Chronic active hepatitis presenting with rheumatoid nodules and arthritis

Chronic active hepatitis is often accompanied by extrahepatic rheumatic symptoms of mild or moderate severity. We report a 16-year-old girl with this disorder who presented with severe polyarthritis and rheumatoid nodules mimicking juvenile rheumatoid arthritis. Rheumatoid nodules have not previously been described in chronic active hepatitis, and the severity of the rheumatic symptoms in our patient led to a delay in the recognition of the underlying liver disease. Our report provides support for an autoimmune etiology in some patients with chronic active hepatitis, notes the occurrence of rheumatoid nodules in the disorder, and emphasizes that severe extrahepatic symptoms may obscure the diagnosis and institution of therapy in some individuals.     

Computed tomography in intracranial,supratentorial metastases in children

Summary This study compares the CT characteristics in a consecutive sample of supratentorial metastases (n=31) with primary tumors of the same location (n=49) in childhood. Postcontrast CT was performed in all but one of the metastases cases. In all but one of these children the location and type of primary tumor was known at time of occurence of cerebral metastasis. Primary CNS tumors (n=12) had a higher incidense of supratentorial metastatic spread than tumor originating elsewhere. Three children had diffuse subarachnoid seeding, while 28 had solid tumors (21 solitary, 7 multiple). The predilection location for the solid metastases was the gray-white matter junction (n=12). The following CT findings were significantly less frquuent in metastases than in primary tumors (P<0.05): Midline location, calcification and cyst formation. On the other hand bleeding, pronouced contrast enhancement and location in the gray-white matter junction were more frequent in the metastatic group (P<0.05).     

Intracranial hemorrhage in hemophilic children. CT follow-up

In a follow-up examination of intracranial hemorrhage in hemophilic children, 9 patients were examined clinically and with CT. The results stress the value of CT in the evaluation of hemophilic children with possible head trauma. The extent of the structural brain damage after intracranial hemorrhage in most cases is more marked than clinically expected, and such damage may also be present in patients who clinically have no neurologic sequelae.