RESUMO
Precocious thelarche usually results from a physiological process but can sometimes be the first sign of precocious pseudopuberty. Ovarian granulosa cell tumors are highly unusual in childhood, appearing as precocious puberty in most prepuberal patients. During adolescence these tumors may cause menstrual irregularities, virilization and abdominal pain. Their malignancy is low and surgical treatment is usually curative if the tumors are limited to the ovaries. More advanced stages require chemotherapy, are difficult to cure and produce high mortality. We present the case of a 16-month-old girl with a granulosa cell tumor who presented with progressive precocious thelarche over 1 month that was satisfactorily resolved after resective surgery. This case demonstrates that other causes of puberal development should be investigated when precocious thelarche with fast progression is observed, with special attention paid to tumoral disease in the differential diagnosis.
Assuntos
Tumor de Células da Granulosa/diagnóstico , Neoplasias Ovarianas/diagnóstico , Puberdade Precoce/etiologia , Feminino , Tumor de Células da Granulosa/cirurgia , Humanos , Lactente , Neoplasias Ovarianas/cirurgiaRESUMO
La telarquia prematura habitualmente corresponde a un proceso fisiológico, aunque en ocasiones excepcionales puede ser el primer signo de una pubertad precoz. Los tumores de células de la granulosa del ovario son muy infrecuentes en la infancia, provocando una seudopubertad precoz en la mayoría de los pacientes prepuberales. Durante la adolescencia puede causar irregularidades menstruales, virilización y dolor abdominal. Son tumores de bajo grado de malignidad y el tratamiento quirúrgico suele resultar curativo si están limitados al ovario. Estadios más avanzados precisan poliquimioterapia, son difíciles de curar y presentan elevada mortalidad. Se presenta el caso de una niña de 16 meses con un tumor de células de la granulosa que se manifestó con telarquia prematura progresiva de un mes de evolución y que se resolvió de forma favorable tras la cirugía resectiva. Este caso indica que ante una telarquia prematura rápidamente evolutiva se deben buscar otros signos de desarrollo puberal, recordando los procesos tumorales dentro del diagnóstico diferencial (AU)
Assuntos
Feminino , Humanos , Lactente , Puberdade Precoce , Tumor de Células da Granulosa , Neoplasias OvarianasRESUMO
No disponible
Assuntos
Masculino , Pré-Escolar , Humanos , Streptococcus pyogenes , Streptococcus pyogenes , Miosite , Varicela , Infecções EstreptocócicasRESUMO
La displasia ectodérmica hipohidrótica (DEH) es una patología que debe considerarse dentro del diagnóstico diferencial de los procesos febriles en la infancia, sobre todo sin son recurrentes o de origen desconocido. Se presenta un nuevo caso de DEH en un lactante varón de 13 meses con cuadro febriles de repetición sin foco y con el fenotipo característico, consistente en un pelo ralo y escaso, hipodoncia, piel fina y seca y una facies peculiar. El conocimiento de las características clínicas tan específicas de esta entidad nos puede permitir un diagnóstico precoz y relativamente sencillo, minimizando así la iatrogenia asociada a la demora diagnostica (AU)
Hypohidrotic ectodermal displasia (HED( is a pathology that must be considered in the differential diagnosis of childhood´s febril processes, mainly if they are recurrent or of unknown origin. We present here a new case of HED in a 13 months old boy with recurrent fevers without focus, exhibiting a particular phenotype consisting of fine and scarce hair, oligodontia, smooth and dry skin and a particular facies. The knowledge of these particular clinical features allow an early and relative simple diagnosis, minimizing the iatrogenia associated to delays in diagnosis (AU)
Assuntos
Humanos , Masculino , Lactente , Febre de Causa Desconhecida/diagnóstico , Displasia Ectodérmica Hipo-Hidrótica Autossômica Recessiva/diagnóstico , Diagnóstico Diferencial , Fácies , Diagnóstico PrecoceRESUMO
The clinical and epidemiological feature of 246 cases of Mediterranean boutonneuse fever diagnosed in 1983-1988 were evaluated. It was found that the clinical and epidemiological profile of the disease remained stable as compared with previous studies. The frequent muscle involvement, with increase in serum muscular enzymes in up to 32% of patients and with histologically documented myositis in 2 patients is emphasized. 7% of patients had severe forms of the disease. The risk factors of these forms were evaluated, and the different features in adults and children were compared. The outcome was favourable in all patients.
Assuntos
Febre Botonosa/complicações , Adolescente , Adulto , Idoso , Febre Botonosa/epidemiologia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosAssuntos
Síndrome da Imunodeficiência Adquirida/complicações , Infecções Oportunistas/etiologia , Síndrome da Imunodeficiência Adquirida/patologia , Síndrome da Imunodeficiência Adquirida/transmissão , Antibacterianos/uso terapêutico , Candidíase/etiologia , Candidíase/patologia , Criança , Pré-Escolar , Criptosporidiose/tratamento farmacológico , Criptosporidiose/etiologia , Humanos , Masculino , Infecções Oportunistas/tratamento farmacológico , Infecções Oportunistas/patologia , Infecções por Salmonella/etiologia , Salmonella enteritidisRESUMO
A seven years old boy with an hypogammaglobulinemia associated to a pauciarticular chronical juvenile arthritis, in which immunitary deficit diagnostic was made investigating his articular disease, is presented. Clinic, immunological screening, therapy and ulterior evolution with a two year substitutive immunoglobulin treatment are discussed. Authors also revise some aspects of these two diseases association.
