Transient myeloproliferative syndrome associated with Down syndrome.

production run with hydrogen peroxide and rinsed with deionized water. As moisture may remain in the less accessible points of the system (bends and filters), Kathon CG is added to the rinse water to ensure a completely sterile process. As a result of this finding, the company marketing the cream compensated the patient and changed the procedure for cleaning the machinery, replacing the Kathon CG in the rinse water with other biocides (methylparaben, propylparaben, and diazolidinyl urea). We believe that the very small amount of methylchloroisothiazolinone/methylisothiazolinone that may be contained in the finished product is due to contamination. The rinse water which is used to clean the packaging machine contains Kathon CG and may briefly come into contact with the cream, especially in the first few bottles of the production run. Although it would have been advisable to determine the presence of Kathon CG in the content of the bottle used by the patient, it was not possible to do so because of the technical difficulty involved. The patient’s atopic predisposition and her work, in which she uses the cream daily, probably accentuated the problem and caused the severe acute dermatitis.