R R de Krijger

Publications (3)6.14 Total impact

• Article: Hypereosinophilic syndrome in children.

  M van Grotel, M de Hoog, R R de Krijger, H B Beverloo, M M van den Heuvel-Eibrink
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  ABSTRACT: Recently, according to the Hypereosinophilic Diseases Working Group of the International Eosinophil Society, six variants of hypereosinophilic syndrome have been proposed, i.e. (1) myeloproliferative, (2) lymphoproliferative, (3) idiopathic/undefined, (4) overlapping, (5) associated and (6) familial variant. Hypereosinophilic syndrome is a rare disorder in children and can occur at any age during childhood. Corticosteroids are the treatment of choice, whereas other treatment options are hydroxyurea, IFNα, imatinib, vincristine, mepolizumab. We present a fulminant fatal case of hypereosinophilic syndrome in a teenager with an initial presentation of an idiopathic thrombocytopenia (ITP) and present a narrative review of literature.
  Leukemia research 06/2012; 36(10):1249-54. · 2.36 Impact Factor
• Article: Self-limiting sternal tumors of childhood (SELSTOC).

  M L te Winkel, M H Lequin, J R de Bruyn, C P van de Ven, R R de Krijger, R Pieters, M M van den Heuvel-Eibrink
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  ABSTRACT: Because a sternal mass is often alarming, it is important to identify the clinical features of benign processes. Data on clinical presentation, diagnostics, treatment and outcome of pediatric patients presenting with a sternal tumor between 2001 and 2009 were collected from medical records. Among the 1,700 children who were referred to our pediatric-oncology center, 14 presented with a rapidly growing sternal mass. All patients (10 males) were Caucasian and median age was 16 (range: 7-50) months. Reported symptoms were local pain (n = 7) and/or raised body temperature (n = 5). No major preceding traumas were reported. Physical examination revealed solid tumors with a median diameter of 3 (range: 1-4.5) cm in a pre-sternal/para-sternal location. Half of the patients showed red/blue discoloration of the skin. On radiology, dumbbell-shaped lesions extended to the area behind the sternal bone, involving the cartilage, leading to increased distance between ossification centers. Histopathology at diagnosis was available from five patients and showed aspecific chronic or acute inflammation (n = 4) and a reactive osteochondromatous lesion (n = 1). Laboratory infection parameters were not/only slightly raised and microbiologic cultures were negative in all patients. All tumors decreased in size within 1 month, in both patients with and without antibiotics. On physical examination the tumors disappeared within 6 months. This study reports 14 young children with a rapidly growing sternal mass due to aseptic inflammation, that we named self-limiting sternal tumor of childhood (SELSTOC). To prevent invasive diagnostic interventions and unnecessary treatment, we advocate a wait-and-see approach with close follow-up in the first weeks.
  Pediatric Blood & Cancer 03/2010; 55(1):81-4. · 1.89 Impact Factor
• Article: Cushing syndrome as a presenting symptom of renal tumors in children.

  H Segers, J C van der Heyden, E L T van den Akker, R R de Krijger, C M Zwaan, M M van den Heuvel-Eibrink
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  ABSTRACT: Cushing syndrome as the presenting symptom of a malignant renal tumor in children is rare. We report the first case of paraneoplastic Cushing syndrome due to a Wilms tumor, in which clinical and biological signs of hypercortisolism regressed during preoperative chemotherapy. Additionally, we reviewed the literature on paraneoplastic Cushing syndrome secondary to pediatric renal tumors.
  Pediatric Blood & Cancer 05/2009; 53(2):211-3. · 1.89 Impact Factor