Liliana Gabriela POPA, Roxana Silvia BUMBACEA, Roxana Oana DARABONT, Olguta Anca ORZAN and Calin GIURCANEANU

ABSTRACT

Background: Background atopic dermatitis patients generally respond to conventional therapies. A small proportion of them have severe disease despite intensive treatment. Efficacy of intravenous immunoglobulin (IVIg) in severe, refractory atopic dermatitis has been reported.
Materials and methods: We present the cases of five children with severe atopic dermatitis. All patients were previously and/or currently treated with systemic steroids, phototherapy and a large selection of topical agents. Immunosupressive therapy was refused by their legal representatives. Due to financial restraints, low dose IVIg was administered (approximately 0.3 g/kg/month for six months), while the corticosteroid dose was tapered. Disease outcome was measured using the eczema area and severity index (EASI) and the children’s dermatology life quality index (CDLQI).
Results: All five patients experienced clinical improvement with significantly reduced EASI and CDLQI scores. No adverse reactions were reported. During the six months follow-up period, no disease flare occured in any of the patients.
Conclusions: Adjunctive IVIg is a useful therapeutic approach in selected patients with refractory atopic dermatitis. Even if most of the reported cases refer to high dose IVIg, low dose regimens are not to be discarded, since they can provide satisfactory results with reduced in-patient costs and high compliance.
Keywords: atopic dermatitis, intravenous immunoglobulin, immunomodulatory effects

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Roxana Oana DARABONT, Alexandru VASILESCU and Dragos VINEREANU

ABSTRACT

The occurrence of left ventricular free wall rupture in acute myocardial infarction decreased with the extent of interventional procedures of reperfusion, but it is still encountered in 1-2% of these patients. We are presenting the case of a 58 years old male with left ventricular free wall rupture occurred as a late complication of an inferior-lateral ST-elevated myocardial infarction. The aim of this case report is to underline the main clinical features, the diagnostic value of the echocardiographic exam and the importance of early surgical intervention in a rare, but very dangerous condition, with persistent high mortality rates. In this context, we will review the current prevalence, clinical forms and prediction factors of left ventricular free wall rupture.
Keywords: Free wall rupture of the left ventricle, acute myocardial infarction, cardiogenic shock

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