Fifteen cases of carcinoma of the thyroid and four cases of thyroid adenoma in children and young adults are reported. In all, except one, irradiation had been given to the head, neck, or chest of these patients 5 to 17 years previously.
These observations suggest that carcinoma of the thyroid in children is related to irradiation, often prescribed for uncertain therapeutic effect. Irradiation to the head, neck, or chest of infants and children should be avoided wherever possible.
We believe these cases represent a remarkably high incidence of thyroid neoplasia to occur in a single practicing pediatric office. The practicing pediatrician who now follows his patients longitudinally from infancy through adolescence has a unique opportunity to observe the development of disease, even years later.
The syndrome of gastrointestinal allergy as observed in 60 infants is a clinical entity characterized by diarrhea, colic or vomiting, alone or in varying combinations. Diarrhea is almost twice as common as colic or vomiting.
The syndrome may be suspected upon the demonstration of clumps of eosinophiles, or large numbers of scattered eosinophiles in the stools. The stools are generally high in mucus content, and the eosinophiles are most numerous in the mucus. A rapid, easy method for demonstrating eosinophiles in the stool mucus is described.
The allergic nature of the signs and symptoms is further suggested by:
a. The positive family background of allergy.
b. The development of other major allergic manifestations in the subsequent course of these patients.
c. The striking frequency with which symptoms disappear after the removal of the offending food from the diet. This may be anything in the diet, but is generally cow's milk. Results may not be apparent until a week has elapsed after specific food elimination.
d. Recurrence of symptoms may be demonstrated upon readministration of the offending substance.
The ultimate fate of these babies with regard to the development of later allergic disturbances will have to await long range follow-up studies. It is hoped that the control of these early allergic manifestations may minimize later allergic symptomatology.
Evidence is presented that the first allergic disturbances may occur in the newborn period.
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