Computed tomography diagnosis of extradural involvement of paraspinal tumors in children.
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Biomedical subjects
Publications and source records attributed to H Rubie.
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Two cases of children treated for malignant tumor and who developed a severe lacticacidosis are reported. A 2 year-old girl and a 8 year-old boy were treated with chemotherapy, irradiation and multiple surgical procedures for nephroblastoma and lymphoma respectively. These two malnourished patients, under exclusive parenteral nutrition for two weeks without vitamin intakes, suddenly developed neurological, cardiovascular and digestive symptoms, associated with cytopenia and lacticacidosis. Injection of vitamin B1 only corrected these abnormalities within a few hours, proving the role of thiamine deficiency as the cause of the symptoms.
The authors studied retrospectively a group of 41 children in prolonged remission of Acute Leukemia (AL) or Non Hodgkin Malignant Lymphoma (NHML) treated with polychemotherapy and prophylactic cranial irradiation, searching for late side effects of the disease or its treatment. The neurological follow-up was satisfying enough (only one major sequela); growth abnormalities were found in 57.5% of children (correlated with hormonal deficiency), and some thyroid and gonadal impairments. Psychoaffective disturbances seemed to be moderate, but difficulties in learning and persistence of anxiety are emphasized. Estimation of cardiac function showed left ventricular alterations in two patients, detected by echocardiography, perhaps related to anthracyclines toxicity. Immunohematological investigations showed an apparent recovery for the first year following the end of the treatment, except for 5 inverted T4/T8 ratios and partial vaccine protection. No liver dysfunction was noticed, although positive HB serological assays were 3 fold more frequent than in a normal population. Lastly, no secondary cancer was observed in this study, but the incidence of a second malignancy in such groups is discussed. With the improvement of prognosis of childhood malignancies, such screenings are indispensable for better management.