Bacille Calmette-Guérin — associated neonatal hepatitis

We describe a full-term immunocompetent neonate who developed jaundice at 3 weeks of age. Physical examination disclosed no abnormalitics. Laboratory investigations showed direct reacting hyperbilirubinaemia and elevated liver enzymes. Liver biopsy revealed a noncaseating granulomatous hepatitis. The patient made an uneventful recovery within 4 weeks without therapy. Bacille Calmette-Guérin hypersensitivity reaction is suggested as the reason for this neonatal hepatitis.     

Renal Granulomatous sarcoidosis in childhood: a report of 11 cases and a review of the literature

We analysed retrospectively 11 children with renal granulomatous sarcoidosis confirmed by renal histology in order to describe the course and prognosis of the disease. Symptomatic sarcoidosis was diagnosed at a mean age of 10.1 years. Nine children had renal involvement at the time of diagnosis. In the course of the disease, nine patients developed renal failure and mild proteinuria, seven had transient sterile leucocyturia, four showed microscopic haematuria, seven had a urinary concentrating defect, and enlarged kidneys were seen in three patients. One child had hypercalcaemia and hypercalciuria, none had hypertension. Light microscopy of the kidney showed interstitial infiltration by mononuclear cells in all children, interstitial fibrosis in nine patients, epithelioid granulomas in seven, tubular involvement in eight, and mild glomerular involvement in seven patients. Renal immunofluorescence was negative. Ten children received prednisone for 1–11 years. After a mean follow up of 5.5 years, three patients had entered end-stage renal failure and one had chronic insufficiency after interruption of medical supervision and prednisone therapy. Conclusion Renal failure, proteinuria, leucocyturia, haematuria, and concentration defect are the prominent features of renal granulomatous sarcoidosis in children. Steroid therapy, adjusted according to disease activity, may prevent end-stage renal failure. Received: 4 December 1997 / Accepted in revised form: 22 June 1998     

The role of conservative treatment in idiopathic granulomatous mastitis

Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast that mimics carcinoma of the breast. Its etiology and treatment remain unclear. A retrospective review of nine women with histopathologic diagnosis of IGM was performed. The women had a mean follow-up of 18.7 months and a mean age of 45.7 years (range 32-83 years). The main presentation was breast mass (100%). Clinically and radiologically, 55.6% of the women were suspected to have malignancy. One patient was treated with lumpectomy without recurrence. Eight patients were treated with expectant management with close regular surveillance. No surgery was performed and no medications were given. Fifty percent of the patients had spontaneous complete resolution of disease after a mean interval of 14.5 months. These four patients had no recurrence. Fifty percent of patients had static disease. In conclusion, it is important to differentiate IGM from carcinoma of the breast. Tissue biopsy remains the gold standard to confirm the diagnosis. Expectant management with close regular surveillance is the treatment of choice.     

Spectrum of lymphoid hyperplasia: Colonic manifestations of sarcoidosis,infectious mononucleosis,and Crohn's disease

The radiographic pattern of nodular lymphoid hyperplasia, perhaps better called the lymphoid follicular pattern, has variously been described as an indication of disease and as a normal variant in the adult, with current opinion favoring the latter. We report 3 cases wherein this pattern resulted from definite pathologic processes: sarcoidosis, infectious mononucleosis, and Crohn's disease. Although usually of no pathological significance, the benign follicular pattern may reflect a variety of diseases.     

Focal osseous lesions in congenital lues

Five babies, aged between one to three months presented with clinical and serological evidence of syphilis. In addition to the usual periosteal and metaphyseal bone lesions of lues, areas of focal lucencies and sequestra were present. The association of sequestra in focal diaphyseal erosions may represent a non-dystrophic manifestation of the disease. The lesions were attributed to the syphilitic process. Trivial trauma to disorganised metaphyses, dystrophic changes and possibly focal osteomyelitis account for the spectrum of bone lesions in congenital syphilis. No tubular bone appears immune to these processes.     

Granulomatous mastitis diagnosed by core-needle biopsy and successfully treated with corticosteroid therapy: A case report

A 46-year-old woman presented to our hospital with a rapidly growing lump in her right breast. Fine-needle aspiration (FNA) cytology and core needle biopsy of the mass revealed many epithelioid cells admixed with multinucleated Langhans-type giant cells, neutrophils, lymphocytes, and stromal cells, leading to a diagnosis of granulomatous mastitis. Mammography and ultrasonography provided little information for differentiating between granulomatous mastitis and carcinoma. This patient was successfully treated with low dose and short period of corticosteroid therapy.     

Methotrexate in the management of granulomatous mastitis

Granulomatous mastitis is a rare benign inflammatory breast disease that often clinically simulates carcinoma. Surgical resection of the entire lesion has been the main method of treatment but recurrence, infection, sinus formation and delayed wound healing can occur relatively commonly. Corticosteroids are also effective in recurrent or resistant cases but are associated with side-effects and relapse of disease after steroid withdrawal. A low weekly oral dose of methotrexate was used in five resistant cases after surgery plus corticosteroid. All cases achieved remission, withdrawal of corticosteroid without relapse and no methotrexate side-effect.     

急性乳腺炎的中西医结合疗法探讨

<正>急性乳腺炎俗称奶疖。细菌经过乳头裂口或糜烂面进入乳头下的淋巴管,侵入乳腺叶间引起的乳房蜂窝组织炎或通过乳腺管直接侵入乳腺而引发炎症。我院在1998年3月至2007年5月共收治23例急性乳腺炎患者,均采用中西医结合疗法取得满意疗效,现介绍如下。     

NORMAL MICROBICIDAL FUNCTION OF MONOCYTES IN A GIRL WITH CHRONIC GRANULOMATOUS DISEASE

ABSTRACT. Weemaes, C., (Department of Paediatrics, University Hospital, Nijmegen, The Netherlands), Leijh, P., Blusse van Oud Alblas, D., van der Meer, J. and van Furth, R. (Department of Infectious Diseases, University Hospital, Leiden, The Netherlands). Normal microbicidal function of monocytes in a girl with chronic granulomatous disease. Acta Paediatr Scand, 70:421, 1981.–The history of a 13-year-old girl with a syndrome resembling Chronic Granulomatous Disease (C.G.D.) is described. Metabolic studies in granulocytes and monocytes classified the patient as having C.G.D. The granulocytes failed to kill Staphylococcus aureus and Candida Albicans; however, the killing of these microorganisms by the patient's monocytes was nearly normal. Family studies revealed no abnormalities in the phagocytic cells of the parents and the siblings.