We report the case of a 12-year-old boy who presented with acute heart failure due to newly developed mitral valve regurgitation. The boy’s history combined with raised levels of inflammatory markers was suggestive of paediatric eosinophilic granuloma with polyangiitis. The echocardiographic course and rapid response to therapy are presented.

The rise in the frequency of detecting prednisolone in bovine urine from northern Italy has come into focus of attention in recent years. The possibility that neo-formation of prednisolone or that prednisone may occur in urine after collection of samples was therefore investigated. Cow urine collected for official routine controls in Lombardy containing more than 80 ng/ml cortisol, and prednisolone and prednisone below the decision limit (CCα) of the method (0.4 and 0.5 ng/ml, respectively) was used. The C1–2 dehydrogenation of naturally present cortisol and cortisone was checked by incubating urine, both contaminated and uncontaminated with faeces, at 37°C and by collecting samples at 0, 1, 2, 4, 6 and 24 h. The influence of Helix pomatia juice was also investigated in order to determine whether deconjugation could influence the reliability of the results. All samples were analysed by HPLC-MS3 for the presence of cortisol, cortisone, prednisolone and prednisone in negative electrospray ionisation mode, utilising the consecutive reaction monitoring of product ions derived from the formate molecular adduct ([M+HCOO]–). The observed neo-formation of prednisolone shows that inappropriate temperatures in sample storage and processing can result in an incorrect accusation of non-compliance. The faecal contamination of urine, performed with the aim to mimic a collection conducted without the necessary care, moreover, evoked a high increase in prednisolone concentration in two out of seven animals. Moreover, H. pomatia juice had no significant effect on the prednisolone concentration, indicating that this corticosteroid is present in its free form in cow urine.

Worm establishment, development and fecundity of Taenia crassiceps in the intestine of prednisolone (PTBA)-treated, 15- and 4-week-old Mongolian gerbils and 9-week-old inbred mice of 4 strains (AKR/J, BALB/cAn, B10D2/oSn and C57BL/KsJ) were investigated following oral administration of metacestodes. Gerbils were divided into 5 groups of 4 animals each according to the host age and commencement day of PTBA-treatment (day −13, −7 or 0 relative to infection). Worm recovery from the intestine on day 35 postinfection was not affected by host age, but fewer worms were recovered the earlier the commencement of PTBA-treatment. Worm size, determined by wet weight, total length and proglottis number, correlated inversely with worm burden, suggesting they were affected by the crowding effect. Proglottides were released normally in the faeces but were markedly depressed in all groups except for that of young gerbils. Furthermore, egg production and its development in gravid proglottides were markedly depressed in all groups. In PTBA-treated mice of 4 strains, sexually mature but not gravid worms were recovered from all mice of the AKR/J strain on days 20–32 postinfection, but none or few worms from the intestine of the others. PTBA-treatment did not inhibit all protective host defence mechanism(s) in the unnatural or alternative rodent definitive host of T. crassiceps.

Echinococcus multilocularis survived, strobilated and matured sexually in the small intestine of 6-week-old male golden hamsters that were either non-treated or treated with prednisolone tertiary-butylacetate (PTBA), following oral administration of 20000 protoscoleces. Non-treated hamsters harboured the adult worms for up to 25 days post-infection (p.i.). Hamsters treated with PTBA from the day of infection (day 0 p.i.) harboured more adults than the non-treated, and their survival periods were extended. Moreover, a remarkable improvement in worm recovery, development and survival periods was observed in hamsters additionally treated with PTBA on days — 14 and — 12 p.i., and the worm development including proglottisation, sexual maturation and egg formation was comparable with that in dogs. With the present results it is suggested that Echinococcus/rodent systems represented by the E. multilocularis/golden hamsters may rejuvenate the current stagnant research on host-parasite interactions of the definitive host-stage and egg-stage of Echinococcus.

Since the McCabe report, growing indirect evidence has accumulated to indicate the implication of immune mechanisms in the pathogenesis of immune-mediated inner-ear disease (IMIED). A clinical study of a group of patients affected by this condition was performed in order to characterize the immune group, based on a recently reported profile, and compared with the vascular, viral and idiopathic aetiologies of sudden deafness. Patients affected by immune-mediated inner-ear disease had the best and the earliest recovery rate of hearing (p = 0.0028 and p = 0.017, respectively). However, this group of patients also had the higher rate of recurrence (p = 0.034), supporting the typical clinical course of the autoimmune disorders. On the basis of the results the criteria used in the diagnosis of the sudden presentation of the immune-mediated inner ear disease could be accepted leading to the characterization of this condition. Likewise, the role of the supporting cells in the pathogenesis of the IMIED is discussed.

Incomplete recovery from Bell's palsy was observed in some patients even after the intake of corticosteroids. This prospective study was performed on 160 patients with unilaterial nonrecurrent Bell's palsy in order to investigate the role of prednisolone on the prognosis of Bell's palsy. Ninety-three patients were given prednisolone tablets (1 mg/kg body wt/day up to 70 mg) for six successive days, then the dose was reduced gradually over the next four days. The remaining 67 patients were not given prednisolone (control group). Facial nerve recovery was assessed clinically and electrophysiologically for up to one year. The results of this study suggested that the most probable contributing factor for the success of prednisolone in improving the prognosis of Bell's palsy was its early intake (within the first 24 hours following onset).

Four male patients with pseudocyst of the auricle were successfully treated with oral corticosteroids. This condition is an asymptomatic, non-inflammatory, cystic swelling, usually located in the scaphoid or triangular fossa of the anti-helix which if untreated, leads to deformity of the pinna. All successful methods of treatment described in the literature so far have been invasive. All four patients in the above series responded to oral steroid therapy alone.