Susan M Nielsen | Search PubMed

PubMed2006

[Serious bleeding in systemic lupus erythematosus complicated by lupus anticoagulant-hypoprothrombinaemia syndrome].

Severe hemorrhagic diathesis due to lupus anticoagulant complicated by hypoprothrombinaemia resulting from prothrombin autoantibodies is a rare disorder and is often associated with systemic lupus erythematosus (SLE). We report a case in which a 15-year-old girl with SLE developed marked haemorrhagic manifestations due to menorrhagia and nosebleeds. The acute bleeding episode was treated with SAGM, tranexamic acid and recombinant factor VIIa. Lupus anticoagulant, cardiolipin antibodies and antiprothrombin antibodies were successfully depressed within weeks after corticosteroid therapy was begun.

Adolescent↗

PubMed2003

[Reflex dystrophy affects children, too].

Reflex dystrophy or Complex Regional Pain Syndrome (CRPS) is a neuropathic pain condition in a limb after a trauma. Pain is not limited to one or more dermatomes and there is a disproportion between the intensity of the pain and the eliciting trauma. Among physicians in Denmark it is not common knowledge that CRPS also affects children. It is not described in paediatric textbooks and until 1978 there were only eight published case reports. CRPS is seen in older children and teenagers and the pain is often located in a leg. CRPS is more common among girls than boys (approx. 4:1). Lack of knowledge of CRPS in children often results in a fairly long delay between the onset of symptoms and the diagnosis. Physiotherapy is an important part of the treatment of CRPS but concomitant pain treatment is often required in order to make physiotherapy possible. Sympathetic nerve block with intravenous regional guanethedine block or an epidural blockade is used. A number of analgesics may also be used. The treatment should be administered by a multi-disciplinary team. The incidence of CRPS in children in Denmark is unknown but the condition is probably under-diagnosed. Early diagnosis and active treatment may reduce the duration of the condition considerably.

Adolescent↗