[51Cr]EDTA was used as a probe molecule to assess intestinal permeability in 7 healthy control adults, 11 control children, 17 children with Crohn's disease, and 6 children with untreated celiac disease. After subjects fasted overnight, 75 kBq/kg (= 2 microCi/kg) 51Cr-labeled EDTA was given by mouth; 24-h urinary excretion of [51 Cr]EDTA was measured and expressed as a percentage of the total oral dose. Mean and SD were as follows: control adults 1.47 +/- 0.62, control children 1.59 +/- 0.55, and patients with Crohn's disease or celiac disease 5.35 +/- 1.94. The difference between control children and patients was statistically significant (p less than 0.001). These results show that intestinal permeability to [51Cr]EDTA is increased among children with active or inactive Crohn's disease affecting small bowel only or small bowel and colon, and with untreated celiac disease. The [51Cr]EDTA permeability test could facilitate the decision to perform more extensive investigations in children suspected of small bowel disease who have atypical or poor clinical and biological symptomatology.

La place de l’œsophagoscopie dans la surveillance du reflux gastro-œsophagien (RGO) chez l’enfant est discutée. L’étude rétrospective des dossiers cliniques de 444 enfants porteurs d’un RGO et ayant bénéficié d’une fîbroscopie œsophagienne révéle que l’œsophagite peptique, découverte dans 11% des cas, évolue exceptionnellement en dehors de toute Symptomatologie clinique. Chacun des 5 signes cliniques suivants peut être proposé comme critére de réalisation de l’œsophagoscopie en cas de RGO: hypotrophie dépassant 2 déviations standard, vomissements hémorragiques, anémie, dysphagie ou pyrosis et accidents paroxystiques respiratoires chez le nouveau-né (apnée, cyanose, pneumopathie d’inhalation). L’utilisation de ces critéres permet de dépister la quasi-totalité des œsophagites et d’éviter plus de la moitié des examens pratiqués inutilement puisque 54 % des enfants ayant une fibroscopie normale n’ont aucun de ces 5 signes cliniques. La pratique systématique d’une œsophagoscopie chez l’enfant porteur d’un RGO est, selon notre expérience, une attitude excessive. L’indication de l’œsophagoscopie dépend de la Symptomatologie clinique que présente l’enfant.

Four cases of frontonasal dysplasia are reported in two boys and two girls. Clinical diagnosis was made at 16 months in one case and sooner in 3 cases (1 month-3 1/2 months) in presence of following features: severe hypertelorism (4/4), paramedian lip and palate cleft (3/4), nose root broadering (4/4), bifid or cleft nose tip (3/4), window's peak (3/4) mediofrontal swelling (4/4), cranium bifidum occultum (2/4). Many abnormalities were associated: conduction deafness (1/4), goldenhar syndrome (1/4), GH deficiency (1/4), etc... In three cases when cerebral investigation was possible, it was pointed out: corpus callosum agenesis (3/3), hydrocephalus (3/3), Dandy-Walker cyst (2/3). Caryotype is normal in whole cases which are sporadic. Two children are dead. The two alive remaining have severe mental impairment.