Pub Date : 2017-01-31DOI: 10.4172/2167-0897.1000246
B. Afolabi
Unlike in many parts of the developed world, the African neonate, in some cases, is disadvantaged right from inception. In many urban slums and in most rural parts of the continent, the mother is often malnourished even before getting pregnant. Once in antenatal period, the pregnancy takes its toll on the already malnourished mother to the extent that the fetus is left on its own to extract all the nutrients it needs to survive in the womb. Feto-maternal malnutrition is often overlooked as a risk factor for stillbirth, low birthweight babies and maternal morbidity and mortality. Maternal conditions are directly linked to neonatal circumstances. An embryo may face many genetic, hereditary, mechanical and/or biological complications such as albinism, Spina bifida, cleft lip/cleft palate, development in the fallopian tube, obstruction due to sub-mucosal fibroid or placenta previa, just to mention a few. While leg or shoulder presentation, cord strangulation or locked heads in twin pregnancy are delicate intra-partum conditions, asphyxia neonatorum is about the commonest immediate post-partum pathology that may lead to neonatal death. This paper briefly describes neonatal morbidity and mortality, their remote and proximal causes and the need for essential health care as a right of mother, a right of the neonate and a right of the growing child.
{"title":"Sub-Sahara African Neonates â Ghosts to Statistics","authors":"B. Afolabi","doi":"10.4172/2167-0897.1000246","DOIUrl":"https://doi.org/10.4172/2167-0897.1000246","url":null,"abstract":"Unlike in many parts of the developed world, the African neonate, in some cases, is disadvantaged right from inception. In many urban slums and in most rural parts of the continent, the mother is often malnourished even before getting pregnant. Once in antenatal period, the pregnancy takes its toll on the already malnourished mother to the extent that the fetus is left on its own to extract all the nutrients it needs to survive in the womb. Feto-maternal malnutrition is often overlooked as a risk factor for stillbirth, low birthweight babies and maternal morbidity and mortality. Maternal conditions are directly linked to neonatal circumstances. An embryo may face many genetic, hereditary, mechanical and/or biological complications such as albinism, Spina bifida, cleft lip/cleft palate, development in the fallopian tube, obstruction due to sub-mucosal fibroid or placenta previa, just to mention a few. While leg or shoulder presentation, cord strangulation or locked heads in twin pregnancy are delicate intra-partum conditions, asphyxia neonatorum is about the commonest immediate post-partum pathology that may lead to neonatal death. This paper briefly describes neonatal morbidity and mortality, their remote and proximal causes and the need for essential health care as a right of mother, a right of the neonate and a right of the growing child.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42316667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-26DOI: 10.4172/2167-0897.100I101
Buyukgoz C, Kitsos E, Zahouani T, Rajegowda B
{"title":"Bilateral Ectrodactyly, Syndactyly with Split Foot Malformation in a HealthyLiving New-Born Infant","authors":"Buyukgoz C, Kitsos E, Zahouani T, Rajegowda B","doi":"10.4172/2167-0897.100I101","DOIUrl":"https://doi.org/10.4172/2167-0897.100I101","url":null,"abstract":"","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"6 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41546552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-25DOI: 10.4172/2167-0897.1000245
Casale Matteo, Mezzetti Maurizio, Tulino Viviana, Morelli Marco, Ciccarelli Iacopo, M. Simone, Giovagnoli Andrea, Busacca Paolo, Dattilo Giuseppe
Introduction. Cardiac arrhythmias are challenging conditions in pediatric patients, especially in the case of newborns. Most of the tachyarrhythmias in children (90,24%) are atrioventricular reentrant tachycardias (AVRT) and atrioventricular nodal reentrant tachycardias (AVNRT). Although the standard 12-lead ECG maintains high diagnostic value, an invasive electrophysiological study and a catheter ablation are often required. Unfortunately these procedures are burdened by the use of radiations. Materials and Methods. We performed a systematic research in PubMed and Embase. We found 257 articles of interest but we selected only 36 as the most representative. Discussion: The main concerns linked to electrophysiological procedures are the need of fluoroscopy and thus the risk of malignancy as well as dermatitis, cataracts, thyroid diseases and birth defects. Children and especially newborns have a greater life expectancy so their cumulative risk is greater than adults. For this reason the guiding principle in electrophysiological procedures involving radiations in pediatric subjects is as low as reasonably achievable (acronym: ALARA). The development of 3-dimensional (3-D) electroanatomical mapping systems allowed a significant reduction of radiation exposure during ablations. The most recent experiences demonstrated the feasibility and the safety of fluoroless ablation procedures of the most common arrhythmias in children. Conclusions: Cardiac arrhythmias could be very challenging conditions in pediatric patients. Predictors of complications are a body weight <15 kg and an age <4 years so it is clear that newborns are the most difficult patients. It is reasonable, because of these evidences, to approach cardiac arrhythmias pharmacologically in younger subjects. More than 20 years of experiences conducted by the electrophysiologists allow us to encourage the use of the electroanatomical mapping systems, with the objective of reducing the radiation exposure in children, especially when accessory pathways are involved.
{"title":"Electroanatomical mapping systems and cardiac arrhythmias: avoiding radiations in pediatric patients","authors":"Casale Matteo, Mezzetti Maurizio, Tulino Viviana, Morelli Marco, Ciccarelli Iacopo, M. Simone, Giovagnoli Andrea, Busacca Paolo, Dattilo Giuseppe","doi":"10.4172/2167-0897.1000245","DOIUrl":"https://doi.org/10.4172/2167-0897.1000245","url":null,"abstract":"Introduction. Cardiac arrhythmias are challenging conditions in pediatric patients, especially in the case of newborns. Most of the tachyarrhythmias in children (90,24%) are atrioventricular reentrant tachycardias (AVRT) and atrioventricular nodal reentrant tachycardias (AVNRT). Although the standard 12-lead ECG maintains high diagnostic value, an invasive electrophysiological study and a catheter ablation are often required. Unfortunately these procedures are burdened by the use of radiations. Materials and Methods. We performed a systematic research in PubMed and Embase. We found 257 articles of interest but we selected only 36 as the most representative. Discussion: The main concerns linked to electrophysiological procedures are the need of fluoroscopy and thus the risk of malignancy as well as dermatitis, cataracts, thyroid diseases and birth defects. Children and especially newborns have a greater life expectancy so their cumulative risk is greater than adults. For this reason the guiding principle in electrophysiological procedures involving radiations in pediatric subjects is as low as reasonably achievable (acronym: ALARA). The development of 3-dimensional (3-D) electroanatomical mapping systems allowed a significant reduction of radiation exposure during ablations. The most recent experiences demonstrated the feasibility and the safety of fluoroless ablation procedures of the most common arrhythmias in children. Conclusions: Cardiac arrhythmias could be very challenging conditions in pediatric patients. Predictors of complications are a body weight <15 kg and an age <4 years so it is clear that newborns are the most difficult patients. It is reasonable, because of these evidences, to approach cardiac arrhythmias pharmacologically in younger subjects. More than 20 years of experiences conducted by the electrophysiologists allow us to encourage the use of the electroanatomical mapping systems, with the objective of reducing the radiation exposure in children, especially when accessory pathways are involved.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"6 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45627707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-11DOI: 10.4172/2167-0897.1000244
B. Daniyan
{"title":"Obstetric Fistula â An Unceasing Scourge in the Developing World","authors":"B. Daniyan","doi":"10.4172/2167-0897.1000244","DOIUrl":"https://doi.org/10.4172/2167-0897.1000244","url":null,"abstract":"","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46332523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-10DOI: 10.4172/2167-0897.1000243
S. Ng, A. Soni, M. Didi
Trisomy 21 is commonly associated with thyroid problems. Although autoimmune hypothyroidism is the commonest thyroid problem in Trisomy 21, infants with this chromosomal disorder are also known to have dysregulated pituitary thyroid axis. This results in elevated thyrotropin (TSH) levels in absence of autoimmunity and structurally normal thyroid gland. The mechanism for this phenomenon is not clearly understood and it is possible that this may be due to genomic imbalance from trisomy of chromosome 21. Some authors have proposed that thyroid hormone resistance (RTH) might be a contributing factor to this. However, the genes coding for TSH receptor and the two proteins known to be implicated in TSH resistance are normal in patients with Trisomy 21. In newborns, transient hyperthyrotropinaemia is considered to be associated with maternal thyroperoxidase (TPO) antibody positivity. We describe a case of term infant with Trisomy 21, who was identified on newborn congenital hypothyroidism screening. The infant had high TSH and raised plasma free T4 (FT4) with clinical signs and symptoms of congenital hypothyroidism. We discuss the management of this case and possible mechanisms contributing to the uncommon presentation.
{"title":"Neonatal Pituitary-Thyroid Axis Dysregulation with Combined Thyroid Hormone and Thyrotropin Resistance in Infant with Trisomy 21 and Maternal Subclinical Hypothyroidism","authors":"S. Ng, A. Soni, M. Didi","doi":"10.4172/2167-0897.1000243","DOIUrl":"https://doi.org/10.4172/2167-0897.1000243","url":null,"abstract":"Trisomy 21 is commonly associated with thyroid problems. Although autoimmune hypothyroidism is the commonest thyroid problem in Trisomy 21, infants with this chromosomal disorder are also known to have dysregulated pituitary thyroid axis. This results in elevated thyrotropin (TSH) levels in absence of autoimmunity and structurally normal thyroid gland. The mechanism for this phenomenon is not clearly understood and it is possible that this may be due to genomic imbalance from trisomy of chromosome 21. Some authors have proposed that thyroid hormone resistance (RTH) might be a contributing factor to this. However, the genes coding for TSH receptor and the two proteins known to be implicated in TSH resistance are normal in patients with Trisomy 21. In newborns, transient hyperthyrotropinaemia is considered to be associated with maternal thyroperoxidase (TPO) antibody positivity. We describe a case of term infant with Trisomy 21, who was identified on newborn congenital hypothyroidism screening. The infant had high TSH and raised plasma free T4 (FT4) with clinical signs and symptoms of congenital hypothyroidism. We discuss the management of this case and possible mechanisms contributing to the uncommon presentation.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47313956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01Epub Date: 2017-05-31DOI: 10.4172/2167-0897.1000257
Ahmed Fageer Osman, Biju Thomas, Nakul Singh, Marc Collin, Prem Singh Shekhawat
Objective: To evaluate the impact of infant-polysomnography studies performed in the NICU on management and outcomes.
Study design: Retrospective study to collect demographics and data on infant-polysomnography studies between Jan 2010 to Dec 2014.
Results: 110 premature neonates had polysomnography study performed at 36.9 ± 2.5 weeks post menstrual age. Almost all the studies were read as abnormal and 95% of the studied infants were discharged home on a cardiorespiratory monitor. 20% of the subjects had apnea >20 s, 18% had apnea of 15-20 s and 50% of infants had apnea of 10-15 s. 24.5% infants were discharged home on caffeine, 28% on metoclopramide and 24% on antacids. There were 11 readmissions for apparent life threatening events with no until 6 month-corrected age. There was no association between polysomnography results and readmission. There was a decline in polysomnography studies performed each year.
Conclusion: Cardiorespiratory monitoring, medications and polysomnography studies do not predict outcomes.
{"title":"Impact of Infant-Polysomnography Studies on Discharge Management and Outcomes: A 5 Year Experience from a Tertiary Care Unit.","authors":"Ahmed Fageer Osman, Biju Thomas, Nakul Singh, Marc Collin, Prem Singh Shekhawat","doi":"10.4172/2167-0897.1000257","DOIUrl":"10.4172/2167-0897.1000257","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of infant-polysomnography studies performed in the NICU on management and outcomes.</p><p><strong>Study design: </strong>Retrospective study to collect demographics and data on infant-polysomnography studies between Jan 2010 to Dec 2014.</p><p><strong>Results: </strong>110 premature neonates had polysomnography study performed at 36.9 ± 2.5 weeks post menstrual age. Almost all the studies were read as abnormal and 95% of the studied infants were discharged home on a cardiorespiratory monitor. 20% of the subjects had apnea >20 s, 18% had apnea of 15-20 s and 50% of infants had apnea of 10-15 s. 24.5% infants were discharged home on caffeine, 28% on metoclopramide and 24% on antacids. There were 11 readmissions for apparent life threatening events with no until 6 month-corrected age. There was no association between polysomnography results and readmission. There was a decline in polysomnography studies performed each year.</p><p><strong>Conclusion: </strong>Cardiorespiratory monitoring, medications and polysomnography studies do not predict outcomes.</p>","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36565114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4172/2167-0897.1000247
K. Maeda, M. Tatsumura
Purpose: To assess fetal well-being and education ability by fetal response to sound and light. Material: Intrauterine fetuses in late pregnancy. Methods: The sound source was a loud speaker connected to an audioamplifier, of which source was sine waves, generated in a stimulator. The sound power was measured by an audiometer. The loud speaker was placed at the pregnant abdomen. A photographic speed light, of which guide number was 25, was flushed at pregnant abdomen around at fetal face, in the photic stimulation. Results: Acoustic and visual stimulation effects were fetal movements and heart rate (FHR) acceleration in fetal actocardiogram. The stimulation with 1,000 Hz 80 decibel (dB) sound for 2 S produced positive effects at 28 weeks, while 60 dB sounds achieved positive effects in 40 weeks, namely, sound sensitivity increased 10 folds in late pregnancy. Although foetuses responded to 250 and 500 Hz sound in 28 and 40 weeks, sound intensity reduction was insignificant. Positive results to photic stimulation were noted in 23 or later weeks and 77% cases achieved positive results in 40 weeks. Discussion: Positive effect of sound and light stimulation was fetal movements and FHR acceleration, which were the sign of healthy fetal brain, while, significant sound power reduction was noted only in 1,000 Hz, higher frequency than maternal voice, thus, fetal education will not be expected, and mother voice should be changed to 1,000 Hz using a voice changer in fetal education, however, healthy fetal hearing is expected by the response to 250-1,000 Hz sound and the response to flush light is the sign of healthy fetal retina and light sensing.
{"title":"Fetal Response to Sound and Light: Possible Fetal Education?","authors":"K. Maeda, M. Tatsumura","doi":"10.4172/2167-0897.1000247","DOIUrl":"https://doi.org/10.4172/2167-0897.1000247","url":null,"abstract":"Purpose: To assess fetal well-being and education ability by fetal response to sound and light. Material: Intrauterine fetuses in late pregnancy. Methods: The sound source was a loud speaker connected to an audioamplifier, of which source was sine waves, generated in a stimulator. The sound power was measured by an audiometer. The loud speaker was placed at the pregnant abdomen. A photographic speed light, of which guide number was 25, was flushed at pregnant abdomen around at fetal face, in the photic stimulation. Results: Acoustic and visual stimulation effects were fetal movements and heart rate (FHR) acceleration in fetal actocardiogram. The stimulation with 1,000 Hz 80 decibel (dB) sound for 2 S produced positive effects at 28 weeks, while 60 dB sounds achieved positive effects in 40 weeks, namely, sound sensitivity increased 10 folds in late pregnancy. Although foetuses responded to 250 and 500 Hz sound in 28 and 40 weeks, sound intensity reduction was insignificant. Positive results to photic stimulation were noted in 23 or later weeks and 77% cases achieved positive results in 40 weeks. Discussion: Positive effect of sound and light stimulation was fetal movements and FHR acceleration, which were the sign of healthy fetal brain, while, significant sound power reduction was noted only in 1,000 Hz, higher frequency than maternal voice, thus, fetal education will not be expected, and mother voice should be changed to 1,000 Hz using a voice changer in fetal education, however, healthy fetal hearing is expected by the response to 250-1,000 Hz sound and the response to flush light is the sign of healthy fetal retina and light sensing.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"6 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-0897.1000247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70814703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4172/2167-0897.1000261
D. Sharma
Hypertension in neonatal is labelled when as blood pressure (BP) is above 2 standard deviation or >95th percentile over the mean of systolic and/or diastolic BP in similar neonate with respect to post-menstrual age, post-natal age and weight. It is an infrequently seen and rarely reported entity in NICU. Presently there are no normogram in neonatal population for BP when compared to pediatric and adult population. It is usually diagnosed during routine BP monitoring but needs timely identification and treatment, with Malignant HT needing urgent treatment, otherwise delay in management can lead to end organ dysfunction and poor long term neonatal outcomes. There are no evidence based guidelines for treatment HT and present treatment guidelines are consensus based. This review article tries to covers all aspects of neonatal hypertension.
{"title":"Hypertension in Neonates: Need for Future Research","authors":"D. Sharma","doi":"10.4172/2167-0897.1000261","DOIUrl":"https://doi.org/10.4172/2167-0897.1000261","url":null,"abstract":"Hypertension in neonatal is labelled when as blood pressure (BP) is above 2 standard deviation or >95th percentile over the mean of systolic and/or diastolic BP in similar neonate with respect to post-menstrual age, post-natal age and weight. It is an infrequently seen and rarely reported entity in NICU. Presently there are no normogram in neonatal population for BP when compared to pediatric and adult population. It is usually diagnosed during routine BP monitoring but needs timely identification and treatment, with Malignant HT needing urgent treatment, otherwise delay in management can lead to end organ dysfunction and poor long term neonatal outcomes. There are no evidence based guidelines for treatment HT and present treatment guidelines are consensus based. This review article tries to covers all aspects of neonatal hypertension.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"6 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-0897.1000261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4172/2167-0897.1000259
Sharon J. Jones
Maternal cradling bias is the act of human females to tend to cradle new-borns to the left side in the first few weeks of life. Many factors contributing to the occurrence of leftward cradling bias have been explored including handedness and hemispheric dominance, neural development in neonates, breast feeding influences and early communicative. Accepted best practices for developmental support for premature infants incorporate positioning and holding neonates in their protocols. Questions as to what function leftward cradling serves and what impact it has on the developmental trajectory of the infant in the first few weeks of life is the subject of much research. This paper will review the literature focusing on maternal cradling bias and explore implications on best practices for paediatric professionals.
{"title":"What is the Significance of Leftward Cradling Bias","authors":"Sharon J. Jones","doi":"10.4172/2167-0897.1000259","DOIUrl":"https://doi.org/10.4172/2167-0897.1000259","url":null,"abstract":"Maternal cradling bias is the act of human females to tend to cradle new-borns to the left side in the first few weeks of life. Many factors contributing to the occurrence of leftward cradling bias have been explored including handedness and hemispheric dominance, neural development in neonates, breast feeding influences and early communicative. Accepted best practices for developmental support for premature infants incorporate positioning and holding neonates in their protocols. Questions as to what function leftward cradling serves and what impact it has on the developmental trajectory of the infant in the first few weeks of life is the subject of much research. This paper will review the literature focusing on maternal cradling bias and explore implications on best practices for paediatric professionals.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"6 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70814944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4172/2167-0897.1000265
Vishal Vishnu Tewari, R. Mehta, K. Tewari
Background: Acute leukemia presenting in the neonate and the young infant is a rare hematological malignancy. It may present at birth or within few days (congenital) or it may be diagnosed in first 4-6 weeks of life (neonatal) and may be myeloid or lymphoid in origin. High index of suspicion along with bone marrow studies, cytochemistry and flow cytometry is the mainstay of diagnosis. Case presentation: We report two cases of congenital acute leukemia presenting in second month of life. The first infant presented with fever, inconsolable crying, loose stools and vomiting of two weeks duration with pallor and hepatosplenomegaly. Lab investigations revealed anemia, leucocytosis and thrombocytopenia with 80% Blasts seen on peripheral blood smear. The bone marrow aspirate was hypercellular with greater than 3% of the blasts positive for myeloperoxidase (MPO). Based on morphology and immunophenotyping (IPT) by flow cytometry a diagnosis of Acute Myeloid Leukemia M2 (AML-M2) was made. The infant was managed with BFM intermediate risk induction protocol. Maintenance therapy was given for 18 months. The infant is in complete clinical and haematological remission. The second infant presented with fever, lethargy, poor feeding and palpable organomegaly. She had similar findings of leucocytosis with 90% blasts on peripheral smear which were negative for MPO. She was diagnosed as a Calla-positive B cell Acute Lymphoblastic Leukemia (ALL). She was managed as per the Interfant collaborative group protocol but succumbed to her illness. Conclusion: Congenital leukemia is characterized by an progressive nature of illness, greater achievement of remission in AML as compared to ALL, higher relapse rate, poor prognosis and difficulty in instituting combination chemotherapy. We report two infants diagnosed with congenital AML-M2 and Calla-positive B cell ALL based on cytochemistry and IPT. Resistance of leukemic cells in congenital ALL to chemotherapeutic drugs entails using a hybrid chemotherapeutic regimen.
{"title":"Congenital Acute Leukemia: A Rare Hematological Malignancy","authors":"Vishal Vishnu Tewari, R. Mehta, K. Tewari","doi":"10.4172/2167-0897.1000265","DOIUrl":"https://doi.org/10.4172/2167-0897.1000265","url":null,"abstract":"Background: Acute leukemia presenting in the neonate and the young infant is a rare hematological malignancy. It may present at birth or within few days (congenital) or it may be diagnosed in first 4-6 weeks of life (neonatal) and may be myeloid or lymphoid in origin. High index of suspicion along with bone marrow studies, cytochemistry and flow cytometry is the mainstay of diagnosis. Case presentation: We report two cases of congenital acute leukemia presenting in second month of life. The first infant presented with fever, inconsolable crying, loose stools and vomiting of two weeks duration with pallor and hepatosplenomegaly. Lab investigations revealed anemia, leucocytosis and thrombocytopenia with 80% Blasts seen on peripheral blood smear. The bone marrow aspirate was hypercellular with greater than 3% of the blasts positive for myeloperoxidase (MPO). Based on morphology and immunophenotyping (IPT) by flow cytometry a diagnosis of Acute Myeloid Leukemia M2 (AML-M2) was made. The infant was managed with BFM intermediate risk induction protocol. Maintenance therapy was given for 18 months. The infant is in complete clinical and haematological remission. The second infant presented with fever, lethargy, poor feeding and palpable organomegaly. She had similar findings of leucocytosis with 90% blasts on peripheral smear which were negative for MPO. She was diagnosed as a Calla-positive B cell Acute Lymphoblastic Leukemia (ALL). She was managed as per the Interfant collaborative group protocol but succumbed to her illness. Conclusion: Congenital leukemia is characterized by an progressive nature of illness, greater achievement of remission in AML as compared to ALL, higher relapse rate, poor prognosis and difficulty in instituting combination chemotherapy. We report two infants diagnosed with congenital AML-M2 and Calla-positive B cell ALL based on cytochemistry and IPT. Resistance of leukemic cells in congenital ALL to chemotherapeutic drugs entails using a hybrid chemotherapeutic regimen.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"6 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-0897.1000265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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