Clínica neurológica en un paciente con bronquiolitis. ¿Pensamos en hiponatremia? / Neurologic impairment and bronchiolitis. Do we think of hyponatremia?

Se presenta el caso clínico de un paciente con hiponatremia grave sintomática, en el contexto de un cuadro de bronquiolitis positiva a virus respiratorio sincitial. El paciente no había recibido previamente fluidoterapia intravenosa. A partir de la analítica urinaria se sospechó una secreción inadecuada de hormona antidiurética. El paciente evolucionó de forma satisfactoria con infusión de suero salino hipertónico, restricción hídrica y furosemida. Es importante determinar la natremia en los pacientes afectados de bronquiolitis, especialmente si se detecta clínica neurológica (AU)

A case report of severe hyponatremia in an infant with RSV bronchiolitis is discussed. The patient didn’t receive previous intravenous fluid therapy. Urine analysis suggested inappropriate secretion of antidiuretic hormone. Patient status improved with hypertonic saline infusion, fluid restriction and furosemide. Natremia should be measured in any RSV bronchiolitis patient if neurologic impairment is suspected (AU)

Granulomatosis de Wegener con anticuerpos anticitoplasma de neutrófilo frente a catepsina G / Wegener's granulomatosis with anti-neutrophil cytoplasmic antibodies against anti-cathepsin G antigen

La granulomatosis de Wegener pertenece al grupo de vasculitis de vaso pequeño asociadas a anticuerpos anticitoplasma de neutrófilo. Se caracteriza por inflamación granulomatosa y vasculitis necrosante que puede afectar a diversos órganos, principalmente cursa con afectación renal y de las vías respiratorias. Es una enfermedad rara en la infancia y el diagnóstico precoz es fundamental para el pronóstico a largo plazo de la enfermedad. La presencia de anticuerpos anticitoplasma de neutrófilo con patrón citoplasmático o de títulos elevados de anticuerpos antiproteinasa-3 ha sido actualmente incluida en los criterios diagnósticos de vasculitis en niños. En este artículo se presenta un caso de granulomatosis de Wegener en la infancia, con presencia de anticuerpos anticitoplasma de neutrófilo con patrón citoplasmático con ausencia de anticuerpos antiproteinasa-3 y presencia de niveles elevados de anticuerpos anticatepsina G, raramente asociados a granulomatosis de Wegener (AU)

Wegener’s granulomatosis belongs to the group of small vessel vasculitis associated with anti-neutrophil cytoplasmic antibodies characterized by granulomatous inflammation andnecrotising vasculitis in various organs with particular involvement of the upper and lower respiratory tracts and kidneys. Wegener’s granulomatosis is a rare disorder in childhood and early diagnosis of this disease is critical to the long-term prognosis of the disease. The presence of positive cytoplasmic antineutrophil cytoplasmic antibody staining or a high titre of proteinase 3 antibodies were added as new criteria of vasculitis in childhood. This article presents a case of Wegener’s granulomatosis, with the presence of anti-neutrophil cytoplasm antibodies with cytoplasmic pattern with absence of anti-proteinase 3 antibodies and presence of high levels of anti-cathepsin G antibodies, rarely described in Wegener’s granulomatosis (AU)

[Wegener's granulomatosis with anti-neutrophil cytoplasmic antibodies against anti-cathepsin G antigen]. / Granulomatosis de Wegener con anticuerpos anticitoplasma de neutrófilo frente a catepsina G.

Wegener's granulomatosis belongs to the group of small vessel vasculitis associated with anti-neutrophil cytoplasmic antibodies characterized by granulomatous inflammation and necrotising vasculitis in various organs with particular involvement of the upper and lower respiratory tracts and kidneys. Wegener's granulomatosis is a rare disorder in childhood and early diagnosis of this disease is critical to the long-term prognosis of the disease. The presence of positive cytoplasmic antineutrophil cytoplasmic antibody staining or a high titre of proteinase 3 antibodies were added as new criteria of vasculitis in childhood. This article presents a case of Wegener's granulomatosis, with the presence of anti-neutrophil cytoplasm antibodies with cytoplasmic pattern with absence of anti-proteinase 3 antibodies and presence of high levels of anti-cathepsin G antibodies, rarely described in Wegener's granulomatosis.

Enfermedad de Kawasaki: importancia del diagnóstico precoz / Kawasaki´s disease: importance of early diagnosis

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