Rationale:Septo-optic dysplasia (SOD) is a rare congenital disorder that may cause jaundice in infants. However, it is usually prone to neglect and misdiagnosis in infants with cholestasis because endocrine disorder such as panhypopituitarism is rare in the cause of infantile cholestasis. We report a case of SOD concurrent with acquired cytomegalovirus (CMV) infection, who presented with prolonged jaundice as the first clinical sign.Patient concerns:The patient was a 2-month-old male infant who presented with cholestasis, combined with fever and panhypopituitarism.Diagnoses:He was diagnosed with SOD and acquired CMV infection.Interventions:He was treated with hormone replacement therapy and ganciclovir.Outcomes:After correction of the pituitary hormone deficiency and ganciclovir treatment, significant improvements of cholestasis, retinal lesions, and growth rate were seen in our patient.Lessons:Although an endocrine disorder such as panhypopituitarism is rare in the cause of neonatal or infantile cholestasis, we must keep this reason in mind.

Summary In order to determine whether low plasma levels of retinol and its carrier (retinol binding protein) are related to increased risk of cancer recurrence, these were measured in 103 patients who had had colorectal cancer surgically removed. According to the modification of the Dukes' classification, 66 had B2 tumours (with no nodal involvement' and 37 had C tumours (with lymph-node metastases). These patients were part of the Cross Cancer Institute Adjuvant GI Cohorts who were on the control arms receiving no further treatment. At the time of blood sample collection, they were believed to be free of neoplastic disease. The post-operative patients were found to be associated with subnormal circulatory levels of retinol (43.3 pg dl-1 vs 65.3 pg dl-1) and its carrier protein (4.6mg dl-1 vs 5.7 mgdl-1), when compared with apparently healthy subjects. The latter being more markedly depressed in patients with "C" type tumour (3.8 mgdl-1) than that in those with "B2" type tumour (5.0mg dl-1). These findings appeared to be persistent during the follow-up study when a second blood sample was collected, one to four months later from 40 patients. Furthermore, the initial plasma retinol level in conjunction with RBP was found to be even lower in 12 patients (35.1 pg dl-1, 3.7 mg dl -1) who subsequently had cancer recurrence than in those who remained free of apparent cancer (44.5 g dl -1, 4.6 mg dl -1). The lowest initial values of retinol (19.3 pg; 18.8 pg dl-1) and RBP (2.4; 1.6 mg dl -1) recorded in the study were seen in the only two patients who died of the disease at the time of follow-up.

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