Professional Documents
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and thrombocytopenia. IgM antibodies titres of less than 1:4 do not result in
against CMV were positive in the neo- transfer of infection(3). Use of washed
nate and negative in the mother. Mater- packed cells and deglycerolized blood
nal CMV IgG was also negative. On has also been shown to reduce CMV
follow up at 6 months of age there was infection(ll).
no jaundice, choreoretinitis or hepato-
REFERENCES
splenomegaly. The developmental age
was 3 months (uncorrected). 1. Baley JE, Goldforb J. Viral infections.
In: Neonatal—Perinatal Medicine: Dis
All our cases had received blood ease of the Fetus and Infant, 5th edn.
transfusions and CMV TgM was nega- Eds. Fanaroff AA, Martin RJ, Chicago
tive in the mothers. We feel that these Mosby Year Book, 1992, pp 666-667.
babies may have acquired it through 2. Cuerine NG. Viral infections in the
blood. All the babies were preterm and newborn. In: Manual of Neonatal
were symptomatic. Care, 3rd edn. Eds. Cloherty TP, Stark
A. Boston Little Brown, 1992.
Discussion
3. Kim HC. Blood component therapy in
CMV infection is found worldwide the neonate. In: Developmental and
and CMV is known to be endemic in In- Neonatal Hematology. Eds. Stockman
dia also. Pal et al.(4) from Chandigarh JA, Pochedly C. New York Raven
reported a prevalence of CMV antibody Press, 1988, pp 169-193.
positivity in 90-100% of the population. 4. Pal SR, Chitkara NL, Krech V.
CMV infection has been reported in Seroepidemiology of cytorn egalovirus
India(5). One fifth of children with infection in and around Chandigarh.
intrauterine infections have GMV anti- Indian J Med Res 1972, 60: 973-978.
body positivity. However, transfusion 5. Broor S, Kapil A, Kishore J, Seth P.
acquired CMV has not been reported. Prevalance of rubella virus and cy-
CMV infection may be acquired tomegalovirus infection in suspected
cases of congenital infection. Indian J
perinatally through a CMV positive Pediatr 1991, 58: 75-76.
mother(6) or through breastmilk(7). One
study has shown that 13.5% of infants 6. Yeager AS, Palumbo PE, Malchowski
transfused with CMV positive blood de- N, Aragno RL, Stevenson DK.
veloped CMV infection of whom 50% Sequelae of maternally derived cy-
were symptomatic(8). Majority of the tomegalovirus infection in premature
infants. J Pediatr 1983,102: 918-922.
babies who develop CMV infection are
asymptomatic but may have sequelae, 7. Dworsky M, Yow M, Stagno S, Pass
the most common being deafness(9,10). RF, Alford C. Cytomegalovirus infec-
In contrast, preterm babies are usually tion of breastmilk and transmission in
symptomatic, symptoms include infancy. Pediatrics 1983, 72: 295-299.
jaundice, hepatosplenomegaly and 8. Yeager AS, Grumet C, Hafleigh EB,
thrombocytopenia. Arvin AM, Bradley JS, Prober CG.
Prevention of transfusion acquired
Transfusion acquired CMV can be cytomegalovirus infection in newborn
prevented by donor screening; donor infants. J Pediatr 1981, 98: 281-287.
576
INDIAN PEDIATRICS VOLUME 32 MAY 1995
Case Reports
Sarcoidosis
Case I: Two and a half year old girl
presented with fever, weight loss and
cough of 5 months duration. The weight
S.K. Kabra and height were below the fifth percen-
A. Bagga tile for the age. Examination showed
Madhulika marked pallor. The liver and spleen
A. Chatterjee were palpable 5 cm and 3 cm, respec-
V. Seth -lively below the costal margin. Rest of
the systemic examination was normal.
Investigations showed a hemoglobin
level of 7 g/dl, total leucocyte count of
Sarcoidosis is a chronic multisystem 7800/cu mm with 60% polymorphonu-
disease of unkmbwn etiology, usually af- clear leucocytes, 30% lymphocytes and
fecting adults. Only a few reports de- 10% eosinophils. The blood levels of
scribing the clinical features and course transaminases, alkaline phosphatase, se-
of sarcoidosis in children have been rum proteins, creatinine, calcium and
published. Only one case in a child has phosphate were normal. The liver biop-
previously been reported from this sy showed non-caseating granulo-
country(1). The rarity of the condition matous lesions. An X-ray film of the
prompts us to report the clinical fea- chest showed bilateral enlarged hilar
tures in two such patients. lymph nodes. The Mantoux test (using 1
TU injected intradermally) and VDRL
From the Department of Pediatrics, All India test were negative.
Institute of Medical Sciences, New Delhi
U0 029. A diagnosis of disseminated tubercu-
Reprint requests: Dr. S.K. Kabra, Department of losis was made and the patient treated
Pediatrics, All India Institute of Medical with isoniazid (5 mg/kg), rifampicin (10
Sciences, Ansari Nagar, New Delhi 110 mg/kg) and pyrazinamide (30 mg/kg)
029. daily for 2 months. Subsequently
Received for publication: May 6, 1994; pyrazinamide was stopped and therapy
Accepted: October 4, 1994 continued with rifampicin and isoniazid.
577