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Chakraborty S, Kaur R, Patra B, Meena JP, Kabra SK, Kabra M, Gupta N. The Great Masquerade: Varying Manifestations of Lysinuric Protein Intolerance. Indian J Pediatr 2024:10.1007/s12098-024-05124-y. [PMID: 38703326 DOI: 10.1007/s12098-024-05124-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/28/2024] [Indexed: 05/06/2024]
Abstract
Lysinuric protein intolerance (LPI) is an inborn metabolic error caused by cationic amino acid transport defects. The disease has a significant degree of phenotypic variation, with no confirmed genotype-phenotype correlation. Because it presents with symptoms similar to far more common diseases, the diagnosis is often missed, resulting in increased morbidity and mortality. This case series describes three examples of LPI with pulmonary, neurological, and immunological manifestations, emphasising the importance of keeping this disorder on the differential list. Appropriate metabolic and genetic testing is important in providing the correct diagnosis and timely care in such cases.
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Affiliation(s)
- Soumalya Chakraborty
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ravneet Kaur
- Pediatric Intensive Care, Department of Pediatrics, ABVIMS & Dr. RML Hospital, New Delhi, 110001, India
| | - Bijoy Patra
- Pediatric Intensive Care, Department of Pediatrics, ABVIMS & Dr. RML Hospital, New Delhi, 110001, India
| | - J P Meena
- Division of Pediatric Oncology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - S K Kabra
- Division of Pulmonology and Pediatric Critical Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Madhulika Kabra
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Neerja Gupta
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Moothedath AW, Meena JP, Gupta AK, Velpandian T, Pandey RM, Seth R. Efficacy and Safety of Olanzapine in Children Receiving Highly Emetogenic Chemotherapy: A Randomized, Double-blind Placebo-controlled Phase 3 Trial. J Pediatr Hematol Oncol 2022; 44:446-453. [PMID: 35091522 DOI: 10.1097/mph.0000000000002408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/26/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In this trial, we evaluated the safety and efficacy of olanzapine in children receiving highly emetogenic chemotherapy. MATERIALS AND METHODS In this study, patients aged 3 to 18 years were randomly assigned to either the olanzapine group or the placebo group. All patients received intravenous ondansetron and dexamethasone 30 minutes before highly emetogenic chemotherapy, followed by oral ondansetron for 48 hours. Participants in the olanzapine group received olanzapine once daily on days 1 and 2, while those in the control group received a placebo in the same dosage and schedule. The primary objective was: (a) to compare the complete control rates of vomiting in the delayed phase and (b) to compare the complete control rates of vomiting in acute and overall phases. The secondary objective was to evaluate the safety of olanzapine and the need for rescue medications. RESULTS A total of 128 patients were randomly assigned either to the olanzapine group (n=63) or the control group (n=65). Complete control of vomiting between olanzapine and placebo group was 73% versus 48% ( P =0.005) in the delayed phase, 60% versus 54% ( P =0.46) in the acute phase, and 48% versus 34% ( P =0.117) in the overall phase, respectively. Grades 1 and 2 sedation was greater in the olanzapine group (46% vs. 14%; P <0.001). A significantly higher proportion of patients in the placebo group required rescue medications for vomiting compared with in the olanzapine group ( P =0.025). CONCLUSIONS Olanzapine significantly improved complete control of vomiting in the delayed phase. A considerably lesser proportion of patients in the olanzapine group needed rescue medications.
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Affiliation(s)
| | | | - Aditya K Gupta
- Division of Pediatric Oncology, Department of Pediatrics
| | | | - Ravindra M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Rachna Seth
- Division of Pediatric Oncology, Department of Pediatrics
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Yadav U, Kakkar A, Meena JP, Jana M, Seth R, Iyer VK, Agarwala S. Preoperative diagnosis of angiomatoid fibrous histiocytoma of rib on core biopsy. Pediatric Hematology Oncology Journal 2022. [DOI: 10.1016/j.phoj.2022.10.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Takia L, Jat KR, Singh A, Priya MP, Seth R, Meena JP, Bagri NK, Kabra SK. Entomophthoromycosis in a child: Delayed diagnosis and extensive involvement. INDIAN J PATHOL MICR 2021; 63:648-650. [PMID: 33154328 DOI: 10.4103/ijpm.ijpm_20_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Entomophthoromycosis is a rare fungal infection of the skin and subcutaneous tissue occurring predominantly in tropical and subtropical regions. In children, it mostly affects the lower half of the body. With this, we report a case of Entomophthoromycosis in a 6-year-old girl who presented late with extensive involvement of the upper half of the body. She responded well to treatment with potassium iodide and itraconazole. We also reviewed cases of Entomophthoromycosis reported in children.
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Affiliation(s)
- Lalit Takia
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Kana R Jat
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ankita Singh
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Mandula P Priya
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Seth
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jagdish P Meena
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Narendra K Bagri
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sushil K Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Seth R, Das G, Kaur K, Mohanaraj R, Siri P, Wajid MA, Mandal P, Sahoo D, Thomas T, Raina M, Gupta AK, Meena JP. Delivering pediatric oncology services during a COVID-19 pandemic in India. Pediatr Blood Cancer 2020; 67:e28519. [PMID: 32588962 PMCID: PMC7361143 DOI: 10.1002/pbc.28519] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/23/2022]
Affiliation(s)
- Rachna Seth
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Gargi Das
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Kanwaljeet Kaur
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - R. Mohanaraj
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Prasanth Siri
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - M. Abdul Wajid
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Piali Mandal
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Debasish Sahoo
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Tincy Thomas
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Meenakshi Raina
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Aditya K. Gupta
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Jagdish P. Meena
- Pediatric Oncology DivisionDepartment of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
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Gupta AK, M AW, Meena JP, ArunRaj ST, Mridha A, Naranje P, Kumar R, Seth R. A rare presentation of Erdheim Chester disease in a pediatric patient subsequently cured on the LCH III protocol. Cancer Rep (Hoboken) 2020; 4:e1304. [PMID: 33025727 PMCID: PMC7941579 DOI: 10.1002/cnr2.1304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 09/15/2020] [Accepted: 09/22/2020] [Indexed: 11/29/2022] Open
Abstract
Background Erdheim Chester disease (ECD) is very rare in pediatrics with no standard treatment guidelines. Here we present the case of a pediatric ECD patient who was cured with a Langerhan cell histiocytosis (LCH) directed chemotherapy protocol. Aim The aim of the report was to publish this rare presentation of ECD in pediatrics and highlight the complete response obtained to treatment. Methods The details of the patient were extracted by a retrospective review of her clinical records. Results (Case) An 11 years old girl presented with fever and bone pain. On investigating she had multiple lytic bony lesions scattered throughout her skeleton. A biopsy from one of the bone lesions confirmed the diagnosis to be ECD. ECD is very rare in pediatrics and this case adds to the existing list of 11 previously reported ones. Also, worth mention is the fact that the child presented with isolated skeletal involvement in form of multiple osteolytic lesions. The child was started on the LCH‐III protocol on which she achieved a cure. Conclusion Lytic bone lesions in a child may be present in ECD. A subset of ECD may have good response to LCH like chemotherapy.
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Affiliation(s)
- Aditya Kumar Gupta
- Division of Pediatric Oncology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Abdul Wajid M
- Division of Pediatric Oncology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jagdish P Meena
- Division of Pediatric Oncology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sreedharan T ArunRaj
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Asit Mridha
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Naranje
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Seth
- Division of Pediatric Oncology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Ganguly S, Seth R, Kumar R, Sharma MC, Meena JP, Gupta AK. Characterization of bone marrow involvement in pediatric hodgkin lymphoma using 18F-FDG-PET/CT and its comparison with blind bone marrow biopsy. Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Meena JP, Seth R, Chakrabarty B, Gulati S, Agrawala S, Naranje P. Neuroblastoma presenting as opsoclonus-myoclonus: A series of six cases and review of literature. J Pediatr Neurosci 2016; 11:373-377. [PMID: 28217170 PMCID: PMC5314861 DOI: 10.4103/1817-1745.199462] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The opsoclonus-myoclonus ataxia syndrome (OMAS) also called “Kinsbourne syndrome” or “dancing eye syndrome” is a rare but serious disorder characterized by opsoclonus, myoclonus, and ataxia, along with extreme irritability and behavioural changes. Data on its epidemiology, clinical features, and outcome are limited worldwide. The aim of the study was to evaluate the clinical profile and outcome of children with OMAS. A retrospective data of all children presented to Pediatric oncology clinic with a diagnosis of opsoclonus-myoclonus from 2013 to 2016 were collected. 6 patients with a diagnosis of OMAS were presented over a 4-year period. All 6 cases had paraneoplastic etiology. All Children had good outcome without any relapse. Paraneoplastic opsoclonus myoclonus had a good outcome in our experience.
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Affiliation(s)
- Jagdish P Meena
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Seth
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sheffali Gulati
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Agrawala
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Naranje
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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Baranwal AK, Meena JP, Singhi SC, Muralidharan J. Dexamethasone pretreatment for 24 h versus 6 h for prevention of postextubation airway obstruction in children: a randomized double-blind trial. Intensive Care Med 2014; 40:1285-94. [DOI: 10.1007/s00134-014-3358-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 05/30/2014] [Indexed: 11/30/2022]
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