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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

HEMIHIPERTROFIA IZOLATA LA SUGAR

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HEMIHIPERTROFIA IZOLATA LA SUGAR

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REZUMAT

Hemihipertrofia sau hemihiperplazia este o boală congenitală rară, a cărei incidenţă este dificil de estimat din cauza faptului că asimetria este foarte uşoară în multe cazuri, rămânând astfel nediagnosticate. Hemihiperplazia poate fi izolată sau asociată unor sindroame genetice. Prezentăm cazul unui sugar, de sex feminin, în vârstă de 6 luni, la care în perioada perinatală s-a ridicat suspiciunea unei hemihipertrofii congenitale, internându-se în clinica noastră din cauza prezenţei unei asimetrii faciale. Examenul obiectiv a scos în evidenţă, de asemenea, pe lângă hemihiperplasia hemifeţei drept, mai evidentă la nivelul frunţii, o hipertrofie a membrului superior şi inferior drepte. Analizele de laborator au identificat o uşoară anemie, nivele crescute ale transaminazelor, precum şi al alfa-fetoproteinei. Ecografia abdominală a decelat uşoară hepatomegalie, iar cea transfontanelară discretă ventriculomegalie şi atrofie frontală. Testul genetic a fost negativ, astfel că diagnosticul final a fost de hemihipertrofie izolată. Reevaluările ulterioare au arătat un nivel al alfa-fetoproteinei în scăderea, fără alte elemente patologice adiţionale. Particularitatea cazului constă în diagnosticarea unei hemihipertrofii izolate la un sugar de 6 luni, cu test genetic negativ, la care s-a observat o uşoară asimetrie facială în momentul naşterii, cu evoluţie ulterioară favorabilă, cu scădere progresivă a nivelului alfa-proteinei şi ecografie abdominală normală.

Cuvinte cheie: hemihipertrofie izolată, hemihiperplazie izolată, sugar, alfa-fetoproteina

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ISOLATED HEMIHYPERTROPHY IN CHILD

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ISOLATED HEMIHYPERTROPHY IN CHILD

, , , , and

ABSTRACT

Hemihypertrophy or hemihyperplasia is a rare congenital condition, whose incidence is difficult to estimate, due to the fact that asymmetry is very mild, therefore remaining undiagnosed. Hemihyperplasia can be isolated or associated to certain genetic syndromes. We present the case of a 6-months-old female infant, in whom, during the neonatal period, was raised the suspicion of a congenital hemihypertrophy. She was admitted in our clinic due to the presence of a facial asymmetry. The clinical exam revealed also, besides the hemihyperplasia of the right hemiface more obvious at the level of the forehead, a hypertrophy of the right superior and inferior limbs. The laboratory tests identified a mild anemia, increased levels of transaminases and alfa-fetoprotein. The abdominal ultrasound revealed a mild hepatomegaly and the transfontanellar one discrete ventriculomegaly and frontal atrophy. The genetic test was negative, therefore the final diagnosis was of isolated hemihypertrophy. The further re-evaluations showed a decreasing level of alfa-fetoprotein, without other additional pathological elements. The particularity of the case consists in diagnosing an isolated hemohypertrophy in a 6-month-old female infant, with negative genetic test, in whom it was observed at the moment of birth a mild facial asymmetry, with afterwards favorable evolution, with progressive decrease of the alfa-fetoprotein level and normal abdominal ultrasound.

Keywords: isolated hemihypertrophy, isolated hemihyperplasia, infant, alfa-fetoprotein

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TIMOMUL: O CAUZA RARA DE TUMORA MEDIASTINALA LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ICMJE- Recommendations

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Promoting Global Health

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TIMOMUL: O CAUZA RARA DE TUMORA MEDIASTINALA LA COPIL

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REZUMAT

Timomul este un neoplasm format din celule epiteliale timice, fiind rar întâlnit la copii. Aproximativ două treimi din tumorile mediastinale sunt asimptomatice la copii, diagnosticul fiind suspicionat în urma efectului de compresie a masei tumorale asupra căilor respiratorii. Prezentăm cazul unui pacient de sex masculin, în vârstă de 7 ani şi 8 luni, care se prezintă în serviciul de urgenţă acuzând oboseală la eforturi mici/repaus, tuse seacă, dispnee marcată, ortopnee, tahipnee, durere toracică, de unde se transferă de urgenţă la Clinica de Cardiologie Pediatrică, Tîrgu Mureş, cu diagnosticele: pericardită lichidiană, tamponadă cardiacă şi pleurezie dreaptă. Examenul computer tomografic toracic descrie o masă solidă inomogenă de 100/89/111 mm, la nivelul mediastinului anterior înglobând timusul şi parţial structurile vasculare ale mediastinului mijlociu. Se practică pericardectomie parţială, prelevare de ţesut tumoral şi citoreducţie tumorală extensivă, examenul histopatologic fiind Timom B3. Se iniţiază chimioterapie conform protocolului VENUTA Tymom, urmat de radioterapie adjuvantă, cu remisie clinică şi radiologică. Particularitatea cazului este dată de faptul că timomul este o tumoră rară la vârsta pacientului, creând dificultăţi de diagnostic, fiind fără complicaţii în timpul tratamentului, cu evoluţie favorabilă, cu remisie clinică şi radiologică la 1,9 ani.

Cuvinte cheie: copil, timom, tumoră mediastinală

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THYMOMA: A RARE CAUSE OF MEDIASTINAL TUMOR IN CHILDREN

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ICMJE- Recommendations

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Promoting Global Health

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THYMOMA: A RARE CAUSE OF MEDIASTINAL TUMOR IN CHILDREN

, , , , and

ABSTRACT

Thymoma is a thymic neoplasm composed of epithelial cells, rarely seen in children. Approximately two-thirds of mediastinal tumors in children are asymptomatic. The diagnosis is suspected following the compression of the tumor mass on the airways. We present the case of a male patient, age 7 years and 8 months, who presented at the emergency room accusing fatigue at rest or minimum effort, dry cough, intense dyspnea, orthopnea, tachypnea, chest pain, being transferred to the Pediatric Cardiology Clinic in Tirgu Mures with the following diagnoses: fluid pericarditis, right pleural effusion and cardiac tamponade. Chest computer tomography examination is carried out, describing a solid mass of 100/89/111 mm in the anterior mediastinum, partially incorporating the thymus and the vascular structures of the middle mediastinum. Pericardectomy is practiced with partial removal of the tumor and extensive tumor cytoreduction and the histopathologic examination is B3 Thymoma. Specific treatment is initiated according to the Tymoma VENUTA protocol, followed by adjuvant radiotherapy, with clinical and radiological remission. The particularity of the case is the fact that thymoma is a rare tumor on the patient’s age, creating diagnostic difficulties, has no complications during treatment, with favorable evolution, with clinical and radiological remission at 1.9 years after.

Keywords: child, thymoma, mediastinal tumor

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HEMORAGIA CEREBRALA FETALA DIAGNOSTICATA ANTEPARTUM

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 3, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ICMJE- Recommendations

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Promoting Global Health

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HEMORAGIA CEREBRALA FETALA DIAGNOSTICATA ANTEPARTUM

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REZUMAT

Diagnosticul antepartum al hemoragiei cerebrale fetale (HCF) este mai puţin raportat (0,9/1.000 naşteri) comparativ cu cel postpartum. Sunt prezentate două cazuri de hemoragie intraventriculară fetală, diagnosticate ecografic antepartum.
Cazul 1: HCF diagnosticată ecografic la vârsta gestaţională de 28 de săptamâni de gestaţie şi confirmată postnatal prin prezenţa în LCR a hematiilor (număr semnificativ, ratatinate) şi a modificărilor semnalate de ecografia transfontanelară (hidrocefalie internă severă, ţesut cerebral minim). Decesul a survenit la 24 de ore postpartum (ex. histopatologic: hemoragie cerebrală intraventriculară). Menţionăm absenţa aparentă a factorilor de risc materni, negativitatea testelor TORCH.
Cazul 2: hidrocefalie internă la vârsta de 37 de săptămâni de gestaţie şi confirmată la nou-născut (după cezariană) de modificările clinice caracteristice, suferinţa neurologică severă asociată cu modificări la ecografia transfontanelară şi aspectul hemoragic şi hipertensiv al LCR. Nu au fost depistaţi factori de risc materni. De asemenea, aparent nu au existat riscuri fetale: greutatea 2.820 g la 37 de săptămâni de gestaţie, teste TORCH negative, culturi şi CRP negative. Hidrocefalia a avut o evoluţie progresivă impunând ventriculotomii şi cisternotomii; plasarea unui şunt ventriculo-peritoneal în timpul celei de-a treia intervenţii neurochirurgicale a ameliorat prognosticul vital.
Concluzii. Prezenţa hidrocefaliei a fost un semn ecografic fidel pentru diagnosticul HCF. Evoluţia şi prognosticul sunt influenţate de severitatea hemoragiei şi de vârsta gestaţională. Supravieţuitorii beneficiază de tratamentul neurochirurgical. Etiopatogenia plurifactorială, incomplet descifrată a HCF conduce la dificultăţi în stabilirea unui grup ţintă de screening, în scopul identificării acestei leziuni.

Cuvinte cheie: hemoragie cerebrală, diagnostic antepartum

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FETAL CEREBRAL HEMORRHAGE DIAGNOSED ANTEPARTUM

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 3, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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FETAL CEREBRAL HEMORRHAGE DIAGNOSED ANTEPARTUM

, , , , , , , , , and

ABSTRACT

The diagnosis of fetal cerebral hemorrhage (HCF) is less reported (0,9/1000 births) in comparison to the postpartum one. We presented 2 cases of fetal intraventricular hemorrhages diagnosed.
Case 1: HCF diagnosed by ultrasound at the gestational age of 28 weeks and confirmed after birth by the presence of erythrocytes (significant number, pathological aspect) in the spinal fluid and by the modifications signaled by the transfontanellar ultrasound (severe internal hydrocephaly, minimum cerebral tissue). The death occurred after 24 hours postpartum (pathological exam: intraventricular cerebral hemorrhage). We mention the apparent lack of maternal risk factors, negative TORCH tests.
Case 2: internal hydrocephaly at the age of 37 gestational weeks and confirmed in newborn (after cesarean section) by the clinical characteristic modifications, severe neurological impairment with modification at the transfontanellar ultrasound and the hemorrhagic and hypertensive aspect of the spinal fluid. We did not encounter maternal risk factors. Also, apparently, there were not any fetal risks: weight 2,820 grams at 37 gestational weeks, negative TORCH tests, negative cultures and CRP. The hydrocephaly had a progressive evolution imposing ventriculotomies and cysternotomies; the placement of a ventriculoperitoneal shunt during the third neurosurgical intervention improved the vital prognosis.
Conclusions. The presence of hydrocephaly was a faithful ultrasound sign for the diagnosis of HCF. The evolution and the prognosis are influenced by the severity of hemorrhage and the gestational age. The survivors benefit from neurosurgical treatment. The multifactorial etiology, of the HCF incompletely elucidated leads to difficulties in establishing a target group of screening, in order to identify this lesion.

Keywords: cerebral hemorrhage, antepartum diagnosis

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METAPLAZIA PANCREATICA A MUCOASEI GASTRICE LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 3, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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METAPLAZIA PANCREATICA A MUCOASEI GASTRICE LA COPIL

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REZUMAT

Metaplazia pancreatică este definită drept apariţia ţesutului pancreatic într-o locaţie anormală şi fară conectare directă la pancreas. Ţesutul pancreatic heterotopic este cel mai frecvent observat la nivelul mucoasei antrale gastrice, în duoden şi jejun. Prezentăm cazul unei paciente în vârstă de 13 ani care s-a internat în Clinica Pediatrie 1 Târgu-Mureş pentru dureri abdominale recurente şi pirozis. Investigaţiile de laborator efectuate au evidenţiat limfocitoză (41%) cu monocitoză (8,9%), eozinofilie (4,9%), un număr crescut de reticulocite (20%), un nivel seric scăzut al trigliceridelor şi o valoare peste limita superioară a calciului şi magneziului. Ecografia abdominală nu a pus în evidenţă modificări patologice. Endoscopia digestivă superioară a evidenţiat o mucoasă gastrică granulară. Astfel, s-a prelevat un fragment de biopsie de la nivel antral, iar examenul histopatologic a evidenţiat prezenţa unui focar de metaplazie pancreatică la nivelul mucoasei antrale gastrice. Evoluţia a fost favorabilă cu dietă şi tratamentul leziunilor asociate. Particularitatea cazului constă în prezenţa metaplaziei pancreatice a mucoasei gastrice la o pacientă cu dureri abdominale recurente şi pirozis, fără antecedente heredo-colaterale sau personale semnificative.

Cuvinte cheie: metaplazie pancreatică, copil, dureri abdominale, pirozis

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PANCREATIC METAPLASIA OF THE GASTRIC MUCOSA IN CHILD

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 3, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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PANCREATIC METAPLASIA OF THE GASTRIC MUCOSA IN CHILD

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ABSTRACT

Pancreatic metaplasia is defined as the development of pancreatic tissue in an abnormal location and without direct connection to the pancreas. The heterotopic pancreatic tissue is most frequently noticed in the antral gastric mucosa, duodenum and jejunum. We present the case of a 13-year-old patient, admitted in Pediatrics Clinic 1 Targu-Mures, for recurrent abdominal pain and heartburns. The laboratory tests pointed out lymphocytosis (41%) with monocytosis (8.9%), eosinophilia (4.9%), an increased number of reticulocytes (20%), a decreased serum level of triglycerides and a value above the superior limit for calcium and magnesium. The abdominal ultrasound did not reveal any pathological modifications. The superior digestive endoscopy showed a granular gastric mucosa, therefore we took a biopsy of the antral mucosa, The pathological exam pointed out a fragment of pancreatic metaplasia in the antral gastric mucosa. The evolution was favorable with diet and treatment for the associated lesions. The particularity of the case consists in the presence of pancreatic metaplasia of the gastric mucosa in a patient with recurrent abdominal pain and heartburns, without significant familial or personal history.

Keywords: pancreatic metaplasia, child, abdominal pain, heartburn

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„KISSING-ULCER“ – DEBUT CU COMPLICATII LA VARSTA MICA

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

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„KISSING-ULCER“ – DEBUT CU COMPLICATII LA VARSTA MICA

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REZUMAT

Ulcerul este o patologie cu incidenţă scăzută la vârsta pediatrică, cu simptomatologie nespecifică sau chiar absentă, ducând astfel la apariţia complicaţiilor. Prezentăm cazul unui pacient în vârstă de 2 ani şi 10 luni, internat la spitalul de la nivel teritorial cu diagnosticul de gastroenterită acută febrilă, care în evoluţie (după 5 zile) a asociat hemoragie digestivă, impunând astfel transferul în Clinica de Pediatrie I, Târgu-Mureş. Endoscopia digestivă superioară, efectuată după reechilibrarea hemodinamică şi metabolică, a evidenţiat prezenţa a două ulcere la nivelul mucoasei duodenale, unul cu sângerare activă. Tratamentul cu inhibitori de pompă protonică şi dieta adecvată iniţiate au determinat evoluţia favorabilă a pacientului. Particularitatea cazului constă în apariţia a două ulcere duodenale la un copil de vârstă mică, fără antecedente personale patologice semnificative, cu condiţii de viaţă adecvate, fără factori de risc asociaţi şi fără infecţie cu Helicobacter pylori.

Cuvinte cheie: „kissing-ulcer“, copil, hemoragie digestivă superioară

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“KISSING-ULCER” – ONSET WITH COMPLICATIONS IN SMALL AGE

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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“KISSING-ULCER” – ONSET WITH COMPLICATIONS IN SMALL AGE

, , , and

ABSTRACT

Ulcer disease is a pathology with low incidence in pediatric population, with an unspecific symptomatology or even absent, thus leading to the development of complications. We present the case of 2 years and 10 monthold male patient, admitted in the regional hospital with the diagnosis of febrile acute gastroenteritis, who in evolution (after 5 days) associated digestive hemorrhage, thus being transferred in the Pediatrics Clinic I, Targu-Mures. The superior digestive endoscopy performed after the hemodynamic and metabolic re-equilibration, pointed out 2 ulcers in the duodenal mucosa, one with active bleeding. The treatment with proton pump inhibitors and the adequate diet initiated determined the patient’s favorable evolution. The particularity of the case consists in the appearance of 2 duodenal ulcers of the duodenal mucosa in a small child, without significant personal history, with adequate life conditions, without associated risk factors and without infection with Helicobacter pylori.

Keywords: “kissing-ulcer”, child, superior digestive hemorrhage

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