ABSTRACT
BACKGROUND AND OBJECTIVES: Infantile hemangiomas (IHs) are the most common benign tumors in infanthood. Although they are often self-limiting, management of IHs is still controversial because residual lesions may persist in some cases. The aim of this study is to report our experience with patients affected with IH and investigate the frequency of residual lesions in treated versus untreated patients. STUDY DESIGN/MATERIALS AND METHODS: This retrospective observational study enrolled patients with IHs evaluated over the past 10 years. Patients were managed with systemic or local pharmacotherapy, laser therapy, a combination of them, or with observation only. RESULTS: A total of 432 patients were included: 71% received one or more therapies for IHs; 75.2% of untreated patients had at least one residual lesion compared with 41.4% of treated patients (P < 0.001). Patients treated with laser therapy or topical timolol had the lowest rate of residual lesions. CONCLUSIONS: This rather large case series suggests that IHs management with pharmacotherapy and especially laser therapy is associated with a lower number of residual lesions than observation only. Although propranolol can be very useful to avoid life-threatening complications and severe tissue impairment, laser therapy and topical timolol are potential effective treatments to decrease the incidence of residual lesions, mostly associated with superficial IHs. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
Subject(s)
Hemangioma, Capillary , Lasers, Dye , Skin Neoplasms , Humans , Infant , Lasers, Dye/therapeutic use , Observational Studies as Topic , Propranolol/therapeutic use , Skin Neoplasms/drug therapy , Timolol/therapeutic use , Treatment OutcomeABSTRACT
A 21-month-old boy came to our attention because of pneumonia. His weight increased before presentation, and his blood test results showed hyponatremia (116 mEq/L), low plasma osmolarity (241 mOsm/L), and high urine osmolarity (435 mOsm/L). He was treated with 0.9% sodium chloride solution and intravenous furosemide, and sodium levels rose up to 135 mEq/L in 36 hours. No standard treatment is available for severe hyponatremia in children. The use of vaptans in pediatric patients is described in literature, but it lacks evidence about safety and effectiveness. We suggest that furosemide administration plus salt replacement is effective in restoring normal values of plasma sodium concentration in severe euvolemic and hypervolemic hyponatremia.
Subject(s)
Hyponatremia/diagnosis , Inappropriate ADH Syndrome/diagnosis , Pneumonia/diagnosis , Diagnosis, Differential , Diuretics/therapeutic use , Fluid Therapy , Furosemide/therapeutic use , Humans , Hyponatremia/therapy , Inappropriate ADH Syndrome/therapy , Infant , Male , Pneumonia/therapyABSTRACT
BACKGROUND: In seizures caused by electrolytes disorders, a prompt diagnosis allows an appropriate treatment and reduces the risk of neurological complications. Hypomagnesemia is a recognized cause of generalized seizures, while it has been anecdotally reported in focal forms. CASE PRESENTATION: We describe a newborn with recurrent focal seizures due to transient hypomagnesemia. CONCLUSION: Physicians should consider the possible occurrence of such disorder also in cases of focal seizures.
Subject(s)
Infant, Newborn, Diseases/etiology , Magnesium/blood , Seizures/etiology , Female , Humans , Infant, Newborn , Infant, Newborn, Diseases/blood , Seizures/bloodABSTRACT
BACKGROUND: Posterior reversible encephalopathy syndrome is a potentially reversible clinicoradiologic syndrome characterized by headache, mental confusion, visual disturbances and seizures associated with posterior cerebral lesions on radiological imaging. Prompt treatment of this condition is mandatory to avoid severe irreversible complications. CASE PRESENTATION: We report a 9-year-old boy with arterial hypertension and headache as unique clinical presentation of posterior reversible encephalopathy syndrome. CONCLUSIONS: Severe and isolated headache associated with arterial hypertension can be the unique clinical presentation of posterior reversible encephalopathy syndrome. This syndrome must be considered even in absence of all typical symptoms to prevent the progression of a potentially life threatening condition.
Subject(s)
Headache/etiology , Hypertension/etiology , Posterior Leukoencephalopathy Syndrome/diagnosis , Child , Humans , Male , Posterior Leukoencephalopathy Syndrome/complications , Severity of Illness IndexABSTRACT
Posterior reversible cerebral edema syndrome is a generally reversible neurologic condition that is diagnosed based on distinctive clinical and radiologic findings. The condition, which is mostly associated with severe arterial hypertension, has also been reported to be induced by several medications. We made the diagnosis of hypertension with posterior reversible cerebral edema syndrome in a lean 12-year-old girl treated with the second-generation antipsychotic risperidone. We applied the Naranjo Adverse Drug Reaction Probability Scale and the World Health Organization-Uppsala Monitoring Centre system for causality assessment to the present case. Both scales indicated that a relationship to risperidone was likely. Second-generation antipsychotic agents may occasionally induce an increase in blood pressure even in the absence of overweight. Given this possibility, we recommend routine monitoring of blood pressure during therapy with these agents.
Subject(s)
Antipsychotic Agents/adverse effects , Brain Edema/chemically induced , Hypertension/chemically induced , Risperidone/adverse effects , Brain Edema/diagnosis , Child , Female , Humans , Hypertension/diagnosisABSTRACT
Episodic idiopathic systemic capillary leak syndrome is a rare disorder that presents with attacks of circulatory shock due to plasma leakage into the extravascular space. Reported here is the case of a girl who had recurrent circulatory shock. The diagnosis of episodic idiopathic systemic capillary leak syndrome was made following the fourth episode. The course was favorable following acute i.v. cristalloids and methylprednisolone.
