Self‐esteem in 6‐ to 16‐year‐olds with monosymptomatic nocturnal enuresis

Aim: Childhood nocturnal enuresis (NE) and incontinence has been shown to be associated with increased behavioural problems and reduced self‐esteem (SE) in Western populations. The impact on Asian children, however, is not known. This study investigates the relationship between SE and monosymptomatic NE in Malaysian children aged 6 to 16 years. Method: Children with wetting frequency of at least 4 out of 14 nights were recruited with controls matched for age, gender and race. SE scores were obtained using the ‘I Think I Am’ questionnaire for five domains: body image, talents and skills, psychological well‐being, relationship with family and relationship with others. Results: A total of 126 children were recruited; 22 enuretics aged 6–9 years and their matched controls (Group1) and 41 enuretics aged 10–16 years and their matched controls (Group 2). SE scores were similar between the enuretic and controls in Group 1, whereas in Group 2, enuretics had significantly lower scores (P < 0.05) in ‘body image’, ‘relationship with others’ and total SE scores. This difference was more pronounced among girls, adolescents and those who wet more than 10/14 nights. Conclusion: The SE of Malaysian children with monosymptomatic NE aged 10 years and above is significantly lower than their peers. This effect is seen particularly among girls, adolescents and those with frequent wetting. In the light of these findings, the ‘wait and see’ approach by the Malaysian medical profession is no longer appropriate. Treatment should begin before the age of 10 years.     

Height gain after two‐years‐of‐age is associated with better cognitive capacity,measured with Raven's coloured matrices at 15‐years‐of‐age in Malawi

Stunting is a measure of chronic undernutrition, and it affects approximately 160 million children worldwide. Cognitive development of stunted children is compromised, but evidence about the association between height gain in late childhood and adolescent cognitive capacity is scarce. We aimed to determine the association between height gains at different ages, including late childhood, and cognitive capacity at 15‐years‐of‐age. We conducted a prospective cohort study in a rural African setting in Southern Malawi. The study cohort was enrolled between June 1995 and August 1996. It originally comprised mothers of 813 fetuses, and the number of children born live was 767. These children were followed up until the age of 15 years. The anthropometrics were measured at one and 24‐months‐of‐age and 15‐years‐of‐age, and cognitive capacity of participants was assessed at 15‐years‐of‐age with Raven's Coloured Matrices score, mathematic test score, median reaction time (RT) (milliseconds) and RT lapses. The associations between growth and the outcome measures were assessed with linear regression. Raven's Coloured Matrices score was predicted by height gain between 24 months and 15‐years‐of‐age (coefficient 0.85, P = 0.03) and (coefficient 0.69, P = 0.06), but not by earlier growth, when possible confounders were included in the model. The association weakened when school education was further added in the model (coefficient = 0.69, P = 0,060). In conclusion, in rural Malawi, better growth in late childhood is likely to lead to better cognitive capacity in adolescence, partly through more school education. In light of these results, growth promotion should not only be limited to early childhood.     

Anaphylaxis after prick‐to‐prick test with fish

Skin prick testing is the diagnostic procedure for allergies and is considered to be safe. It is usually performed using the prick and the prick‐to‐prick method. Herein is described a pediatric case of anaphylaxis during prick‐to‐prick testing with raw fish in a patient who had consumed fish without any systemic allergic reactions beforehand, to illustrate that skin prick testing should be carefully planned and performed with caution in order to avoid potentially serious risks for the patient.     

Administration of high‐dose interleukin‐2 in a 2‐year‐old with metastatic melanoma

Malignant melanoma is rare in pediatrics, and therapies for patients with disseminated disease have not been well studied. This report describes our experience with the use of high‐dose interleukin 2 (aldesleukin, IL‐2) in a 2‐year‐old child with metastatic melanoma and describes our approach for the administration of this agent to young patients. Pediatr Blood Cancer 2009; 53:1346–1348. © 2009 Wiley‐Liss, Inc.     

Successful treatment with placenta‐derived decidual stromal cells in a pediatric patient with life‐threatening acute gastrointestinal graft‐versus‐host disease

Severe aGvHD is a life‐threatening complication after allogeneic HSCT. The GI tract is considered to play a key role in aGvHD, where the disease process can start and is one of the major target organs. Here, we present a case of a one‐year‐old child with a life‐threatening GI‐aGvHD stage IV, post‐HSCT, resistant to steroids and MMF for 4 weeks. He was successfully treated with placenta‐derived DSC.     

Cat‐scratch disease with severe pleuritis in a 6‐year‐old girl

We present the case of a 6‐year‐old girl with cat‐scratch disease (CSD), who developed severe pleuritis without lymphadenitis. Bartonella henselae DNA was detected on real‐time polymerase chain reaction (PCR) analysis of whole blood. This is the first report of CSD diagnosed on real‐time PCR using whole blood.     

First experience of the AML‐Berlin‐Frankfurt‐Münster group in pediatric patients with standard‐risk acute promyelocytic leukemia treated with arsenic trioxide and all‐trans retinoid acid

Recently, studies in adults with acute promyelocytic leukemia (APL) showed high cure rates in low‐risk patients treated with all‐trans retinoid acid (ATRA) and arsenic trioxide (ATO), while toxicities were significantly reduced compared to the standard treatment with ATRA and chemotherapy. Here we report about first experience with 11 pediatric patients with low‐risk APL treated with ATRA and ATO. All patients stayed in molecular remission. All suffered from hyperleukocytosis. Two patients experienced reversible severe side effects. One suffered from osteonecroses at both femurs, seizures, as well as posterior reversible encephalopathy syndrome, the other patient had an abducens paresis.     

Two‐year‐old boy with cervical and liver abscesses

Pyogenic liver abscesses are rare in children but relatively common in those with chronic granulomatous disease (CGD). We present a case of a 2 year old boy who initially presented with BCGitis and Staphylococcus aureus cervical adenitis, and then subsequently developed liver abscesses. A diagnosis of X‐linked CGD was confirmed. This case demonstrates the typical radiological features of liver abscesses in CGD, its management without surgical intervention, and the increasingly recognised complications of BCG vaccination in CGD.     

Marked thrombocytopenia in a neonate is associated with anti‐HPA‐5b,anti‐HLA‐A31, and anti‐HLA‐B55 antibodies

Maternal antibodies against human platelet antigen (HPA) and/or human leukocyte antigen (HLA) cause fetal and neonatal alloimmune thrombocytopenia (FNAIT) in 0.09‐0.15% of live births. Severe cases account for 5‐31% and the frequency of multiple kinds of alloantibodies is 6.9‐9% of FNAIT. We present a case of severe FNAIT associated with anti‐HPA‐5b, anti‐HLA‐A31, and anti‐HLA‐B55 antibodies, successfully treated with immunoglobulin and platelet transfusion. The anti‐HLA‐B55 antibody was detected in the newborn's serum, but disappeared on the 20th day, which was followed by an increase of the platelet count. These findings suggested the potential involvement of an anti‐HLA antibody in the pathogenesis of FNAIT.