ABSTRACT
La hiperfosfatasemia transitoria benigna infantil (HTBI) es una entidad en la que se observan marcadas elevaciones de fosfatasa alcalina sérica, sin evidencia clínica, bioquímica ni en exámenes complementarios de patología ósea, hepática, renal o endocrinometabólica. Se presenta el caso de una paciente de ocho meses ingresada por un cuadro febril y elevación importante de fosfatasa alcalina. La HTBI es una entidad frecuente que debe tenerse en cuenta para evitar preocupaciones y exploraciones innecesarias. Si un paciente tiene elevación de fosfatasa alcalina, con exploración física, calcio, fosfatos y perfil hepático normales, se le debe controlar clínicamente y continuar midiendo los niveles de fosfatasa alcalina hasta la normalización. Si persiste elevada tras tres meses, debería investigarse el origen de las isoenzimas y estudiar a familia (AU)
Benign transient hyperphosphatasemia of infancy (BTHI) is a condition where disproportionately high levels of serum alkaline phosphatase are observed, without clinical or biochemical evidence of bone, liver, renal or metabolic disease. We report a case of an eight months old patient presenting with fever and important increase of serum alkaline phosphatase. The HTBI is a frequent entity to be considered in order to avoid unnecessary investigations. If a patient has high alkaline phosphatase level, with physical examination, calcium, phosphate and liver normal profile, he/her should be monitored clinically and by measuring alkaline phosphatase levels until normalization. If high level persists after 3 months, the origin of the isoenzymes and a family study should be investigated (AU)
Subject(s)
Humans , Female , Infant , Alkaline Phosphatase/administration & dosage , Alkaline Phosphatase/analysis , Isoenzymes/analysis , Sedimentation/methods , Bone Diseases/complications , Bone Diseases/diagnosis , Liver Diseases/complicationsABSTRACT
OBJECTIVE: To describe the epidemiological and clinical pattern of a Bordetella pertussis infection (whooping cough) among hospitalised infants in a paediatric hospital in Gran Canaria island (Spain). METHODS: A retrospective review of the patient hospital records was performed considering only those with a microbiological diagnosis of pertussis by polymerase chain reaction (PCR) for the period September 2003-September 2007. RESULTS: Forty nine patients were identified, of which 47 were < 6 months of age. The annual incidence of hospitalisation was estimated between 103.9 and 204.5 cases per 100,000 infants < 12 months old. Household members were the potential source of infection in at least 65.3 % of the cases. Clinical data were obtained from 47 patients. Complications occurred in 23.4 % of the patients (11 infants), three of them died (6.4 %). Viral coinfections occurred in 33.3 % of the infants diagnosed with pertussis. CONCLUSIONS: Pertussis presents a high complication rate among infants < 6 months old. Pertussis must be considered in the differential diagnosis of infants < 6 months old who present with severe pneumonia. Immunization strategies in the adult population must be reviewed and updated in order to attain higher protection of the more vulnerable paediatric population.
Subject(s)
Whooping Cough/diagnosis , Whooping Cough/epidemiology , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Retrospective Studies , Spain/epidemiologyABSTRACT
Objetivo. El objetivo del estudio fue conocer el patrón clínico-epidemiológico de la tos ferina en niños diagnosticados en un hospital pediátrico de la isla de Gran Canaria. Métodos. Se revisaron retrospectivamente las historias clínicas de los pacientes con diagnóstico de infección por Bordetella pertussis mediante reacción en cadena de la polimerasa (PCR) en el período septiembre 2003-septiembre 2007. Resultados. Se detectaron 49 casos de tos ferina, 47 en menores de 6 meses. La incidencia anual de hospitalización osciló entre 103,9 y 204,5 por cada 100.000 niños menores de 12 meses. En al menos el 65,3 % de los casos, la posible fuente de contagio fue un adulto cercano. Se obtuvieron datos clínicos de 47 pacientes. Once niños (23,4 %) presentaron complicaciones, y tres de ellos fallecieron (6,4 %). El 33,3 % de los niños presentaron coinfección con virus. Conclusiones. La tos ferina presenta una alta tasa de complicaciones en lactantes menores 6 meses y debe considerarse en el diagnóstico diferencial de la neumonía grave del lactante. Deberían revisarse las estrategias de vacunación en la población adulta para conseguir una mayor protección de la población pediátrica más susceptible
Objetive. To describe the epidemiological and clinical pattern of a Bordetella pertussis infection (whooping cough) among hospitalised infants in a paediatric hospital in Gran Canaria island (Spain). Methods. A retrospective review of the patient hospital records was performed considering only those with a microbiological diagnosis of pertussis by polymerase chain reaction (PCR) for the period September 2003-September 2007. Results. Forty nine patients were identified, of which 47 were < 6 months of age. The annual incidence of hospitalisation was estimated between 103.9 and 204.5 cases per 100,000 infants < 12 months old. Household members were the potential source of infection in at least 65.3 % of the cases. Clinical data were obtained from 47 patients. Complications occurred in 23.4 % of the patients (11 infants), three of them died (6.4 %). Viral coinfections occurred in 33.3 % of the infants diagnosed with pertussis. Conclusions. Pertussis presents a high complication rate among infants < 6 months old. Pertussis must be considered in the differential diagnosis of infants < 6 months old who present with severe pneumonia. Immunization strategies in the adult population must be reviewed and updated in order to attain higher protection of the more vulnerable paediatric population
