1/3. pellagra: a rare disease observed in a victim of mental and physical abuse.Lesions of the brain stem and cerebellum due to nutritional deficiencies are mostly seen in chronic alcohol abuse and more rarely in severe malnutrition. We report the case of a 27-year-old woman, found dead in the family flat. She presented cachexia (167 cm, 25 kg) and multiple hematomas of the limbs. Postmortem examination revealed lesions due to peritonitis. Neuropathological examination showed severe atrophy of the corpus callosum and central neuronal chromatolysis, which are observed in pellagra. Inflammatory colitis or celiac disease was not found. Toxicological analysis was negative, in particular no alcohol absorption. pellagra, which is due to nicotinamide deficiency, is a disease rarely seen in this country. In this case, nutritional deficiency was the consequence of failure to eat in a context of abuse. The woman was born of an incestuous relationship and presented intellectual retardation due to poor affective relations with her mother.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/3. Malnutrition, a rare form of child abuse: diagnostic criteria.Infantile malnutrition is often difficult to diagnose as it is rarely observed in industrialized countries. It may be associated with physical violence or occur in isolation. The essential clinical sign is height and weight retardation, but malnutrition also causes a variety of internal and bone lesions, which lead to neuropsychological sequelae and death. We report a rare case of death by malnutrition in a female child aged 6 1/2 months. The infant presented height and weight growth retardation and internal lesions related to prolonged protein-energy malnutrition (fat and muscle wasting, thymic atrophy, liver steatosis) resulting in a picture of marasmus or kwashiorkor. We detail the positive and negative criteria that established the diagnosis of abuse, whereas the parents had claimed a simple dietary error.- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |
3/3. Esophageal involvement in cicatricial pemphigoid.We report on a 17-year-old male patient with dysphagia, cachexia, and physical underdevelopment. Despite a known esophageal stenosis, the patient received several months of psychiatric treatment, which failed to improve the clinical picture. After systematic diagnostic procedures, including repeated biopsies of the esophageal stenosis, a cicatricial pemphigoid was diagnosed and adequate therapy could be initiated.- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |