Arch Dis Child: first published as 10.1136/adc.52.12.980 on 1 December 1977. Downloaded from

Archives of Disease in Childhood, 1977, 52, 980-981

Scottish Paediatric Society

At the Summer Meeting held in the Postgraduate should be informative and possibly of value in assess- Centre, Hospital, , on 4 June ing diabetic control. 1977, the President, Dr. R. A. Shanks, was in the Chair. Long-term results in children born to mothers treated The titles of the clinical demonstrations were as with chlorpropamide in pregnancy. J. A. Reid (intro- follows: duced), G. Russell, H. W. (introduced), Congenital lymphangiectasia. C. A. S. Galloway. J. M. Stowers (introduced), and P. D. Bewsher (in- Raigmore Hospital. troduced). Departments ofChild Health, and Obstet- rics, and Therapeutics, , Gaucher's disease. A. Hamilton (introduced). Foresterhill. Raigmore Hospital. Sulphonylurea therapy for diabetes was introduced Bilateral Wilms's tumour. J. L. Welch (intro- in 1955, and although teratogenicity has not been a duced). Raigmore Hospital. problem, anxiety has been expressed regarding beta- Hyperchylomicronaemia. K. E. Byrne (intro- cytotrophic effects on the fetal pancreas so that this duced). Raigmore Hospital. type of therapy has not been widely used in preg- nancy. In Aberdeen, considerable experience had Kawasaki's disease. A. D. Smith (introduced). accumulated in the use of chlorpropamide therapy in Raigmore Hospital. chemical gestational diabetes. In their study the copyright. authors had compared the long-term results in child- Scientific communications ren whose mothers had chemical gestational dia- betes, and who were treated with chlorpropamide or Hepatomegaly of childhood diabetes mellitus. J. 0. insulin or without drugs. Investigations included oral Craig and E. M. Sweet. Royal Hospital for Sick glucose tolerance tests (with, in the older children, Children, Glasgow. plasma insulin assay), together with detailed neuro- Mauriac's syndrome (hepatomegaly and dwarfism in logical and anthropometric examinations. Initial child diabetics) is less common than before the intro- results suggested an alarming incidence of impaired http://adc.bmj.com/ duction of depot insulins, but lesser degrees of hepa- glucose tolerance in the offspring of mothers in all tomegaly and retarded growth persist. 50 diabetic three groups. children were examined at 13 years in an attempt to ascertain the incidence of hepatomegaly and its rela- Reflex anoxic seizures: white attacks without a name. tionship to growth. A vertical liver axis on x-ray of J. B. P. Stephenson. Royal Hospital for Sick Child- at least 21 cm was taken as indicative of hepato- ren, Glasgow. megaly. 8 patients showed hepatomegaly, not always Among the anoxic and epileptic seizures of child- detected clinically; all had retarded growth between hood the least well known is the vagal-mediated on September 29, 2021 by guest. Protected the ages of 10 and 13 years, lagging behind their reflex anoxic seizure sometimes referred to as a white expected increment by 2 14 cm per year on average. breath-holding attack or infantile syncope. The first 14 others without hepatomegaly but matched for step in diagnosis is recognition of the existence of this duration of disease, had an annual lag of only 0-27 disorder without a name. If the history of consistent cm per year, and 4 even exceeded their expected provocation is not clear, or if the deathly pale growth rate. appearance of the child has been unnoticed by the Twice daily soluble insulin may or may not cause parents, then ocular compression under polygraphic hepatomegaly but is certainly not the cure; 7 of the 8 control may be necessary to show the abnormally with hepatomegaly were on that regimen at the time sensitive oculocardiac reflex which is a regular of diagnosis. The occurrence of hepatomegaly seems feature. In the author's presentation of a series of related more often to social and emotional factors personally observed cases, the electrocardiographic than to inherent instability of the disease. This pre- and electroencephalographic changes were illus- liminary study suggests that serial measurements of trated by polygraphic records of anoxic seizures liver size beginning as soon as the diagnosis is made which were induced for diagnostic verification. 980 Arch Dis Child: first published as 10.1136/adc.52.12.980 on 1 December 1977. Downloaded from

Scottish Paediatric Society 981 Failure to refer children of short stature for specialist tioners but no investigations had followed; the opinion: a Scottish survey. G. V. Vimpani (intro- parents of 4 children had not been concerned by the duced), A. F. Vimpani (introduced), and J. W. child's short stature, but in 3 cases at least one of Farquhar. Department of Child Life and Health, the parents was abnormally short. 17 Hatton Place, Edinburgh. Only 42% of parents of 272 children with short Short stature resulting from idiopathic growth hor- stature unassociated with major organic disease had mone deficiency is usually apparent by the age of 2 been concerned about their child's growth. Only 19 % years, yet currently the mean (±SD) age at diagnosis had consulted their general practitioners. Apparently is O1 1 I'1 years. In a study of short stature in 6- fewer than one-third of the general practitioners con- to 9-year-old Scottish children to determine the sulted had initiated further investigations. An analy- prevalence of growth hormone deficiency, 13, all sis of factors associated with parental motivation with a height -2.5 SD or more below the mean for towards seeking advice confirmed the view that com- age, had maximum growth hormone levels of plete ascertainment of growth hormone deficiency <10 mU/l. Growth hormone deficiency had been will only be achieved by the regular recording of previously diagnosed in only 4. The parents of 5 of height on growth charts and the investigation of all the remaining children had consulted general practi- children with persistently low height velocities. copyright. http://adc.bmj.com/ on September 29, 2021 by guest. Protected