Assuntos
Antituberculosos/uso terapêutico , Tronco Encefálico/patologia , Infartos do Tronco Encefálico/diagnóstico , Pré-Escolar , Diagnóstico Diferencial , Quimioterapia Combinada , Feminino , Glucocorticoides/uso terapêutico , Humanos , Resultado do Tratamento , Tuberculoma Intracraniano/diagnóstico , Tuberculoma Intracraniano/tratamento farmacológicoRESUMO
We present a 10-year-old girl who presented to our emergency services with difficulty in breathing of 2-days duration and progressive weakness of a month's duration. In a previous admission elsewhere, she had not been detected to have hyperthyroidism or electrolyte abnormalities. On admission, the child was in hypercapnic respiratory failure with tachycardia and hepatomegaly. A small goiter as well as signs of thyrotoxicosis were present. Laboratory investigations showed anemia, mildly elevated liver enzymes and serum potassium of 4.8mEq/L. Despite intubation and ventilation and other supportive management including propranolol, the patient could not be saved. Post-mortem biopsy of the thyroid showed diffuse hyperplasia of the follicles and muscles showed evidence of thyroid myopathy.
Assuntos
Criança , Feminino , Humanos , Paralisias Periódicas Familiares/sangue , Insuficiência Respiratória/complicações , Tireotoxicose/complicaçõesRESUMO
Paraesophageal hernia in children is relatively rare entity. These children usually present with recurrent respiratory tract infection or vague GI symptoms. An 11 year female presented with episodic vomiting, heartburn and features of hypocalcemic tetany. Investigations revealed right paraesophageal hernia. Reduction of the contents and repair of the defect with fundoplication was done. Patient is asymptomatic on follow-up.
Assuntos
Criança , Feminino , Refluxo Gastroesofágico/etiologia , Hérnia Hiatal/complicações , Humanos , Índice de Gravidade de DoençaRESUMO
The authors report 6 children with the diagnosis of acute disseminated encephalomyelitis. Diagnosis was based on clinical and radiological findings. The most common presenting symptoms were fever and disturbed consciousness, followed by cranial nerve abnormalities and pyramidal signs. Brain MRI showed hyperintense signals on T2-weighted images, most commonly in the subcortical and periventricular white matter, brainstem, basal ganglia and thalamus. The lesions were bilateral, asymmetrical and highly variable in size and number. A preceding infection was present in 3 of 6 children. Early high-dose corticosteroids were given to all the patients. All patients recovered clinically. Follow-up ranged from 10 months to 2 years. No relapses were observed during this period. Early high-dose steroid therapy seems to be an effective treatment in acute disseminated encephalomyelitis.
Assuntos
Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Esquema de Medicação , Encefalomielite Aguda Disseminada/diagnóstico , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Metilprednisolona/administração & dosagem , Prognóstico , Medição de Risco , Estudos de Amostragem , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Bilateral anotia or microtia is known to be associated with multiple order malformations. The authors report a young infant who presented with failure to thrive and recurrent respiratory tract infections.The patient had bilaterally absent pinnae; instead small skin tags were present. He also had asymmetric crying facies and clinical evidence of hypothyroidism in the form of hoarse voice, constipation and generalized hypotonia. Thyroid function tests confirmed the diagnosis of hypothyroidism.