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Biomedical subjects

S Wirth

Publications and source records attributed to S Wirth.

114 records · Page 7Linked to original sources
PubMedDate not supplied

[Parenteral nutrition in treatment of short stature in adolescents with Crohn disease].

Growth retardation and delayed puberty occur in 20-35% of children and adolescents with Crohn's disease. Alternate day corticosteroid treatment, use of azathioprine, enteral or parenteral hyperalimentation and surgery have been advocated to reverse growth failure. Because of nonacceptance of elemental diet 7 patients with Crohn's disease and growth retardation received parenteral nutrition for 2-3 months (maximal for more than 30 months in one patient). All of them exhibited a mean weight gain of 10 kg and a mean increase of their height velocity from 2.4 to 7.1 cm/year. Main problems were bacterial infections and dislocations of the central lines. Surgery was performed in 3 adolescents immediately after parenteral nutrition. One patient showed a catch-up growth during a 30-months nocturnal home parenteral nutrition at a biological age of 21 years. Parenteral nutrition is an effective regimen to manage growth failure in children with Crohn's disease, but has to be performed for larger periods in individual cases.

Adolescent↗
PubMedDate not supplied

[Kawasaki syndrome with acute gallbladder hydrops--case report and review of the literature].

We describe a 2 3/4-year-old boy with Kawasaki disease associated with the rare complication of acute hydrops of the gallbladder. Because of the severe abdominal symptoms cholecystectomy was performed. A review of the literature shows that about half of the patients had been operated upon. Therefore conservative treatment may provide complete improvement. Ultrasonography is not only very helpful in the diagnosis but also in follow-up.

Child, Preschool↗
PubMedDate not supplied

Alpha-interferon treatment in HBeAg positive children with chronic hepatitis B and associated hepatitis D.

The main problem of children with HBeAg positive hepatitis B and associated hepatitis D is progression to liver cirrhosis with decompensation of liver function and need for liver replacement therapy within 15-20 years after infection. To determine whether interferon-alpha (IFN-alpha) therapy has a positive effect on HBV replication and inflammatory activity, we evaluated clinical and serological data of 8 children treated with IFN-alpha and 6 historic control patients without treatment. 4 of the nontreated patients seroconverted from HBeAg to anti-HBe between 7 to 17 years after initial diagnosis and showed decreased inflammatory activity in the liver. In the treatment group, the rate of seroconversion to anti-HBe (3 early, 2 late seroconverters) corresponded well to former trial results obtained in patients exclusively infected by HBV. Serum aminotransferase levels decreased or normalized in seroconverted children. In chronic HBV infection with associated hepatitis D (HDV) infection--compared to the spontaneous course of the disease--IFN-alpha therapy reduced inflammatory activity by earlier seroconversion to anti-HBe in responding patients. Moreover, viral replication and infectivity of hepatitis B was markedly reduced, but no effect on replication of HDV could be documented. Although long-term effects cannot be exactly estimated, at present IFN-alpha remains the only available treatment for HBeAg and anti-HDV positive children and seems to be of benefit for responding patients.

Adolescent↗
PubMedDate not supplied

[Long-term follow-up of a boy with recurrent hypoglycemia and cholestasis in congenital growth hormone deficiency].

We report on a four-year-old boy with congenital growth hormone deficiency who first presented at age 13 weeks with jaundice and recurrent hypoglycemia. Growth hormone deficiency was diagnosed two years later, after cholestasis and hypoglycemia had almost completely disappeared, but length deficiency became apparent. The reason for the association of cholestasis with growth hormone deficiency remains unexplained. Cholestasis can, especially in combination with hypoglycemia, be a first sign of congenital growth hormone deficiency.

Biopsy↗
PubMedDate not supplied

Some aspects of changed histopathologic appearance of acute rejection in cardiac allografts after prophylactic application of OKT3.

The histopathologic findings of therapy-requiring acute rejection in the cardiac allograft observed in endomyocardial biopsy specimens taken from patients under prophylactic administration of OKT3 show certain differences in comparison with the classic description of acute rejection. These differences are characterized above all by a distinctly reduced cellularity of the infiltrates, with a relative decrease of T cells, as well as edema and retrogressive changes, up to necroses of myocytes with marked fragmentation; some patients also have increased vascular reactions. Furthermore, an earlier occurrence of and an increased frequency of changes corresponding to the so-called lymphoma-like lesions ("Quilty" effect) were observed in patients who received immunosuppressive prophylaxis with OKT3. The changed histopathologic findings of therapy-requiring acute rejection under prophylactic application of OKT3 may, to a certain extent, explain the discrepant results reported by different transplant groups with respect to the frequency of rejection episodes and the time when the first episode of therapy-requiring rejection occurs after heart transplantation.

Antibodies, Monoclonal↗