ABSTRACT
Acute post-streptococcal glomerulonephritis (APSGN) is the most common glomerulonephritis of childhood, and clinical presentation can vary widely. This case report presents an atypical manifestation of APSGN in an 8-year-old female patient with pleuritic chest pain and elevated troponin-I, despite lacking classical kidney symptoms. Imaging studies showed cardiomegaly and interstitial lung opacities. Further investigations revealed hematuria and proteinuria, and the diagnosis was confirmed through elevated antistreptolysin-O (ASO) titers and low complement 3 (C3) levels. The patient was successfully managed with fluid restriction, diuretics, and antihypertensives, resulting in the resolution of symptoms and normalization of laboratory values. This case highlights the significance of recognizing atypical manifestations of APSGN for ensuring prompt diagnosis and proper management in the pediatric population.
ABSTRACT
BACKGROUND: Mitral valve prolapse (MVP) is a heart valve anomaly with specific electrocardiographic findings and arrhythmia. A predominant sympathetic tone and diminished vagal activity have been reported especially in symptomatic MVP patients. OBJECTIVES: In the current study, we aim to review heart rate variability (HRV) parameters of MVP children in order to determine if there is an impaired autonomic regulation. METHODS: The data of children with MVP were retrospectively analyzed. Demographic characteristics, body mass index, symptomatology, MVP type and mitral regurgitation, MVP-related electrocardiographic changes, arrhythmia, and HRV parameters in 24-h Holter monitoring were recorded. HRV parameters of the control group were obtained from children applying for sport participation. Statistical significance limit was accepted as p < 0.05. RESULTS: 154 of the patients (74.8%) were girls, the median age was 13.58 ± 2.99 years. While MVP patients had shorter PR intervals, those who had syncope had longer PR intervals. Short PR distance may be a feature of MVP, long PR distance may be a condition associated with syncope with the underlying paroxysmal atrioventricular block. Moreover, the minimum heart rate was significantly lower in the MVP group compared to the control and there were no significant differences in terms of remaining parameters. The number of low LF values was higher in MVP patients than the control. Comparing HRV values of groups by gender, we found that overall HRV parameters were lower in girls with MVP while minimum, maximum, and average heart rate were lower in boys with MVP. CONCLUSION: Impaired HRV associated with MVP could be age, gender, and symptom related. In addition, low LF may indicate impaired baroreflex sensitivity in MVP patients.
ABSTRACT
BACKGROUND: Necrotizing enterocolitis (NEC) is one of the most important life- threatening diseases in neonates. Recurrent episodes of supraventricular tachycardia (SVT) can lead to gut ischemia, with subsequent reperfusion injury resulting in NEC. Mesenchymal stem cells (MSCs) are multi-potential cells which can differentiate into multiple cell types. Case report: A 22-day old male baby delivered to 34 yr old mother at 37-weeks' gestation via cesarean section, birth weight 3550 g, developed NEC 14 hours after being treated with cardioversion for SVT. At laparotomy, there was pan-NEC, and 60 cm of necrotic and perforated bowel was resected. 1 × 107 umbilical cord origin allogeneic MSCs were given intravenously, with subsequent improvement of the remaining bowel. Conclusion: MSC may be a promising treatment for adjacent ischemic bowel in NEC helping prevent short bowel syndrome.
