The case reported by Falciglia et al1 in the October issue of AJDC reminds us of a similar case with a different diagnosis. A 411-g female infant was born prematurely at 28 weeks' gestation shortly after the in utero death of her larger monozygotic twin. The infant received surfactant in the delivery room and, despite all efforts, died at 3 days of age of renal failure and pulmonary edema. At autopsy, meconium aspiration was described by the pathologist. Because the clinicians believed that the diagnosis was inconsistent with the gestational age and clinical course, a second opinion of the photomicrograph was requested and the alternate diagnosis of yellow hyaline membrane disease was made by a perinatal pathologist.
Yellow hyaline membrane disease has been described several times, including a review by Turkel and Mapp,2 and should have been discussed in the report as a differential diagnosis.
Seguin J, Rosenberg E, Macpherson T. Intrauterine Meconium Aspiration in an Extremely Premature Infant. Arch Pediatr Adolesc Med. 1994;148(9):991. doi:10.1001/archpedi.1994.02170090105021