Points: Evaluation of portable haemoglobinometer in general practice

sensitivity to halothane in children with a, anti- trypsin deficiency,3 but they refer to an article in the New England 3rournal of Medicine.4Again, there is no mention of this sensitivity.This is an example ofan error compounded through misread- ing and referencing.The authors present seven cases of suspected halothane hepatitis.In case 7, however, they found no halothane antibody, but they still classified this child as having halothane hepatitis, explaining that it is possible that the antibody was produced but was undetectable.In the case report they state that a 3½/2 year old boy weighed 1800 g.This is an extremely small child.Though halothane hepatitis may occur in children, it is extremely rare, and Dr Kenna and coworkers cannot give the incidence that might be expected in children.In a review article on halothane hepatitis Stock et al concluded that there is no diagnostic test that is specific for halothane induced liver damage and that therefore the diagnosis can be made only by excluding all other causes of postoperative liver dysfunction.5Walton states that non-A, non-B hepatitis may be responsible for halothane hepatitis after a single exposure.6Thus we still cannot define specifically the diagnostic criteria for halothane hepatitis.If it exists it remains extremely rare in children and has an incidence less than that of non-A, non-B hepatitis in the general population.An extensive clinical study of preoperative liver function in asymptomatic children who received halothane and were then followed up for a long period would be needed to provide clearer conclusions.