Background Eating disorders are prevalent in the adolescent and young adult population, with 2.7% of adolescents effected. The American Academy of Pediatrics recommends yearly screening for eating disorders in adolescents. Even with this recommendation, eating disorders often go underdiagnosed. AYAs with cancer possess several risk factors for eating disorders that may place them at an even higher risk, including receiving weight-altering therapies and having their weight/nutrition emphasized. Since these patients see their oncology team frequently, oncology clinics are opportune settings for eating disorder screening. This describes a single-institution study to implement screening for eating disorders in AYA patients in an oncology clinic. Procedures During regularly scheduled oncology visits, eligible patients were given the SCOFF questionnaire. Patients with an oncologic diagnosis aged 13 and older were screened. Patients with known eating disorders and patients receiving cytotoxic therapy were excluded. The questionnaire was scored by a study team member. Patients with a positive screening were referred to adolescent medicine. Results 163 eligible patients filled out the SCOFF questionnaire with 11 positive results (6.75%). Conclusions Our results demonstrate that eating disorder screening was successfully implemented in our pediatric oncology clinic. With a rate more than double than the general population, we observed that AYA patients with a history of cancer are indeed at a higher risk for eating disorders and should undergo routine screening. Since these patients have frequent oncology appointments, oncology clinics should implement screening for eating disorders. Further studies are needed to develop appropriate screening methods for on therapy patients.
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a drug hypersensitivity reaction characterized by rash, multiple systemic symptoms, and eosinophilia. DRESS syndrome develops following exposure to inciting medications, typically antibiotics and antiepileptics. Anticoagulants are not classically associated with this syndrome, though cases exist in association with vitamin K antagonists and oral anticoagulants. There are two known cases of enoxaparin-induced DRESS syndrome in adults, but no reports in the literature in the pediatric setting. In this report, we present the case of a pediatric patient who developed classic symptoms and lab findings of DRESS syndrome secondary to enoxaparin therapy.
Both vinblastine and low dose cytarabine therapy for Langerhans cell histiocytosis (LCH) have historically been delivered intravenously. Due to a vinblastine shortage and the SARS-CoV2 pandemic, frontline subcutaneous cytarabine was used to treat six pediatric patients with LCH with greater than 93% of the cytarabine doses administered at home by family. On average, 164 infusion chair hours (65.7 infusions) and 5,607 miles of driving were saved per patient, highlighting that subcutaneous cytarabine is a feasible treatment option for pediatric patients with LCH resulting in notably decreased patient travel burden and infusion center utilization.