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קוסיות גבר ואישה שוכבים

קוסיות גבר ואישה שוכבים

Oblong porcelain tray, by Rosenthal series Maria, painted with green flowers. Large porcelain plate by Meissen, with fruit pattern, marked, repair on the rim. Three Porcelain figurines, by Nao, Spain: Pair of porcelain plaques, each with an image from Greek mythology Transfer print , Paris and the three Graces, and Zeus. Small porcelain pitcher with lid, by Herend, Hungary, with hand painted flowers. Pair of porcelain figurines, boy with a grape collecting vessel and a girl collecting eggs damages.

Antique Viennese porcelain cup, hand painted, early 19th c. Porcelain box, by Rodez-Aveyron Limoges, France, cobalt with gilding and a pattern of fairy drawings minor damage.

Porcelain box with bronzework decorations and hand painted, flowers on Bordeaux background. Porcelain plate by Limoges, France, gilded and with flowers. Goblet shaped vase, porcelain with cobalt and gilding, images from Greek mythology.

Two Porcelain figurines, by Nao, Spain: Porcelain cup by Lindner, Bavaria, with cobalt and gilding, marked. Porcelain plate, by Royal Goedewaagen, Netherlands, hand painted, Frysia pattern. Bisque figurine, angel kissing a little girl, Austria, 19th c damages.

Pair of porcelain figurines, Austria, 19th c, man and woman in late 18th century costume. Small porcelain box with lid, by Sevre, France, hand painted. Porcelain figurine, woman sunbathing with dog repaired crack.

Three porcelain kitchen implements, Zwiebelmuster pattern: Five porcelain saucers, by Herend, Hungary, green floral pattern.

Small porcelain tobacco box, by Limoges, with landscape painting. Porcelain vase by Herend, Hungary, with billy goat head shaped handles. Pair of porcelain figurines, France, 19th c, a lady and a gentleman in periodical costume. Antique porcelain centerpiece, Germany, 19th c, with the figure of a girl next to a tree and a bowl on top, damages and repairs dating back to its time.

Two Porcelain figurines, by Nao, Spain, the baby delivered by the stork: Ornamental porcelain vase, by Limoges, with cobalt, gilt and hand painted. Pair of French porcelain vases, cobalt with decorative bronze work.

Porcelain figurine by Herend, Hungary, dancer in traditional costume. Porcelain plate set for fruit by Herend, Hungary, comprises: Porcelain plate set by Herend, Hungary, comprises: Five porcelain plates by Bing a. Grondahl, Jule After, for the years , , , , Porcelain figurine by Herend, Hungary, young girl with mirror. Pair of ceramic vessels for vinegar and oil, in ceramic rack, Italy. Ceramic candlesticks with two small satirical figurines on the base.

Stoneware jar, by Shoblet, England, embossed with images of faces. Ceramic box, Capodimonte work, Italy, embossment work, children with grapes. Ceramic pitcher with Italian majolica work, repaired damage. Islamic amulet, engraved on an oval plate, with Arabic inscription. Silver amulet case, cylinder shaped, with Islamic hammered silverwork. Islamic amulet, engraved on a round silver plate, Arabic on table.

Brass chandelier, pierced and hammered metalwork, damascene work, star shaped. Two-sided Islamic amulet, engraved on a rectangular siler plate, Arabic script on table.

Six silver plated teaspoons, Ottoman Empire stamp, not silver. After several days, the rash becomes more petechial or hemorrhagic, sometimes with palpable purpura. These range from impetigo to cellulitis, lymphadenitis, and subcutaneous abscesses. An early manifestation of secondary bacterial infection is erythema of the base of a new vesicle.

These symptoms are often misdiagnosed as indicating flu or food poisoning. At higher exposure levels, patients can develop mental status changes, confusion, ataxia, syncope, tachycardia, and tachypnea. Severe poisoning is manifested by coma, seizures, myocardial ischemia, acidosis, cardiovascular collapse, and potentially death.

On exam, patients might have cherry-red skin. ED evaluation should include a COHb level in all symptomatic patients, arterial blood gas and creatine kinase in severely poisoned patients, and an ECG in any patient with cardiac symptoms. The resultant brain swelling manifests as seizures or coma.

The clinical suspicion is confirmed by study of indices of copper metabolism. The prognosis varies depending on the severity of the insult and the treatment.

It is frequently encountered in Ashkenazi Jews but has been found in many other ethnic groups. They can also reveal hyperkalemia, hyponatremia if volume overloaded , acidosis, hypocalcemia, hyperphosphatemia, and an elevation in uric acid. Untreated, the vast majority of these infants would not survive the neonatal period. If the symptoms are severe, presumptive treatment is started pending results of the culture. If the symptoms are mild or the diagnosis is doubtful, treatment can be delayed until the results of culture are known, and the culture can be repeated if the results are uncertain.

If treatment is initiated before the results of a culture and sensitivities are available, a 3- to 5-day course of therapy with trimethoprim-sulfamethoxazole TMP-SMX or trimethoprim is effective against most strains of E. Hemoglobin may be decreased if there have been profuse nosebleeds or menorrhagia.

Macrocephaly, not associated with hydrocephalus, may develop. In the 2nd yr of life, seizures develop which may be refractory to anticonvulsant therapy. Case finding by liberal use of anti-endomysium or anti-TG2 antibodies, followed by confirmatory jejunal biopsy, is more cost effective in primary care than mass screening is.

Patients with symptoms or diseases known to be associated with celiac disease should undergo serologic evaluation. In a grade I hemorrhage, bleeding is isolated to the subependymal area. In Grade II hemorrhage, there is bleeding within the ventricle but without evidence of ventricular dilatation.

In Grade IV hemorrhage, there is intraventricular and parenchymal hemorrhage. Marfan — Aortic Stenosis. Down Syndrome — Endocardial cushion malformation. DiGeorge — conotruncal deformity. Allagile — Peripheral Pulmonary stenosis. Complete cardiologic evaluation, including echocardiography, reveals isolated nonstenotic bicuspid aortic valves in one third to one half of patients. In later life, bicuspid aortic valve disease can progress to dilatation of the aortic root. There may also be ocular abnormalities posterior embryotoxon, microcornea, optic disk drusen, shallow anterior chamber , cardiovascular abnormalities usually peripheral pulmonic stenosis, sometimes tetralogy of Fallot, pulmonary atresia, VSD, ASD, aortic coarctation , vertebral defects butterfly vertebrae, fused vertebrae, spina bifida occulta, rib anomalies , and tubulointerstitial nephropathy.

Excessive glucose production coupled with reduced glucose utilization raises serum glucose. This produces an osmotic diuresis, with loss of fluid and electrolytes, dehydration, and activation of the renin-angiotensin-aldosterone axis with accelerated potassium loss. If glucose elevation and dehydration are severe and persist for several hours, the risk of cerebral edema increases. Increased catabolic processes result in cellular losses of sodium, potassium, and phosphate.

Increased release of free fatty acids from peripheral fat stores supplies substrate for hepatic keto acid production. When keto acids accumulate, buffer systems are depleted and a metabolic acidosis ensues. Therapy must address both the initiating event in this cascade insulinopenia and the subsequent physiologic disruptions. Upper airway obstruction varies in degree and level i.

Major blood group incompatibility between the mother and fetus generally results in milder disease than Rh incompatibility does. Non Alcoholic Fatty Liver Disease. The initial assessment should ensure an adequate airway with effective respiration, circulation, and perfusion. Epinephrine is the most important medication, and there should be no delay in its administration. If an intravenous line is not available, epinephrine should be given by the intramuscular route 0.

Patients typically report episodic attacks of angioedema or deep localized swelling, most commonly on a hand or foot, that begin during childhood and become much more severe during adolescence. In infants born in areas with no screening program, severe cases manifest features in the first few weeks of life, but in cases of lesser deficiency, manifestations may be delayed for months.

The severity of the valve abnormalities varies considerably; in the complete form of AV septal defect, a single AV valve is common to both ventricles and consists of an anterior and a posterior bridging leaflet related to the ventricular septum, with a lateral leaflet in each ventricle. The lesion is common in children with Down syndrome. Conversely, a large head may be associated with a large brain, or macrocephaly, which is most commonly familial but may be due to a disturbance of growth, neurocutaneous disorder e.

Alternatively, the head size may be increased secondary to hydrocephalus Fig or chronic subdural hemorrhages. It also contains protective bacterial and viral antibodies secretory IgA and nonspecific immune factors, including macrophages and nucleotides, which also help limit infections.

For school-aged children and in children in whom infection with M. In adolescents, a respiratory fluoroquinolone levofloxacin, moxifloxacin, gemifloxacin may be considered as an alternative. The intensity of the murmur often changes with respiration and position and may be attenuated in the sitting or prone position.

Methlyn blue — methanol. Fomepizole see Table , a potent competitive inhibitor of alcohol dehydrogenase, has almost entirely replaced the use of ethanol owing to its ease of administration, lack of CNS and metabolic effects, and overall excellent patient tolerability profile.

One unique characteristic of CCB overdose is that patients can exhibit profound hypotension with preserved consciousness. Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis. In mammals ammonia is detoxified to urea via the urea cycle.

Chromosomal abnormalities, including hypodiploidy, the Philadelphia chromosome, and MLL gene rearrangements, and certain mutations, including deletion of the IKZF1 gene, portend a poorer outcome. The classic triad of arthritis, urethritis, and conjunctivitis formerly referred to as Reiter syndrome is relatively uncommon in children. The arthritis is typically oligoarticular, with a lower extremity predilection. Clinical signs of this disorder are anorexia, diarrhea, failure to thrive, humoral and cell-mediated immunodeficiency poor wound healing, recurrent infections , male hypogonadism, skin lesions vesicobullous dermatitis on the extremities and perirectal, perigenital, and perioral regions, and alopecia , and neurologic abnormalities tremor, apathy, depression, irritability, nystagmus, photophobia, night blindness, and hypogeusia.

Other features of cerebellar dysfunction include errors in judging distance dysmetria , inability to inhibit a muscular action rebound , impaired performance of rapid alternating movements dysdiadochokinesia , intention tremor, nystagmus, scanning dysarthria, hypotonia, and decreased deep tendon reflexes. Tea- or cola-colored urine, facial or body edema, hypertension, and oliguria are classic symptoms of acute nephritic syndrome. Pneumonia — VQ mismatch. Neuromuscular disease — diffusion defect.

RDS — right to left shunt. Because of concerns about penicillin- or cephalosporin-resistant S. Children in relapse have increased susceptibility to bacterial infections because of urinary losses of immunoglobulins and properdin factor B, defective cell-mediated immunity, their immunosuppressive therapy, malnutrition, and edema or ascites acting as a potential culture medium.

In addition to sodium restriction, fluid restriction may be necessary if the child is hyponatremic. Gastroesophageal reflux and laryngospasm are the most common causes of ALTE, and they are associated with emesis, choking, or gagging. Cardiovascular causes, metabolic causes, airway obstruction, and child abuse account for smaller percentages.

A toxoid is a modified bacterial toxin that is made nontoxic but is still able to induce an active immune response against the toxin. A lactose-free formula based on either soy or cow's milk can be used in infants.

The coagulopathy manifests with thromboembolic events. An injection kit should be kept at home and school. The intramuscular dose is 0. This produces a brief release of glucose from the liver. Thus, the diagnosis may not be made in boys until signs of adrenal insufficiency develop. Because patients with this condition can deteriorate quickly, infant boys are more likely to die than infant girls.

For this reason, many states and countries have instituted newborn screening for this condition. Some patients remain asymptomatic into adulthood, but others have severe anemia with pallor, jaundice, fatigue, and exercise intolerance. Its characteristic clinical features are progressive weakness, intellectual impairment, hypertrophy of the calves, and proliferation of connective tissue in muscle.

A normal serum CK level is incompatible with the diagnosis of DMD, although in terminal stages of the disease, the serum CK value may be considerably lower than it was a few years earlier because there is less muscle to degenerate. This physiologic abnormality can also occur with atrioventricular septal defect, ventricular septal defect, patent ductus arteriosus or any other communication between the aorta and pulmonary artery, and in many forms of complex congenital heart disease with unrestricted pulmonary blood flow.

Grade I changes involve medial hypertrophy alone, grade II consists of medial hypertrophy and intimal hyperplasia, grade III involves near obliteration of the vessel lumen, grade IV includes arterial dilatation, and grades V and VI include plexiform lesions, angiomatoid formation, and fibrinoid necrosis.

Apple and pear juices contain higher amounts of fructose than glucose, a feature postulated to cause diarrhea in toddlers.

Apnea may be the only symptom. Apnea and cyanosis both are more common with pertussis than with neonatal viral infections, including respiratory syncytial virus RSV.

Some children with typical CF manifestations are found to have 1 or no detectable mutations by this methodology. Patients with polysplenia frequently have poor splenic function and may also require prophylaxis against pneumococcal sepsis. Thereafter, they acquire infections with extracellular pyogenic organisms, such as Streptococcus pneumoniae and Haemophilus influenzae, unless they are given prophylactic antibiotics or immunoglobulin therapy.

Avascular necrosis of head of femur.

קוסיות גבר ואישה שוכבים

Water pitcher with spout and silver hoop, London, England, on matching plate. Crystal vase, artisan engraving worl, Bohemia, floral pattern. Set of cut glass cups, including: Six Champagne glasses by Lalique, France, angel pattern, hallmarked. Cameo glass vase, marked Galle, floral pattern, height 25 cm.

Silver 84 tobacco box, with enamel, import stamp to Austria, repaired damages to the paint. Silver tongs, with embossed pattern of a dragon on each gripping end.

Silver ashtray, Peru, with Pre Colombian style embossments and Peruvian coin, Four silver articles, two salt cellars, toothpick holder, and mocha cup.

Pair of saltcellars, each with spoon and liner Birmingham silver, England Pair of lettuce servers, silver handles, horn servers, together with roast servers, silver handles, nikel plated servers.

Silver ring set with amber colored sapphires and green colored tsaporite. Victorian style silver ring set with three aquamarines and eight fire opals. Silver pin with transparent enamel work, set with zircons, butterfly shaped. Silver pendant set with 2 pink gemstones of the moonstone family and a pearl. Lot of jade jewelry: Silver pendant set with 14 marcasite rubies and 12 marcasite opals.

Silver ring with gold plating set with white sapphires and green stones, tiger head shaped. Silver pendant set with a red topaz, purity of stone IF, weight 22 ct. Pair of silver earrings, each set with two blue topazes and white sapphires. Pair of 14k gold earrings, set with diamonds, designers signature. Porcelain box, by KPM, Germany, with an embossment of a face on the lid. Porcelain figurine by Royal Dux, Czechoslovakia, lady with hat.

Porcelain box by Herend, Hungary, with a cat figurine on the lid. Porcelain figurine by Holohaza, Hungary, two young girls dancing, marked. Porcelain box by Rosenthal, Bavaria, with gilding and painted roses. Porcelain plate by Rosenthal, with a lithograph print after a painting by Angelica Kaufmann, The Three Graces distressing Cupid, signed. Porcelain figurine by Royal Dux, Czechoslovakia, young girl with jug the jug is separate.

Oblong porcelain tray, by Rosenthal series Maria, painted with green flowers. Large porcelain plate by Meissen, with fruit pattern, marked, repair on the rim.

Three Porcelain figurines, by Nao, Spain: Pair of porcelain plaques, each with an image from Greek mythology Transfer print , Paris and the three Graces, and Zeus. Small porcelain pitcher with lid, by Herend, Hungary, with hand painted flowers. Pair of porcelain figurines, boy with a grape collecting vessel and a girl collecting eggs damages. Antique Viennese porcelain cup, hand painted, early 19th c.

Porcelain box, by Rodez-Aveyron Limoges, France, cobalt with gilding and a pattern of fairy drawings minor damage. Porcelain box with bronzework decorations and hand painted, flowers on Bordeaux background. Porcelain plate by Limoges, France, gilded and with flowers. Goblet shaped vase, porcelain with cobalt and gilding, images from Greek mythology. Two Porcelain figurines, by Nao, Spain: Porcelain cup by Lindner, Bavaria, with cobalt and gilding, marked. Porcelain plate, by Royal Goedewaagen, Netherlands, hand painted, Frysia pattern.

Bisque figurine, angel kissing a little girl, Austria, 19th c damages. Pair of porcelain figurines, Austria, 19th c, man and woman in late 18th century costume. With each relapse, symptoms are usually milder than at presentation.

Children with a more severe initial course are at higher risk for relapse. Dullness to flatness may be found on percussion. Breath sounds are decreased or absent, and there are a diminution in tactile fremitus, a shift of the mediastinum away from the affected side, and, occasionally, fullness of the intercostal spaces.

The rash usually lasts days but is often described as evanescent and may be visible only for hours, spreading from the trunk to the face and extremities. The rash begins on the forehead around the hairline , behind the ears, and on the upper neck as a red maculopapular eruption. The exanthem frequently becomes confluent on the face and upper trunk. It often begins around the neck and spreads over the trunk and extremities.

It is a diffuse, finely papular, erythematous eruption producing a bright red discoloration of the skin, which blanches on pressure. It is often more intense along the creases of the elbows, axillae, and groin.

The skin has a goose-pimple appearance and feels rough. The initial exanthem consists of intensely pruritic erythematous macules that evolve through the papular stage to form clear, fluid-filled vesicles. Causes include congenital viral infections CMV, rubella, and parvovirus , congenital neoplastic disease, and Rh hemolytic disease.

The atretic plate may be seen directly with fiberoptic rhinoscopy. The anatomy is best evaluated by using high-resolution CT. Differential diagnosis includes trauma and demyelinating disease. In children with hydrocephalus, impairment of vertical gaze and pathologic lid retraction are referred to as the setting-sun sign. A transient supranuclear disorder of gaze is sometimes seen in healthy neonates.

It is typically symmetric, affecting proximal muscles such as the neck flexors, shoulder girdle, and hip flexors. Parents may report difficulty climbing stairs, combing hair, and getting out of bed. Chronic regional lymphadenitis is the hallmark, affecting the 1st or 2nd set of nodes draining the entry site. The vomiting may or may not be projectile initially but is usually progressive, occurring immediately after a feeding.

Emesis might follow each feeding, or it may be intermittent. Ultrasound examination confirms the diagnosis in the majority of cases. Interstitial Nephritis, Drug Induced. KD may occur in adolescents. Initially, discrete, pale, rose-red blanching macules or maculopapules appear, characteristically on the extremities, including the ankles, wrists, or lower legs Fig. The rash then spreads rapidly to involve the entire body, including the soles and palms.

After several days, the rash becomes more petechial or hemorrhagic, sometimes with palpable purpura. These range from impetigo to cellulitis, lymphadenitis, and subcutaneous abscesses. An early manifestation of secondary bacterial infection is erythema of the base of a new vesicle. These symptoms are often misdiagnosed as indicating flu or food poisoning. At higher exposure levels, patients can develop mental status changes, confusion, ataxia, syncope, tachycardia, and tachypnea.

Severe poisoning is manifested by coma, seizures, myocardial ischemia, acidosis, cardiovascular collapse, and potentially death.

On exam, patients might have cherry-red skin. ED evaluation should include a COHb level in all symptomatic patients, arterial blood gas and creatine kinase in severely poisoned patients, and an ECG in any patient with cardiac symptoms. The resultant brain swelling manifests as seizures or coma. The clinical suspicion is confirmed by study of indices of copper metabolism. The prognosis varies depending on the severity of the insult and the treatment.

It is frequently encountered in Ashkenazi Jews but has been found in many other ethnic groups. They can also reveal hyperkalemia, hyponatremia if volume overloaded , acidosis, hypocalcemia, hyperphosphatemia, and an elevation in uric acid. Untreated, the vast majority of these infants would not survive the neonatal period. If the symptoms are severe, presumptive treatment is started pending results of the culture. If the symptoms are mild or the diagnosis is doubtful, treatment can be delayed until the results of culture are known, and the culture can be repeated if the results are uncertain.

If treatment is initiated before the results of a culture and sensitivities are available, a 3- to 5-day course of therapy with trimethoprim-sulfamethoxazole TMP-SMX or trimethoprim is effective against most strains of E. Hemoglobin may be decreased if there have been profuse nosebleeds or menorrhagia. Macrocephaly, not associated with hydrocephalus, may develop. In the 2nd yr of life, seizures develop which may be refractory to anticonvulsant therapy.

Case finding by liberal use of anti-endomysium or anti-TG2 antibodies, followed by confirmatory jejunal biopsy, is more cost effective in primary care than mass screening is.

Patients with symptoms or diseases known to be associated with celiac disease should undergo serologic evaluation. In a grade I hemorrhage, bleeding is isolated to the subependymal area.

In Grade II hemorrhage, there is bleeding within the ventricle but without evidence of ventricular dilatation. In Grade IV hemorrhage, there is intraventricular and parenchymal hemorrhage. Marfan — Aortic Stenosis. Down Syndrome — Endocardial cushion malformation.

DiGeorge — conotruncal deformity. Allagile — Peripheral Pulmonary stenosis. Complete cardiologic evaluation, including echocardiography, reveals isolated nonstenotic bicuspid aortic valves in one third to one half of patients. In later life, bicuspid aortic valve disease can progress to dilatation of the aortic root. There may also be ocular abnormalities posterior embryotoxon, microcornea, optic disk drusen, shallow anterior chamber , cardiovascular abnormalities usually peripheral pulmonic stenosis, sometimes tetralogy of Fallot, pulmonary atresia, VSD, ASD, aortic coarctation , vertebral defects butterfly vertebrae, fused vertebrae, spina bifida occulta, rib anomalies , and tubulointerstitial nephropathy.

Excessive glucose production coupled with reduced glucose utilization raises serum glucose. This produces an osmotic diuresis, with loss of fluid and electrolytes, dehydration, and activation of the renin-angiotensin-aldosterone axis with accelerated potassium loss.

If glucose elevation and dehydration are severe and persist for several hours, the risk of cerebral edema increases. Increased catabolic processes result in cellular losses of sodium, potassium, and phosphate. Increased release of free fatty acids from peripheral fat stores supplies substrate for hepatic keto acid production.

When keto acids accumulate, buffer systems are depleted and a metabolic acidosis ensues. Therapy must address both the initiating event in this cascade insulinopenia and the subsequent physiologic disruptions.

Upper airway obstruction varies in degree and level i. Major blood group incompatibility between the mother and fetus generally results in milder disease than Rh incompatibility does.

Non Alcoholic Fatty Liver Disease. The initial assessment should ensure an adequate airway with effective respiration, circulation, and perfusion. Epinephrine is the most important medication, and there should be no delay in its administration.

If an intravenous line is not available, epinephrine should be given by the intramuscular route 0. Patients typically report episodic attacks of angioedema or deep localized swelling, most commonly on a hand or foot, that begin during childhood and become much more severe during adolescence. In infants born in areas with no screening program, severe cases manifest features in the first few weeks of life, but in cases of lesser deficiency, manifestations may be delayed for months.

The severity of the valve abnormalities varies considerably; in the complete form of AV septal defect, a single AV valve is common to both ventricles and consists of an anterior and a posterior bridging leaflet related to the ventricular septum, with a lateral leaflet in each ventricle.

The lesion is common in children with Down syndrome. Conversely, a large head may be associated with a large brain, or macrocephaly, which is most commonly familial but may be due to a disturbance of growth, neurocutaneous disorder e.

Alternatively, the head size may be increased secondary to hydrocephalus Fig or chronic subdural hemorrhages. It also contains protective bacterial and viral antibodies secretory IgA and nonspecific immune factors, including macrophages and nucleotides, which also help limit infections. For school-aged children and in children in whom infection with M. In adolescents, a respiratory fluoroquinolone levofloxacin, moxifloxacin, gemifloxacin may be considered as an alternative.

The intensity of the murmur often changes with respiration and position and may be attenuated in the sitting or prone position. Methlyn blue — methanol. Fomepizole see Table , a potent competitive inhibitor of alcohol dehydrogenase, has almost entirely replaced the use of ethanol owing to its ease of administration, lack of CNS and metabolic effects, and overall excellent patient tolerability profile.

One unique characteristic of CCB overdose is that patients can exhibit profound hypotension with preserved consciousness. Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis. In mammals ammonia is detoxified to urea via the urea cycle.

Chromosomal abnormalities, including hypodiploidy, the Philadelphia chromosome, and MLL gene rearrangements, and certain mutations, including deletion of the IKZF1 gene, portend a poorer outcome. The classic triad of arthritis, urethritis, and conjunctivitis formerly referred to as Reiter syndrome is relatively uncommon in children. The arthritis is typically oligoarticular, with a lower extremity predilection. Clinical signs of this disorder are anorexia, diarrhea, failure to thrive, humoral and cell-mediated immunodeficiency poor wound healing, recurrent infections , male hypogonadism, skin lesions vesicobullous dermatitis on the extremities and perirectal, perigenital, and perioral regions, and alopecia , and neurologic abnormalities tremor, apathy, depression, irritability, nystagmus, photophobia, night blindness, and hypogeusia.

Other features of cerebellar dysfunction include errors in judging distance dysmetria , inability to inhibit a muscular action rebound , impaired performance of rapid alternating movements dysdiadochokinesia , intention tremor, nystagmus, scanning dysarthria, hypotonia, and decreased deep tendon reflexes.

Tea- or cola-colored urine, facial or body edema, hypertension, and oliguria are classic symptoms of acute nephritic syndrome. Pneumonia — VQ mismatch.

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