Indian Journal of Trauma and Emergency Pediatrics

Neuroblastoma is the common extracranial solid tumor in children.Very often they are described as “enigmatic tumor” for its broad spectrum of clinical presentation and biological features. Prognosis varying from clinically incidence benign to unresectable or metastic disease with very poor outcomes. They may present with proptosis, periorbital ecchymosis, abdominal distension, bone pain, pancytopenia, fever, anemia, hypertension, paralysis, watery diarrhea, subcutaneous skin nodule and also with paraneoplastic syndromes. Very rarely they may present as a case of Fever of Unknown origin

Background: Pediatric thyroid cancer is an uncommon malignancy. Though rare it is treatable and has an excellent prognosis. The disease characteristics are different among children and adults. In children the disease is aggressive at presentation and often associated with lymph node metastasis, extracapsular extension and a higher incidence of multifocality. This report adds to the few studies detailing thyroid cancers in children. Clinical Description: 12 year old girl presented with swelling in anterior aspect of neck for the past six months. It was a diffuse swelling with an insidious onset. It gradually increased to the present size. She had no family history of thyroid cancer or any history of exposure to radiation. On examination, child had pallor, lymphadenopathy. The thyroid gland was diffusely enlarged and firm with a hard nodule on the left lateral aspect. Management: She had normal thyroid function tests and highly elevated anti-TPO levels. USG thyroid showed evidence of papillary carcinoma in a background of thyroiditis and bilateral cervical lymphadenopathy. FNAC confirmed the diagnosis. CT evaluation revealed mediastinal lymph nodes. The child underwent total thyroidectomy with modified neck dissection. Conclusion: Though an aggressive malignancy at presentation with meticulous treatment it is curable, has an excellent prognosis, and can avoid complications

Therapeutic plasma exchange (TPE) has been a key immunotherapeutic strategy in numerous neurological syndromes, predominantly during the acute phase of illness.The rarity of these immunological disorders in children, combined with a lack of understanding of their pathobiology, has hampered the creation of a solid scientific rationale for TPE therapy and the practicality of larger controlled studies. TPE is still used, but it's a pricey treatment with a lot of side effects. Uncertainty persists over how to compare the various TPE procedures, the best therapeutic dosage, and TPE monitoring and integration with other immunotherapies. The extracellular component of blood (plasma) is extracted from the cellular component (plasmapheresis), replaced with a colloid or crystalloid substitute, reintegrated with the cellular component, and returned to the patient in therapeutic plasma exchange (TPE). The goal of treatment is to get rid of potential illness mediators such toxic macromolecules and pathogenic autoantibodies from the body. The method was first described in the early twentieth century, and by the early 1970s, it was widely available for therapeutic application. Since then, the list of therapy indications has grown dramatically, with neurological diseases accounting for a sizable share. However, only 13.4 percent of children admitted for category I (first-line) American Society for Apheresis (ASFA) indications and 9.3 percent of those admitted for category II (second-line) indications received TPE, according to a recent survey of 42 North American Paediatric hospitals that provide the treatment.