1/6. Multiple hepatic tumors and peliosis hepatis in Fanconi's anemia treated with androgens.We report the case of a 13-year-old boy who was known to have Fanconi's anemia for five years. For treatment of this condition he was given androgens and corticosteroids. Two months before his death, severe varicella developed complicated by pneumonia, jaundice, and prolonged fever; all of which resolved during a five-week hospitalization. Three weeks later he died of clostridium septicum sepsis caused by necrotizing enterocolitis. At autopsy he was found to have multiple hepatocellular neoplasms. A striking feature of the neoplasms was cholestasis. The liver also showed peliosis hepatis. The association of the use of certain androgenic steroids with hepatic neoplasms histologically resembling hepatocarcinomas, but characterized by lack of metastases and apparent reversibility, suggests the desirability of a new nomenclature for these hepatocellular lesions.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
2/6. Varicella gangrenosa.A four year old girl presented with varicella gangrenosa, and haematological investigations showed a disseminated intravascular coagulation. The child subsequently developed a unilateral deep venous thrombosis. She was treated with oral steroids and intravenous heparin and made a full recovery.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
3/6. Hemorrhagic complications of varicella.Although normally a benign illness, varicella can be accompanied by purpuric syndromes. While thrombocytopoiesis is normal, a shortened platelet survival time has been demonstrated with no increase in splenic sequestration. Various mechanisms have been suggested, including an autoimmune mechanism, direct interaction between virus and platelets, and vascular damage resulting in platelet removal on nonendothelialized surfaces.- - - - - - - - - - ranking = 5keywords = varicella (Clic here for more details about this article) |
4/6. The orthopaedic implications of purpura fulminans.The syndrome of purpura fulminans has frequently been reported in the surgical and pediatric literature, but rarely in the orthopaedic literature. The mortality rate has decreased dramatically from early reports of approximately 90 per cent to more recent reports of 18 per cent. amputation of a portion of the involved extremities, however, is usually required in the patients who survive. Over a twelve-month period, we treated four patients who had purpura fulminans, with resultant vasospasm and secondary ischemic gangrene. In three of the patients the syndrome developed following a one to two-day febrile illness, and in one, following varicella. All four patients survived, but two required a bilateral lower-limb amputation; one, a Syme amputation and a partial hand amputation; and one, an amputation of the fore part of the foot. Autoamputation of multiple fingertips and toes occurred in two of the four patients.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
5/6. Varicella and thrombotic complications associated with transient protein C and protein S deficiencies in children.We report six cases of protein s deficiency secondary to varicella. Five cases were complicated by thrombotic and vascular events, namely purpura fulminans and necrotic vasculitis, deep vein thrombosis and stroke. Two cases were associated with protein c deficiency and one case revealed a heterozygous factor xii deficiency. The underlying mechanism of this acquired protein s deficiency is unclear but could be related to a direct effect of zoster virus.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
6/6. Hemorrhagic varicella: a case report and review of the complications of varicella in children.The case of a previously healthy child who developed progressive systemic varicella with purpura is reported. The clinical course of this patient is outlined, and the range of potential complications of chickenpox in children is reviewed. Familiarity with the usual uncomplicated natural history of primary varicella infection should alert the clinician to signs and symptoms that signal significant systemic involvement.- - - - - - - - - - ranking = 10keywords = varicella (Clic here for more details about this article) |