When kid was last noticed, he was successful and he was lost to follow-up thereafter. Histopathology The peeled pseudomembranes Adriamycin sent for histopathological examination with Adriamycin eosin and hemotoxylin stains showed thinned and eroded epithelium with subepithelial debris of hyaline-like eosinophilic materials containing clotted fibrinogen, immunoglobulins, and albumin [Fig. because of plasminogen insufficiency.[2] Therefore, these optical eye are inclined to develop pseudomembranes within the mucosal areas, possibly or carrying out a trivial injury spontaneously. Basic pathogenesis of LC is usually thought to be due to impaired wound healing of bruised mucosal surfaces due to ineffective extracellular fibrinolysis. Histopathology of such peeled of membranes does suggestive of residual by-products of clotted fibrin.[3] Herein, we describe a child who presented with a rare clinical association of LC with a congenital hydrocephalus, conceivably due to Adriamycin aqueductal stenosis. Case Report A Adriamycin 10-month-old infant was referred to us by a local ophthalmologist for further evaluation with the suspected clinical diagnosis of chronic conjunctivitis. The child first presented to us with parents describing swollen lids, mucus discharge from both eyes, and gradual enlargement of head since birth. Prenatal USG at 34th week of gestation showed dilated 3rd and 4th ventricle with a posterior fossa cyst, communicating with 4th ventricle indicative of DandyCWalker syndrome [Fig. ?[Fig.1a1a and ?andbb]. Open in a separate window Physique 1 (a) Prenatal USG at 34th week of Adriamycin gestation showed dilated 3rd and 4th ventricle with a posterior fossa cyst, communicating with 4th ventricle and (b) computed tomography scan of the brain showing enlarged 3rd and 4th ventricle with a posterior fossa cyst During newborn physical assessment, the primary care pediatrician had noted an abnormal head size and referred the child for a thorough neurological examination. Neuroimaging did confirm the diagnosis of DandyCWalker syndrome for which child then had undergone a right-sided ventriculoperitoneal shunt. Family history was unfavorable for known genetic disorders. Family history revealed a 2nd degree parental consanguinity and his four elder male siblings and two still given birth to diagnosed to have hydrocephalus on prenatal USG scans had a similar manifestation of swollen lids and hydrocephalus at birth; eventually all of them expired due to the neurological complications at the age of 1C2 years. General physical examination revealed a healthy appearing baby with an enlarged head [Fig. 2a] with a palpable subcutaneous tube from head to abdomen. The anterior fontanel was soft and appeared enlarged in size for his age. Rest of the systemic examination was within Rabbit Polyclonal to BRI3B normal limits. Open in a separate window Physique 2 (a) Clinical photograph of the index patient showing enlarged head, swollen lids, and discharge and (b and c) grayish white, thick, gelatinous, pseudomembranes adherent to the tarsal conjunctiva more in the right eye than left Anterior segment vision examination under general anesthesia revealed markedly swollen lids. On eversion of the lids, the conjunctiva showed grayish white, thick, gelatinous, pseudomembranes with woody consistency adherent to the tarsal conjunctiva not attached to the bulbar conjunctiva or cornea, more in right vision then left [Fig. ?[Fig.2b2b and ?andc].c]. Both eyes cornea showed few superficial punctuate keratitis. Rest of the anterior segment was within normal limits. The intraocular pressure and fundus examination were within normal limits in both the eyes. The child was diagnosed with LC with congenital hydrocephalus with a ventriculoperitoneal shunt in place. This prompted us to get a serum plasminogen levels and a referral to a clinical hematologist for evaluation. The hematological examination was consistent with a clinical diagnosis of plasminogen deficiency. Surgical details Diagnostic conjunctival swabs were obtained and sent for microbiological workup prior to membrane removal. Then, pseudomembranes were gently peeled off from the mucosal surfaces meticulously and minimal bleeding was noted after the removal, which was controlled.