Reflex sympathetic dystrophy syndrome (RSDS) is a well-recognized disorder in adult group. But it is rarely diagnosed in the pediatric age group. RSDS is often a response to a physical or an emotional distress. Diagnosis of RSDS is made on a clinical basis whenever a patient with a painful limb presenting two or more of the following signs and symptoms : Persistent pain and swelling, vasomotor instability, trophic skin changes in the same extremity and autonomic imbalance. We report a case of RSDS in a 14- year-old girl. Her left arm was cold, edematous and blue with a limited active range of movement. Bone scan and thermography showed abnormal findings in affected arm. Prednisolone therapy, 60mg/day, was started. She also received sympathetic blocks and conservative treatment with physical therapy, transcutaneous electrical nerve stimulation, psychological therapy and anti-depressants. She showed gradual improvement in symptoms and signs.
Adult ; Arm ; Diagnosis ; Extremities ; Female ; Humans ; Prednisolone ; Prednisone ; Reflex Sympathetic Dystrophy* ; Reflex* ; Skin ; Thermography ; Transcutaneous Electric Nerve Stimulation

Acute fatty metamorphosis is a rare but potentially fatal complication of the third trimester of pregnancy. In 20~40% of cases, acute fatty metamorphosis is associated with preeclampsia and may be difficult to distinguish from preeclamptic liver involvement. Recent reports suggest that the mortality has decreased to 25% fo both mother and fetus, due to largely to early delivery and to the recognition of a higher proportion of mild and nonfatal cases. We experienced one case of acute fatty liver metamorphosis that caused fulminant hepatitis and complete resolution, so we report the case and review of literature briefly.
Fatty Liver ; Female ; Fetus ; Hepatitis ; Humans ; Liver ; Mortality ; Mothers ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, Third

Peritonitis is a serious problem in patients undergoing peritoneal dialysis. Rarely pneumatosis intestinalis can occur as a complication of this infectious process. Pneumatosis intestinalis is a potential life threatening condition with a challenging management. The mortality of peritoneal dialysis patients with pneumatosis intestinalis secondary to mesenteric ischemia is almost 100%. We describe a rare case of pneumatosis intestinalis in a peritoneal dialysis patient who developed Staphylococcus aureus peritonitis which was initially treated with appropriate antibiotics. Since initial response to therapy was not achieved, an abdominal computerized tomography was done which revealed a pneumatosis intestinalis. A laparotomy was performed and small bowel necrosis was seen. A segmental resection with ileostomy, jejunostomy was done. Though surgical treatment was performed, the patient died in 2 weeks after admission. Pneumocystitis intestinalis in peritoneal dialysis peritonitis is a uncommon complication which requires prompt evaluation to rule out mesenteric ischemia as it carries a high mortality and its management will be surgical.
Anti-Bacterial Agents ; Humans ; Ileostomy ; Ischemia ; Jejunostomy ; Laparotomy ; Necrosis ; Peritoneal Dialysis ; Peritonitis ; Staphylococcus aureus