Two cases of ischemic stroke in children of Tunisian descent with sickle cell anemia are reported. Patients were aged 3 years and 14 years, respectively. Periodic partial exchange transfusions with sedimented red blood cells of identical phenotype prevented further episodes of ischemic stroke. Transplantation of HLA-identical bone marrow from a family member offers a chance of complete cure of the hemoglobin disorder in these children who are at risk of recurrent stroke.
The case of a 15-month-old, strictly breast-fed infant whose mother had been following a vegetarian diet for ten years is reported. The infant had severe megaloblastic anemia with an arrest in growth, hypotonia, and failure of psychomotor development. The very low levels of vitamin B12 in the infant's serum and mother's milk confirmed the diagnosis. Management of such cases consists in administration of vitamin B12 supplements, with a blood transfusion if needed. Other concomitant deficiencies should be looked for. The outcome is rapidly favorable. The patient reported here is now four years of age and has normal statural growth and psychomotor development.
A case of anorexia nervosa revealed by water intoxication with severe hyponatremia is reported after a search of the literature demonstrated the rarity of such cases. Pathophysiological mechanisms involved are discussed. Hospitalization in a unit for adolescents in which pediatricians and psychiatrists work together allowed both prompt treatment of metabolic disorders and early management of anorexia nervosa, which is associated with improved prognosis.
Lipomas of the small bowel and mesentery are exceedingly rare in young pediatric patients. This article reports a case which underlines the difficulty of establishing this diagnosis before exploratory laparotomy.
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