Assuntos
Linfadenite Histiocítica Necrosante/diagnóstico , Doença de Leigh/diagnóstico , Deficiência de Tiamina/diagnóstico , Acidose Láctica/etiologia , Adolescente , Colite Ulcerativa/cirurgia , Dispneia/etiologia , Fadiga/etiologia , Febre/etiologia , Cefaleia/etiologia , Linfadenite Histiocítica Necrosante/terapia , Humanos , Lactente , Doença de Leigh/genética , Masculino , Hipotonia Muscular/etiologia , Complicações Pós-Operatórias , Redução de PesoRESUMO
BACKGROUND: Intravenous immunoglobulin is the favored therapy in childhood immune thrombocytopenic purpura. It is usually well tolerated with manageable side effects, but venous and arterial thrombosis following its administration have been described, mostly in adults. METHODS: We describe a 3-year-old girl with immune thrombocytopenic purpura and intracranial hemorrhage who received intravenous immunoglobulin therapy and subsequently developed multifocal cerebral infarctions. RESULTS: Product specific as well as other factors may play a role in the development of this complication of intravenous immunoglobulin therapy. This is the only reported case of intravenous immunoglobulin-related thrombosis in a child with immune thrombocytopenic purpura and intracranial hemorrhage. CONCLUSIONS: Thrombotic complications are associated with intravenous immunoglobulin administration and this includes cerebral infarcts.
Assuntos
Infarto Cerebral/etiologia , Imunoglobulinas Intravenosas/efeitos adversos , Fatores Imunológicos/efeitos adversos , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Encéfalo/fisiopatologia , Infarto Cerebral/patologia , Pré-Escolar , Imagem de Difusão por Ressonância Magnética , Potenciais Evocados Visuais , Feminino , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Hemorragias Intracranianas/complicações , Hemorragias Intracranianas/patologia , Hemorragias Intracranianas/terapia , Imageamento por Ressonância Magnética , Púrpura Trombocitopênica Idiopática/complicações , Púrpura Trombocitopênica Idiopática/patologia , Púrpura Trombocitopênica Idiopática/terapia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Moyamoya disease (MMD) is a progressive cerebrovascular occlusive disease of the bilateral internal carotid arteries that leads to a compensatory abnormal vascular network at the base of the brain. Its average annual incidence 0.54 per 100,000 population but it is the most common pediatric cerebrovascular disease in East Asia. The reported incidence in USA is approximately 0.086 per 100,000 patients. CASE REPORT: We present a case of Moyamoya disease that was to detected in a 7-year-old female who presented with transient altered mental status. CONCLUSIONS: Moyamoya disease can be diagnosed if history, physical exam and brain imaging is highly suspicious. Conventional angiography remains the gold standard for diagnosis and aids in surgical planning for patients with suspected Moyamoya disease.
