Cerebral sinovenous thrombosis in a nephrotic child

Nephrotic syndrome in infancy and childhood is known to be associated with a hypercoagulable state and thromboembolic complications, but cerebral sinovenous thrombosis (CST) is a very rare and serious one, with only a few isolated reports in the literature. A case is presented of a 9-year-old boy with nephrotic syndrome that acutely developed signs and symptoms of intracranial hypertension syndrome. CST was diagnosed on cranial CT and MRI and he gradually recovered after treatment with anticoagulants. The diagnosis of CST should be considered in any patient with nephrotic syndrome who develops neurologic symptoms. The discussion of this case, coupled with a review of the literature, emphasizes that early diagnosis is essential for institution of anticoagulation therapy and a successful outcome. This report also illustrates the difficulties that may be encountered in managing such a patient

Homofiltração e circulação extracorpórea em pediatria / Hemofiltration and cardiopulomonary bypass in pediatrics

A ultrafiltração arteriovenosa contínua durante a circulação extracorpórea, principalmente a técnica modificada, representam um grande avanço nos pacientes submetidos a CEC associada a hipotermia, e hemodiluição, porque promove uma retirada efetiva de água corporal acumulada reduzindo portanto o edema miocárdico, além de reduzir a concentração sérica de alguns mediadores inflamatórios relacionados a resposta inflamatória sistêmica após cirurgia cardíaca com CEC. Estes resultados são significativos principalmente quando este procedimento for realizado em neonatos e em lactentes desnutridos onde há maior risco de acúmulo de líquidos