ABSTRACT
Describimos el caso de una niña con enfermedad de Chagas congénita. Su diagnóstico se realizó a los 8 meses de edad por persistencia de la serología positiva, ya que no estaba disponible la reacción en cadena de la polimerasa (PCR) para esta enfermedad al nacimiento. Se trató a la paciente con benznidazol durante 60 días, sin que presentara reacciones adversas ni toxicidad. La serología disminuyó tras el tratamiento. Es importante detectar estos casos pediátricos lo antes posible. Para ello, debe realizarse un cribado de serología a Chagas en mujeres gestantes procedentes de áreas endémicas que emigran a Europa y, si es positiva, realizar una PCR y una serología en el niño (AU)
We present the case of a child affected by congenital Chagas disease. Her serologys for the detection of Chagas persisted positive and she was diagnosed and treated at the age of 8 months. Chagas PCR was not available. She was treated with benznidazole for 60 days, without secondary effects or toxicity. After treatment her serologies decreased. It is important to detect these children as soon as possible. That is the reason why Chagas screening tests should be performed in pregnant women who come from endemic areas and emigrate to European countries and if it is positive, to do a PCR and serological tests to the child (AU)
Subject(s)
Humans , Female , Child, Preschool , Chagas Disease/complications , Chagas Disease/diagnosis , Chagas Disease/pathology , Polymerase Chain Reaction/instrumentation , Polymerase Chain Reaction/methods , Trypanosoma cruzi/parasitology , Trypanosoma cruzi/pathogenicity , Enzyme-Linked Immunosorbent Assay/instrumentation , Enzyme-Linked Immunosorbent Assay/methodsABSTRACT
Nonsteroidal anti-inflammatory drugs induce the inhibition of prostaglandin synthesis, which can cause constriction of the fetal ductus arteriosus in the pregnancy. We report two cases of antenatal closure of ductus arteriosus with severe pulmonary hypertension following maternal ingestion of nonsteroidal anti-inflammatory drugs (niflumic acid and acetylsalicylic acid) in the last days before delivery. To our knowledge, this is only the second case in literature describing antenatal closure of ductus arteriosus after the administration of niflúmic acid. Prescription of nonsteroidal anti-inflammatory drugs must be avoided during pregnancy. Fetal echocardiography must be monitored in those women treated with nonsteroidal anti-inflammatory drugs.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Hypertension, Pulmonary/chemically induced , Niflumic Acid/adverse effects , Prenatal Exposure Delayed Effects/epidemiology , Adult , Female , Humans , Hypertension, Pulmonary/diagnosis , Infant, Newborn , Male , PregnancyABSTRACT
Los antiinflamatorios no esteroideos inhiben la síntesis de prostaglandinas y producen una vasoconstricción del conducto arterioso fetal durante la gestación. Presentamos los casos de dos recién nacidos con hipertensión pulmonar grave secundaria a cierre ductal. En las semanas previas al parto, una de las madres había recibido tratamiento con ácido acetilsalicílico y la otra, con ácido niflúmico. Éste es el segundo caso descrito en la literatura médica de cierre ductal intraútero tras administración de ácido niflúmico. La ingestión de antiinflamatorios no esteroideos durante el embarazo está desaconsejado. No obstante, en las gestantes tratadas se debe realizar una monitorización continua, y la ecocardiografía fetal es de gran utilidad (AU)
Nonsteroidal anti-inflammatory drugs induce the inhibition of prostaglandin synthesis, which can cause constriction of the fetal ductus arteriosus in the pregnancy. We report two cases of antenatal closure of ductus arteriosus with severe pulmonary hypertension following maternal ingestion of nonsteroidal anti-inflammatory drugs (niflumic acid and acetylsalicylic acid) in the last days before delivery. To our knowledge, this is only the second case in literature describing antenatal closure of ductus arteriosus after the administration of niflúmic acid. Prescription of nonsteroidal anti-inflammatory drugs must be avoided during pregnancy. Fetal echocardiography must be monitored in those women treated with nonsteroidal anti-inflammatory drugs (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Persistent Fetal Circulation Syndrome/chemically induced , Niflumic Acid/adverse effects , Hypertension, Pulmonary/chemically inducedABSTRACT
OBJECTIVE: To analyze whether erythropoietin treatment increases hemoglobin and decreases transfusion requirements in critically ill children. PATIENTS AND METHODS: We performed an observational, prospective study of 23 critically ill children aged between 1 month and 6 years. Recombinant human eritropoietin (rHuEPO) was administered at a dosage of 150-750 U/kg/week over 3 days. Hemogram, reticulocyte, iron metabolism, serum ferritin and transferrin were measured before treatment started and weekly thereafter. RESULTS: After erythropoietin treatment, hematocrit, hemoglobin and red blood cells progressively increased, with a maximal response in the sixth week. At the end of treatment, hemoglobin increased 1.68 g/dl, hematocrit by 5 % and erythrocytes 600,000/ml/mm3. Transfusion requirements decreased from 59 transfusions at baseline to 12 in the first week of treatment and none from the sixth week. No treatment-related adverse effects were observed. CONCLUSION: Erythropoietin can be an effective treatment for anemia in some critically ill children, decreasing the number of transfusions and increasing hemoglobin.
Subject(s)
Anemia/drug therapy , Erythropoietin/therapeutic use , Child , Child, Preschool , Critical Illness , Female , Humans , Infant , Male , Prospective StudiesABSTRACT
Objetivo: Analizar si el tratamiento con eritropoyetina aumenta la hemoglobina (Hb) y disminuye las necesidades transfusionales en niños críticamente enfermos. Pacientes y métodos: Estudio observacional prospectivo, en 23 niños enfermos en estado crítico de edades entre un mes y 6 años. Se administró una dosis de eritropoyetina humana recombinante (r-HuEPO) entre 150-750 U/kg/semana distribuida en 3 días. Antes del inicio del tratamiento y semanalmente se realizaron los siguientes controles: hemograma, reticulocitos, sideremia, ferritina y transferrina. Resultados: Tras el tratamiento con eritropoyetina se observó un aumento progresivo de la serie roja (Hb, hematocrito, hematíes), y la mayor respuesta se encontró a la sexta semana. La Hb al final del tratamiento aumentó un 1,68 g/dl; el hematocrito, un 5 por ciento, y los hematíes, 600.000/mm3. La necesidad de transfusiones disminuyó de 59 antes del inicio del tratamiento con eritropoyetina a 12 en la primera semana de tratamiento; ninguna se realizó a partir de la sexta semana. No se observaron efectos secundarios al tratamiento. Conclusión: La eritropoyetina puede ser un tratamiento eficaz de la anemia en algunos niños enfermos en estado crítico, disminuyendo el número de transfusiones y aumentando las cifras de Hb (AU)
