A Chinese adolescent girl with Fechtner-like syndrome

We describe a 15-y-old girl with Fechtner-like syndrome, who is the first Chinese reported to have this rare syndrome. She presented with left homonymous hemianopia and neuroimaging revealed haemorrhage in both parietal and occipital lobes. Peripheral blood smear showed macrothrombocytopenia and intracytoplasmic inclusion bodies inside leucocytes. Thrombocytopenia and proteinuria responded to intravenous immunoglobulin and pulsed methylprednisolone. This case illustrates that life-threatening haemorrhage can occur in patients with Fechtner syndrome. Although there was no effective treatment reported in the literature, high dose steroid and immunoglobulin seemed to be useful in our patient. Our patient also had nephritic-nephrotic syndrome with renal insufficiency, which is unusual in adolescent female patients.     

The percutaneous vena cava umbrella filter in the prevention of pulmonary embolism

The Kimray-Greenfield filter is the most commonly used of all filters. Percutaneous insertion technique has made this filter more attractive also for interventional radiology. Its drawbacks are, in particular, the large calibre of the insertion instruments and its low effectivity in case of eccentric placing. Good results have been obtained to date with the specially developed cava filters that can be introduced percutaneously. Clinical and experimental studies have shown that some filters are particularly effective, such as the "basket filter"; at the same time, these have also a higher thrombogenicity. However, independent of the choice of the cava filter, it seems that the operatively inserted filters are increasingly a thing of the past.