Persistent parvovirus-associated chronic fatigue treated with high dose intravenous immunoglobulin

We report a 16-year-old boy with no evidence of immunodeficiency who had a 2-year history of chronic fatigue, low grade fever and slapped-cheek rash associated with chronic parvovirus B19 viremia. Prolonged intravenous immunoglobulin therapy resulted in resolution of his symptoms and viremia. Intravenous immunoglobulin may be useful in the resolution of parvovirus viremia regardless of immune status.     

High dose intravenous methylprednisolone for Kassabach-Merritt syndrome

Kassabach-Merritt syndrome involving the sternum in a 2-month-old child is described. Treatment with high dose intravenous methylprednisolone resulted in normalization of the platelet count and disappearence of haemangioma.Abbreviations K-MS Kassabach-Merritt syndrome - DIC disseminated intravascular coagulation - i.v. MP intravenous methylprednisolone     

Treatment of patients with pineoblastoma with high dose cyclophosphamide

The outcome for patients with pineoblastoma has historically been very poor, with most patients dying of disseminated disease despite irradiation. Furthermore, the low incidence of this tumor has hindered progress toward defining better treatment strategies. Here we report the activity and toxicity of cyclophosphamide administered as a single agent at a dose schedule of 2 g/m²/day for 2 successive days at monthly intervals for a maximum of four courses. Eight patients were evaluated, six newly diagnosed and two recurrent. Amongst the six newly diagnosed patients, there were three patients demonstrating partial responses, and three had stable disease throughout the cyclophosphamide treatment period. All six patients are alive and disease free after further therapy. One patient with recurrent disease demonstrated tumor progression on cyclophosphamide, and the other had stable disease throughout the cyclophosphamide treatment period. Both patients subsequently died of progressive disease. The major toxicity of high dose cyclophosphamide was hematopoietic, with one patient requiring a dose reduction after three courses due to prolonged thrombocytopenia. One patient was also withdrawn from treatment with cyclophosphamide due to impaired pulmonary function. This study demonstrates the activity of high dose cyclophosphamide in the treatment of pineoblastoma and may serve as basis for the design of future studies of this tumor. © 1996 Wiley-Liss, Inc.     

静脉注射大剂量人血丙种球蛋白治疗病毒性心肌炎

为探讨采用大剂量静脉注射人体丙种球蛋白 (IVIG)治疗小儿病毒性心肌炎的临床疗效及其作用机制 ,本文总结 2 0例小儿病毒性心肌炎患儿应用IVIG的结果。现报告如下资料与方法一、一般资料　 1997年 1月～ 2 0 0 2年 5月我科收治 35例病毒性心肌炎患儿 ,均符合 1999年 9月昆明会议修订的小儿病毒性心肌炎诊断标准[1] 。其中男 2 0例 ,女 15例 ;<4岁 2 3例 ,>?12例 ;病程 <1个月 14例 ,1～ 2个月 10例 ,2～ 3个月 6例 ,3～ 4个月 5例。随机分为治疗组 2 0例 ,对照组 15例。两组在发病年龄、性别、病程、病情轻重方面无差异性。二、方法　两…     

Kawasaki's disease with thrombocytopenia

A thrombocytopenia has been observed at the initial stage of a mucocutaneous lymph node syndrome in a 8 year-old patient; it appeared at the 5th day of the disease in another 11 year-old patient. This unusual and unexplained transitory thrombocytopenia led to delayed administration of intravenous gammaglobulins.     

大剂量静脉注射免疫球蛋白辅助治疗狼疮肾炎的疗效观察

目的　观察大剂量静脉注射免疫球蛋白(IVIG)治疗狼疮肾炎(LN)的疗效。方法　在激素联合环磷酰胺的基础上对观察组29例LN患儿加用IVIG治疗,并与对照组33例LN患儿比较。结果　观察组在降低LN疾病活动性指数计分、血尿及蛋白尿消失、抗核抗体(ANA)及抗ds-DNA阴转率和降低院内感染率方面明显优于对照组,未见明显副作用。结论　IVIG配合激素及环磷酰胺治疗LN是一种有效、安全的方法。     

大剂量免疫球蛋白治疗川崎病32例临床观察

目的探讨大剂量静脉滴注免疫球蛋白(IVIG)治疗川崎病的效果。方法将36例川崎病患儿按治疗方法不同分成两组:A组给予阿司匹林治疗,未用IVIG;B组给予大剂量IVIG治疗,比较两组临床疗效。结果大剂量IVIG治疗较单一阿司匹林疗效显著,总热程缩短,皮疹、结膜充血、口腔黏膜改变、颈淋巴结肿大消退明显,冠状动脉损害发病率明显降低。结论大剂量IVIG对川崎病临床疗效显著,能有效防治冠状动脉损害。     

静注大剂量丙种球蛋白治疗小儿耐药菌感染

目的　探讨静注大剂量丙种球蛋白（ Ｉ Ｖ Ｉ Ｇ） 对小儿耐药菌感染性疾病的疗效。方法　将１９ 例耐药菌感染随机分组治疗,观察组采用 Ｉ Ｖ Ｉ Ｇ（２００ ～３００ ｍｇ／ｄ ,用２ ～３ 天） 治疗小儿耐药菌感染９例。结果　有效率１００ ％ ,与对照组相比,１２ ～２４ ｈ 后发热、咳喘憋渐缓解,病程缩短３ ～７ 天。结论　 Ｉ Ｖ Ｉ Ｇ 能迅速改善小儿耐药菌感染的症状,明显缩短病程和提高治愈率。     

Treatment of advanced malignant melanoma with high dose methotrexate and folinic acid rescue

Twenty-eight patients with advanced malignant melanoma were treated with high dose methotrexate (HDMTX) and folinic acid (FA) rescue. Nineteen patients were treated with 6-hour infusions and 10 patients with 24-hour infusions. One patient in the 6-hour infusion group showed a partial response. In the 24-hour infusion group there were no responses but there was a significant increase in renal toxicity. It is concluded that HDMTX and FA rescue are not useful agents in the treatment of advanced malignant melanoma.     

Severe mitral insufficiency associated with Kawasaki's valvulitis

Summary A two-month-old male infant with Kawasaki's disease, severe mitral insufficiency, and normal coronary arteries is described. We postulate the mitral insufficiency was secondary to Kawasaki's valvulitis, and that this occurred in the absence of other forms of cardiac involvement characteristic of Kawasaki's disease.     

Treatment of relapsed or refractory acute leukemia in childhood with bisantrene combined with high dose aracytine

Bisantrene is an anthracene derivative which has demonstrated activity in acute myeloblastic leukemia (AML) and in lymphoma. The present study was designed to assess the reinduction rate and toxicity of bisantrene (250 mg/m²/d × 5) associated with aracytine (1000 mg/m² twice a day × 5) in refractory and relapsed acute childhood leukemia. Patients who relapsed after bone marrow transplantation were eligible. Twenty-six children were included. Diagnoses were as follows: 13 AML, 9 acute lymphoblastic leukemia (ALL), and 4 undifferentiated leukemia (AUL). All patients had been very highly pretreated, especially with anthracyclines, and most of them were of poor prognosis. The overall response rate was 46% with a 95% confidence interval ranging from 27-65%. According to diagnosis, complete remission (CR) rates are: AML: 5/13, ALL: 5/9, and AUL: 2/4. Four children died, three from infection and one from acute lysis syndrome. The major toxicity was infection with grade 3 and 4 episodes occurring in 42% of patients. No significant cardiac toxicity was noted. Hepatic and renal toxicity were limited and transient. Bisantrene in association with aracytine is effective in both AML and ALL of childhood. Bisantrene should be evaluated with a five-day schedule in other pediatric malignancies. In children with acute leukemia previously treated with high dose aracytine, new combination regimen is warranted. © 1994 Wiley-Liss, inc.     

Treatment of Crohn disease with intravenous immunoglobulin

In a 14.5 year old girl with Crohn's disease a complete remission was achieved with intravenous immunoglobulins. Earlier treatment with various therapeutical regimens had been unsuccessful. During the next two relapses the same prompt positive response was reproducible, whereas in the third the dose of immunoglobulin had to be doubled.     

Treatment of Kimura disease with intravenous immunoglobulin

Kimura disease is an uncommon chronic inflammatory condition of unknown etiology and is characterized by painless subcutaneous nodules, usually affecting the head and neck, eosinophilia, and markedly elevated immunoglobulin E levels. Several reports have described the main modalities of treatment; both corticosteroids and surgery have provided good results, but occasionally corticosteroids cannot be tapered as the disease flares up. We report here the case of an 8-year-old boy diagnosed with Kimura disease who was successfully treated with 1 dose of intravenous immunoglobulin as a steroid-sparing agent.     

Treatment of hyperkalaemia with intravenous salbutamol.

Thirteen children with hyperkalaemia were treated by intravenous infusions of salbutamol, 4 micrograms/kg over 20 minutes. Reductions in the mean (SD) plasma potassium concentrations, of 1.48 (0.5) and 1.64 (0.5) mmol/l were obtained at 40 and 120 minutes, respectively, after completion of the infusions. No side effects were noted.