 18; mean age, 43.1 months), or a recent history of systemic H. influenzae type b infection (n = 17; mean age, 11.9 months). After one dose of polyribosylribitol phosphate-tetanus toxoid conjugate vaccine the geometric mean titers for polyribosylribitol phosphate antibody were 4.8 micrograms/ml (14/19 greater than 1 microgram/ml), 1.4 micrograms/ml (9/18 greater than 1 microgram/ml), and 5.6 micrograms/ml (15/17 greater than 1 microgram/ml) in these three groups, respectively. Children with sickle cell anemia or a recent history of systemic H. influenzae type b infection had polyribosylribitol phosphate antibody levels comparable to those of normal children of similar age after one or two doses of polyribosylribitol phosphate-tetanus toxoid conjugate vaccine. We conclude that this vaccine is immunogenic in children with underlying conditions associated with an increased risk of H. influenzae type b infection.
Assuntos
Anemia Falciforme/imunologia , Anticorpos Antibacterianos/biossíntese , Vacinas Bacterianas/imunologia , Infecções por Haemophilus/imunologia , Vacinas Anti-Haemophilus , Haemophilus influenzae/imunologia , Neoplasias/imunologia , Toxoide Tetânico/imunologia , Pré-Escolar , Humanos , Lactente , Neoplasias/tratamento farmacológico , Pentosefosfatos/imunologia , Polissacarídeos Bacterianos/imunologiaRESUMO
We studied two children with recurrent schistocytic hemolytic anemia and thrombocytopenia beginning in the neonatal period. One patient had a stroke during one of the episodes of thrombotic thrombocytopenic purpura. The presence of unusually large von Willebrand factor multimers was demonstrated in both children during clinical and hematologic remissions. Treatment with corticosteroids and intravenous injections of immune globulin was unsuccessful in the one patient who received it. Immediate improvement occurred in both patients after the infusion of fresh-frozen plasma. Symptoms of thrombocytopenia continue to recur at regular intervals in the absence of periodic fresh-frozen plasma infusions. One of these children apparently has chronic relapsing thrombotic thrombocytopenic purpura; the second has a chronic relapsing disorder similar to thrombotic thrombocytopenic purpura.