Hemodialysis Catheter Breakage in an Infant.

A 3-month-old male infant was admitted to our unit due to acute decompensation of chronic kidney disease of unknown etiology. Further investigation led to the diagnosis of primary hyperoxaluria type 1. As the patient did not recover, hemodialysis was initiated with a non-tunneled femoral catheter. A tunneled Hickman catheter was placed in the internal jugular vein. The patient experienced moderate intradialytic exit-site bleeding and catheter malfunction, which initially responded to pressure and postural changes. During the third session, the patient suffered cardiopulmonary arrest. After stabilization, a chest hematoma was identified. Fluoroscopy revealed a catheter breakage. Despite initial stabilization, the patient developed septic shock due to Pseudomonas aeruginosa and died several days later. Hemodialysis is sometimes necessary in children under 24 months with chronic kidney disease. Vascular access is a major challenge in these patients due to lack of appropriate catheter sizes and high complication rates. Hemodialysis catheter fracture is an uncommon complication, and diagnosis can be difficult when the breakage involves the subcutaneous segment. Persistent intradialytic bleeding and mechanical malfunction should raise suspicion of this complication and should elicit catheter revision under fluoroscopy. Without prompt diagnosis, catheter breakage may have fatal consequences, as in our case.

Hiperpotasemia asintomática como forma de presentación de pseudohipoaldosteronismo / Asymptomatic hyperkalemia as a form of presentation of pseudohypoaldosteronism

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Digital ischemia as the initial presentation of catastrophic antiphospholipid syndrome.

Catastrophic antiphospholipid syndrome is an infrequent disease in children, but of major relevance because of its high morbidity and mortality. We report the case of a child with digital ischaemia in whom, after aetiological screening, the diagnosis of catastrophic antiphospholipid syndrome was made.

Isquemia digital como forma de presentación de síndrome antifosfolípido catastrófico pediátrico / Digital Ischemia as the Initial Presentation of Catastrophic Antiphospholipid Syndrome

El síndrome antifosfolípido catastrófico es una entidad infrecuente en Pediatría, pero con importante relevancia dada la elevada morbimortalidad. Se expone el caso de un niño con isquemia digital en el que, tras realizar despistaje etiológico de diferentes entidades infecciosas e inflamatorias, se llegó al diagnóstico de síndrome antifosfolípido catastrófico primario.(AU)

Catastrophic antiphospholipid syndrome is an infrequent disease in children, but of major relevance because of its high morbidity and mortality. We report the case of a child with digital ischaemia in whom, after aetiological screening, the diagnosis of catastrophic antiphospholipid syndrome was made.(AU)

Displasia fibromuscular: una causa rara de hipertensión arterial / Fibromuscular dysplasia: an uncommon cause of arterial hypertension

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Correction to: A rare cause of nephrocalcinosis in an infant: Answers.

Due to an unfortunate error during the processing of this article, the HTML version of this article contained a mistake.

Digital Ischemia as the Initial Presentation of Catastrophic Antiphospholipid Syndrome. / Isquemia digital como forma de presentación de síndrome antifosfolípido catastrófico pediátrico.

Catastrophic antiphospholipid syndrome is an infrequent disease in children, but of major relevance because of its high morbidity and mortality. We report the case of a child with digital ischaemia in whom, after aetiological screening, the diagnosis of catastrophic antiphospholipid syndrome was made.

Púrpura y artritis, ¿siempre púrpura de Schönlein-Henoch? / Purpura and arthritis: Is it always Henoch-Schönlein purpura?

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