ABSTRACT
Mounier-Kuhn syndrome (MKS) or tracheobronchomegaly includes clinical and radiographic findings of tracheobronchial dilatation and recurrent respiratory infections. MKS is a very rare pathology, especially in the paediatric age group which makes it a diagnostic challenge. A 4-year-old girl suffered from dyspnea, recurrent respiratory infections and joint pain. Chest radiography detected peribronchial reinforcement and CT-scan revealed extended tracheal dilatation and bronchiectasis. In addition to MKS our patient was diagnosed with juvenile idiopathic arthritis (JIA) and scleroderma. MKS can be caused by congenital disorder or acquired aetiology. Several connective tissue diseases have been associated with MKS but no cases of JIA or scleroderma are described previously. Our case illustrates that patients who suffer from recurrent respiratory infections with unsatisfactory evolution and unspecific chest X-ray alteration, MKS always has to be considered in the differential diagnosis particularly in patients who suffer from connective tissue diseases.
Subject(s)
Arthritis, Juvenile/complications , Arthritis, Juvenile/epidemiology , Tracheobronchomegaly/complications , Tracheobronchomegaly/epidemiology , Arthralgia/etiology , Arthritis, Juvenile/diagnosis , Child, Preschool , Diagnosis, Differential , Dyspnea/etiology , Female , Humans , Recurrence , Respiratory Tract Infections/etiology , Scleroderma, Localized/complications , Scleroderma, Localized/epidemiology , Tomography, X-Ray Computed , Tracheobronchomegaly/diagnosisABSTRACT
En este seminario se trata el abordaje diagnóstico y terapéutico inicial de las enfermedades reumáticas pediátricas a través de la resolución interactiva de unos casos clínicos representativos de la artritis idiopática juvenil en sus distintas formas de expresión clínica, por ser esta la enfermedad más frecuente en esta especialidad. Se repasan los últimos avances en el diagnóstico y tratamiento de interés para el pediatra de Atención Primaria (AU)
This seminar approaches the initial diagnosis and treatment of juvenile idiopathic arthritis, the most frequent rheumatic disease in children. We present interactive cases report where the different clinical forms of juvenile idiopathic arthritis are distinguished. We review the recent advances in diagnosis and treatment of interest for the primary care pediatrician (AU)
Subject(s)
Humans , Male , Female , Child , Arthritis, Juvenile/diagnosis , Arthritis, Juvenile/therapy , Antirheumatic Agents/therapeutic use , Rheumatic Diseases/epidemiology , Sickness Impact Profile , Tendinopathy/epidemiology , Comorbidity , Joint Diseases/epidemiologyABSTRACT
Dissection of the internal carotid artery is an important cause of ischemic stroke in children and young patients. Trauma and/or an underlying structural defect of the arterial wall have been suggested to be predisposing factors. The typical patient presents with ipsilateral headache or neck pain, ipsilateral Horner's syndrome and delayed ischemic symptoms. Diagnosis is given by ultrasound, transcranial Doppler, magnetic resonance imaging, magnetic resonance angiography and conventional angiography. Treatment of this type of injury includes anticoagulation therapy, antiplatelet therapy and surgery. We report a 14-year-old boy with internal carotid artery dissection who presented with ischemic stroke.
Subject(s)
Carotid Artery, Internal, Dissection/etiology , Cerebral Infarction/etiology , Adolescent , Brain/blood supply , Brain/diagnostic imaging , Brain/pathology , Carotid Artery, Internal, Dissection/diagnosis , Echoencephalography , Humans , Male , Tomography, X-Ray ComputedABSTRACT
La disección de la arteria carótida interna es una causa importante de ictus isquémico en niños y pacientes jóvenes. En la patogenia se han implicado traumatismos y/o un posible defecto estructural de la pared arterial. Las manifestaciones clínicas típicas incluyen cefalea o dolor de cuello y síndrome de Horner en el lado de la disección, con la aparición después de síntomas isquémicos cerebrales. La ecografía, el Doppler transcraneal, la resonancia magnética (RM), la angiorresonancia y la angiografía proporcionan el diagnóstico. Las opciones de tratamiento comprenden anticoagulantes, antiagregantes plaquetarios y cirugía. Presentamos un adolescente de 14 años con un ictus isquémico secundario a disección de la arteria carótida interna. (AU)
