Rituximab was trialed in a refractory Vogt-Koyanagi-Harada disease (VKH). A 10-year-old girl with panuveitis recalcitrant to treatment, including corticosteroids, was diagnosed with VKH 20 months later. Following rituximab at 0, 1, 6, and 18 months, response was favorable after the second dose, usual life activity resumed after the third dose (uveitis was inactivated and vision improved), and eyes stabilized 9 months after the fourth dose. Rituximab is effective in the treatment and long-term control of advanced, pediatric VKH.

Maternity overload contributed to the high neonatal mortality, whereas implementation of clinical guidelines and of medical staff training improved neonatal outcomes. Future target interventions include optimized timing of cesarean section and the detection of potentially complicated deliveries.

Objective This study aims to evaluate the correlation of changes in serum insulin-like growth factor-1 (IGF-1) levels with the clinical staging of hypoxic-ischemic encephalopathy (HIE) in term newborns. Study Design A prospective study of 29 newborns with HIE (stage I = 15, stage II + III = 14) and 28 healthy term newborns as the control group was performed in the neonatal intensive care unit. IGF-1 levels were obtained within 6 hours after birth from HIE and control groups and again on day 3 from HIE group. HIE was classified using the Sarnat staging I to III. Results IGF-1 levels were significantly lower in the HIE group than in the control group (p = 0.024). It was lower in the HIE stage II to III group compared with HIE stage I group at birth (p < 0.0001) and on day 3 (p = 0.009). The mean IGF-1 levels were significantly higher on day 3 than on day 1 among stage II to III HIE (p = 0.006) and it was inversely correlated with staging (R =  - 0.475, p = 0.009). There was a significant correlation between IGF-1 levels and Apgar score at 5 (R = 0.39, p = 0.042) and 10 minutes (R = 0.38, p = 0.035). Conclusions IGF-1 was lower in HIE and inversely correlated with clinical staging. It was increased with clinical improvement in the subsequent days.

Objective Transient tachypnea of the newborn (TTN), a common neonatal respiratory morbidity, is associated with failure of adequate clearance of fetal lung fluid. Glucocorticoids have an important role in lung maturity and the mechanisms of lung fluid clearance. The aim of this study is to assess the association between umbilical cord cortisol levels and transient TTN in late preterm and term neonates delivered by elective cesarean section (CS). Study Design A case-control study of 37 newborns diagnosed with TTN (cases) was compared with 40 healthy newborns (controls). All infants were delivered by elective CS without labor. Umbilical cord cortisol levels were measured using enzyme-linked immunosorbent assay. Results Mean cord cortisol levels were significantly lower in cases than controls (131.36 vs. 233.32 nmol/L, p = 0.0001; odds ratio [OR] = 3.7; 95% confidence interval [CI]: 1.40–9.53), respectively. Cord serum cortisol correlated inversely with the duration of tachypnea and the respiratory rate (r =  − 0.678 and −0.535, respectively). Conclusion Umbilical cord cortisol levels are significantly lower in newborns with transient TTN, and lower cortisol levels are associated with an increased respiratory rate and longer duration of admission. Antenatal glucocorticoids can be recommended for late preterm delivered by CS. Key Points