Lyme disease in paediatrics

Article Abstract:

Lyme disease was first recognized in the town of Old Lyme, Connecticut. It is transmitted by ticks (Ixodes dammini) that are infected with the spirochete bacteria of the species Borrelia burgdorferi. Infected ticks can be found on animals, such as deer, in wooded areas with bushes and shrubs, and in fields with tall grass. Infected ticks have been identified in many areas of the eastern United States, Northern Europe, Russia, China, and Japan. Lyme disease is most common in the summer months and it occurs most frequently in children less than 15 years of age and in adults between 25 and 44 years of age. The disease develops in three stages. The first stage occurs within two to 30 days and is associated with a skin rash and the appearance of a red circle at the site of the tick bite. However, this symptom may be absent in some cases. Abdominal pain, cough, sore throat, headache, and joint pain may be present as well. The second stage of the disease develops one to four months after the tick bite. In many cases the disease damages the central nervous system, causing encephalitis (inflammation of the brain) and meningitis (inflammation of the brain and spinal cord membranes). Arthritis, with joint pain and degeneration, is the most common feature of the final stage of Lyme disease. Laboratory tests for Lyme disease using samples of body fluids are not always accurate and better methods of diagnosis are needed. Tetracycline is the treatment of choice of patients older than nine years of age. Doxycycline can be used as an alternative treatment. Young children with Lyme disease should be treated with amoxicillin and probenecid. Cefotaxime has been shown to be more effective than penicillin in the late stages of Lyme diseases. Current research is focusing on the development of a vaccine for Lyme disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Lyme disease

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Chronic cough in a hospital population; its relationship to atopy and defects in host defence

Article Abstract:

Persistent cough is one of the most frequent symptoms seen by pediatricians, but there are so many possible causes that often it is difficult to isolate the source of the patient's illness. A study was conducted of 60 children with chronic, simple cough with no wheeze, 60 with asthma and 60 without respiratory symptoms, to determine whether the children with simple cough could be distinguished from the other groups by the presence of atopy (an allergic reaction that may include asthmatic symptoms) or possible defects in the immune system. There was no evidence of atopy in approximately 40 percent of the children with simple cough. No correlation was confirmed between those with simple cough with atopy and the asthmatic children. Some children with chronic cough showed a chronic airway obstruction. Hypersensitivity to house dust mite affected 45 of the children with asthma, who also exhibited high concentrations of the immunoglobulin IgE. There was no evidence that either the asthmatic children or those with chronic cough had any serious immunoglobulin deficiencies. A study is now in progress to determine whether chronic cough is a minor symptom existing independent of asthma, or whether it may be a precursor of asthma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Respiratory tract diseases, Cough

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Myopathy with hypophosphatasia

Article Abstract:

Hypophosphatasia is an inherited metabolic disorder with a deficiency of the enzyme alkaline phosphatase, and is characterized by abnormalities of the skeleton, including rickets, the presence of defects in shape and structure of bone; osteomalacia, or increased softness of bones; defective tooth development; and phosphoethanolamine, a phosphate and nitrogen-containing compound, in the urine. The role of alkaline phosphatase in promoting normal bone formation is not clear, but may be related to the formation of hydroxyapatite crystals, a form of calcium phosphate and a component of bone. Three cases are described of children with hypophosphatasia who developed muscle pains, stiffness, and lower muscle weakness at an early stage of the disease. These muscle disorders were the initial symptoms of hypophosphatasia in two cases. These findings suggest that myopathy, or muscle disease, may be an important sign of hypophosphatasia. The blood levels of calcium and phosphate were normal in these patients, although it is possible that the muscle cell content of phosphate may be altered. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Muscle diseases, Muscular diseases, Metabolic diseases, Metabolic disorders in children

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