Cast bronchitis in infants and children
Article Abstract:
Bronchitis, swelling in the bronchial tree of the breathing structures, can produce mucus. Cast bronchitis is characterized by the production of material that takes on the shape of breathing structures, much like a mold. These fibrous or mucus-like materials, called casts, differ from plugs of mucus by their shape and consistency. Although this type of bronchitis has been reported in adults, few cases have been found among children. It is suspected that many children with asthma-like bronchitis have bronchial casts. The clinical and X-ray findings of 72 children, three months to 5.5 years of age, with asthma-like or spastic bronchitis lasting more than two weeks and bronchial casts, are reported. Bronchial casts were found either in the stomach contents (from swallowing) or spontaneously coughed up. In 65 patients, the bronchitis lasted 10 to 24 months. An allergic response is not a likely cause, since laboratory indications of allergy were not found in the eight patients evaluated. Only one patient had a hypersensitive reaction, indicating an allergic condition. The casts were usually soft, hollow, white and had a branch-like appearance measuring 0.2 to 0.8 inches. They were composed of abnormal epithelial cells (the cells covering internal organs), inflammatory cells (which cause swelling) and some noncellular material. Viruses were not found in any of the 11 cast specimens studied. It is not known how the casts are formed. The strength of the casts depended on the ability of the epithelial cells to become attached. The more clumped the cells, the harder the cast. The epithelial cell transformation found in patients with cast formation is different from that caused by irritants (smoke for example) and allergens. Cystic fibrosis, a genetic condition causing excess mucus production, was later confirmed in one patient. It is concluded that cast formation may be a common event in infants and children with obstructive bronchitis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Diseases of Children
Subject: Health
ISSN: 0002-922X
Year: 1989
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Neurofibromatosis type I (Recklinghausen's disease)
Article Abstract:
Neurofibromatosis type 1, also known as Recklinghausen's disease, is a genetic disorder that causes tumors of the skin and nerves. The disease is characterized by cafe-au-lait spots (pale tan patches) on the skin, muscle, skeletal and organ malformations, and various degrees of mental deficiency. Subtle neurological and mental deficiencies were evaluated in 13 children with neurofibromatosis type 1 and 13 normal siblings. The children were evaluated using neurodevelopmental assessment tools. The incidence of mental retardation, attention deficit disorder and learning disabilities was not greater in the children with neurofibromatosis. However, 21 children with the disease were found to have subtle neurological abnormalities, compared with only 6 siblings. Full-scale IQ scores were significantly lower among the children with neurofibromatosis (94 versus 105). The IQ scores of the affected children were scattered throughout the downward end of the scale; the scores were not concentrated in the very low spectrum. Of nine affected children who were evaluated for visual-spatial ability, eight were found to have deficits. These findings indicate that a widespread alteration in brain function occurs in children with neurofibromatosis type 1 and that it leads to one or more types of neuropsychologic deficits. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Diseases of Children
Subject: Health
ISSN: 0002-922X
Year: 1989
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