Diencephalic syndrome of infancy which is characterized by progressive and profound emaciation often with normal or accelerated skeletal growth, hyperkinesias, hypotension, and hypoglycemia. The profound emaciation so characteristic this syndrome has yet to be explained. The diencephalic syndrome is caused by low grade astrocytoma, ependymoma in the third ventricle including the hypothalamus. Authers report a case of diencephalic syndrome which was confirmed in this patient with ependymoma in the region of anterior hypothalamus by transcallosal approach.
Astrocytoma ; Emaciation ; Ependymoma ; Humans ; Hyperkinesis ; Hypoglycemia ; Hypotension ; Hypothalamus ; Hypothalamus, Anterior ; Third Ventricle

Diencephalic syndrome is a rare cause of failure to thrive in infancy and early childhood. The syndrome is characterized by profound emaciation with normal appetite, loss of cutaneous adipose tissue, hyperactivity, euphoria, and nystagmus. It commonly occurs in association with chiasmatic and hypothalamic gliomas. It has also been described in association with other histologic types. There is the marked increase of serum growth hormone, which may exhibit an inappropriate, even paradoxical response in stimulation test. A male infant of 12 months of age, showed markedly elevated growth hormone but he had failure to thrive findings. Evenly enhanced round mass was seen at suprasella area in brain CT. Its histological findings was "Desmoplastic infantile ganglioglioma", very rare histologic type. Here we report a case of diencephalic syndrome presented by failure to thrive in association with hypothalamic tumors.
Adipose Tissue ; Appetite ; Brain ; Emaciation ; Euphoria ; Failure to Thrive ; Glioma ; Growth Hormone ; Humans ; Hypothalamic Neoplasms ; Infant ; Male

OBJECTIVETo search for a non-medicine therapy for infant emaciation.

METHODSThe observation group of 55 cases were treated with auricular point sticking combined with chiropractics. For the auricular point sticking therapy, vaccaria seeds were stuck at 9 points such as small intestine, Shenmen, spleen, endocrine, and others, and replaced once every 5 days, 10 days constituting one course. Chiropractics: knead or massage the muscles from lumbosacral area upward to Dazhui (GV 14). The control group were treated with oral administration of pepsin mixture, 10 mL after meals, thrice each day. They were treated for 5 courses.

RESULTSOf the 55 cases in the observation group, 7 were cured, 20 markedly effective, 24 effective and 4 ineffective, with a total effective rate of 92.7%, and among the 23 cases in the control group, 2 cases were cured, 7 markedly effective, 8 effective and 6 ineffective, with a total effective rate of 73.9%.

CONCLUSIONAuricular point sticking combined with chiropractics is a better non-medicine therapy for emaciation in children.

Acupuncture, Ear ; Child ; Child, Preschool ; Combined Modality Therapy ; Emaciation ; therapy ; Female ; Humans ; Male ; Manipulation, Chiropractic

Authors report a case of diencephalic syndrome which was observed in the patient with astrocytoma in the region of anterior hypothalamus and optic chiasm. An enlarged head, emaciation and hyperactive response were the symptoms. The subject, 8-month-old female infant, was bright and alert and had a history of failure to gain weight for months in spite of the fact that the child had eaten well. Skull X-rays showed no significant pathological findings but for enlarged head with suture separation. Conray ventriculography and CT scanning disclosed signs of presence of tumor in the suprasellar region. Craniotomy for removal of the tumor was followed by ventriculoperitoneal shunt.
Astrocytoma ; Child ; Craniotomy ; Emaciation ; Female ; Head ; Humans ; Hypothalamus, Anterior ; Infant ; Optic Chiasm ; Skull ; Sutures ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

Letterer-Siwe disease occurred in a 3 year 7 month old male child showing severe emaciation, hepatosplenomegaly, otitis media, hemorrhagic and impetiginous crusted patches on the body, and seborrheic dermatitis like skin rashes in the scalp. Also showed are severe anemia, thrombocytopenia, bronchopneumonia and multiple bony defects in skull. The child expired in a month after admission.
Anemia ; Bronchopneumonia ; Child ; Dermatitis, Seborrheic ; Emaciation ; Exanthema ; Histiocytosis, Langerhans-Cell* ; Humans ; Infant ; Male ; Otitis Media ; Scalp ; Skull ; Thrombocytopenia

We have presented a case of juvenile pilocytic astrocytoma of the third ventricle with the features of the diencephalic syndrome. A 18 month old female child developed progressively lethargy, emaciation, pallor, tremor, right hemiparesis, nystagmus and marked hydrocephalus with symptoms of increased intracranial pressure. CT scan showed large decreased density in the suprasellar area with extension to the left middle fossa and moderate right parasellar extension with irregular contrast enhancement, and dilatation of both lateral ventricles. The growth hormone increased very severely(80ng%). Biopsy was done through the left temporal lobe. Literatures were also reviewed.
Astrocytoma* ; Biopsy ; Child ; Dilatation ; Emaciation ; Female ; Growth Hormone ; Humans ; Hydrocephalus ; Infant ; Intracranial Pressure ; Lateral Ventricles ; Lethargy ; Pallor ; Paresis ; Temporal Lobe ; Third Ventricle* ; Tomography, X-Ray Computed ; Tremor

A 14-month-old child visited emergency room with stuporous mental state. He had been suffering from failure to thrive (FTT) and emaciation since three months of age, but he had good appetite and had been euphoric. A large mass was found in the third ventricle by brain CT and MRI. His parents refused operative removal of the mass and he expired 14 days after admission. It is necessary to include diencephalic syndrome in the differential diagnosis of failure to thrive when infants show FTT despite of good appetite and euphoric status.
Appetite ; Brain ; Brain Neoplasms ; Child ; Diagnosis, Differential ; Emaciation ; Emergency Service, Hospital ; Failure to Thrive* ; Humans ; Infant ; Magnetic Resonance Imaging ; Parents ; Stupor ; Third Ventricle

BACKGROUND: There are few studies that have reported on the pharmacokinetic(PK) disposition of fluoroquinolones in patients with multi-drug resistant tuberculosis(MDR-Tb), even though fluoroquinolones are frequentl y co-prescribed to those patients. In this study, the PK disposition of ofloxacin, a fluoroquinolone, was evaluated in patients with MDR-Tb. METHODS: Twenty patients with MDR-Tb were given 2nd line Tb drugs including ofloxacin (300mg twice a day), prothionamide, cycloserine, para-aminosalicylic acid, kanamycin, and streptomycin. The patients were grouped according to their body mass index(BMI) as an index of emaciation (group A: 18.5emaciation appears to have an influence on the pharmacokinetics of ofloxacin in chronic debilitated MDR-Tb patients.
Aminosalicylic Acid ; Area Under Curve ; Chromatography, High Pressure Liquid ; Cycloserine ; Emaciation ; Fluoroquinolones ; Humans ; Kanamycin ; Ofloxacin* ; Pharmacokinetics* ; Prothionamide ; Streptomycin ; Tuberculosis, Multidrug-Resistant*

As the physical abnormalities seen in eating disorders seem to be largely secondary to these patients' disturbed eating habits and their compromised nutritional state, most physical abnormalities associated with eating disorders are reversed by restoring healthy eating habits and sound nutrition. However, some medical consequences of eating disorders are irreversible or have later repercussions on health, especially those affecting the skeleton, the reproductive system, and the brain. Early medical intervention and psychiatric treatment are particularly important for those with or at risk of severe emaciation. Eating disorders are common among adolescent girls and young women and are associated with potentially serious medical complications, yet they often go undetected and untreated. All patients with eating disorders should be evaluated and treated for medical complications of the disease at the same time that psychotherapy and nutritional counseling are undertaken.
Adolescent ; Anorexia Nervosa ; Binge-Eating Disorder ; Brain ; Bulimia Nervosa ; Counseling ; Early Medical Intervention ; Eating ; Emaciation ; Feeding and Eating Disorders ; Female ; Humans ; Psychotherapy ; Skeleton

OBJECTIVES: To investigate the nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease (IBD). METHODS: A retrospective analysis was conducted on the clinical data of children who were diagnosed with IBD for the first time in Hunan Children's Hospital from January 2015 to December 2021. Diagnostic delay was defined as the time from the symptom onset to IBD diagnosis being in the upper quartile (P₇₆-P₁₀₀) of all IBD children in the study. Multivariate logistic regression analysis was used to explore the risk factors for emaciation and growth retardation. RESULTS: A total of 125 children with newly diagnosed IBD were included, with Crohn's disease being the main type (91.2%). The rates of emaciation and growth retardation were 42.4% (53 cases) and 7.2% (9 cases), respectively, and the rate of anemia was 77.6% (97 cases). Diagnostic delay was noted in 31 children (24.8%), with the time from the symptom onset to IBD diagnosis of 366 to 7 211 days. Multivariate logistic regression analysis showed that diagnostic delay was a risk factor for emaciation and growth retardation (OR=2.73 and OR=4.42, respectively; P<0.05) and that age was positively associated with emaciation (OR=1.30, P<0.05). CONCLUSIONS Children with newly diagnosed IBD have poor nutritional status, and the rates of anemia, emaciation, and growth retardation are high. Diagnostic delay is associated with malnutrition in children with IBD.
Humans ; Child ; Colitis, Ulcerative/diagnosis* ; Nutritional Status ; Retrospective Studies ; Emaciation/complications* ; Delayed Diagnosis ; Inflammatory Bowel Diseases/complications* ; Malnutrition/complications* ; Growth Disorders/complications*