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Lorena Elena Melit

Latest posts by Lorena Elena Melit (see all)

  • HEMIHIPERTROFIA IZOLATA LA SUGAR - 23/02/2017
  • ISOLATED HEMIHYPERTROPHY IN CHILD - 23/02/2017
  • METAPLAZIA PANCREATICA A MUCOASEI GASTRICE LA COPIL - 03/11/2016

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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National Awards “Science and Research”

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HEMIHIPERTROFIA IZOLATA LA SUGAR

Lorena Elena Melit, Cristina Oana Mărginean, Claudia Bănescu, Raluca Damian, Andreea Dinca and Claudiu Mărginean

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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Lorena Elena Melit

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”

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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ISOLATED HEMIHYPERTROPHY IN CHILD

Lorena Elena Melit, Cristina Oana Mărginean, Claudia Bănescu, Raluca Damian, Andreea Dinca and Claudiu Mărginean

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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Lorena Elena Melit

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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HIGHLIGHTS

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

Cristina Oana Mărginean, Lorena Elena Melit, Maria Oana Marginean, Nicoleta Suciu, Raluca Damian and Simona Mocan

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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Cristina Oana Mărginean

PANCREATIC METAPLASIA OF THE GASTRIC MUCOSA IN CHILD

SELECT ISSUE

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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HIGHLIGHTS

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

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

Promoting Global Health

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PANCREATIC METAPLASIA OF THE GASTRIC MUCOSA IN CHILD

Cristina Oana Mărginean, Lorena Elena Melit, Maria Oana Marginean, Nicoleta Suciu, Raluca Damian and Simona Mocan

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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Cristina Oana Mărginean

„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”

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“ – DEBUT CU COMPLICATII LA VARSTA MICA

Andreea Dinca, Cristina Oana Mărginean, Lorena Elena Melit, Maria Oana Marginean and Raluca Damian

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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Andreea Dinca

“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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HIGHLIGHTS

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

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” – ONSET WITH COMPLICATIONS IN SMALL AGE

Lorena Elena Melit, Cristina Oana Mărginean, Raluca Damian, Maria Oana Marginean and Andreea Dinca

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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Lorena Elena Melit

GASTROENTERITA ACUTA CU CLOSTRIDIUM DIFFICILE LA UN COPIL MIC CU INTOLERANTA EREDITARA LA LACTOZA

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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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GASTROENTERITA ACUTA CU CLOSTRIDIUM DIFFICILE LA UN COPIL MIC CU INTOLERANTA EREDITARA LA LACTOZA

Andreea Dinca, Cristina Oana Mărginean, Lorena Elena Melit, Maria Oana Marginean and Raluca Damian

REZUMAT

Acute gastroenteritis with Clostridium difficile is insufficiently studied in the specialty literature due to its small incidence at this age, with increased rates of morbidity and mortality. We present the case of a 1 year and 10 month-old child, diagnosed with hereditary lactose intolerance in the neonatal period, admitted in the Pediatrics Clinic I, Targu-Mures, for vomiting, loss of appetite, decreased consistency stools, with a bed smell, with bacterial infection signs in the blood tests and slowly favorable evolution under treatment with cephalosporin. The patient is readmitted after 1 day from discharge with the reappearance of bad smell stools and loss of appetite, with unfavorable evolution after administering a 3rd generation cephalosporin, thus we raise the suspicion of infection with Clostridium difficile, confirmed by the identification of toxins in the stools, with favorable evolution under treatment for anaerobe germs (metronidazole). The particularity of the case consists in the development of a gastroenteritis with Clostridium difficile in a small child (1 year and 10 months), known with retardation in the neuro-psychomotor and language development, repeated episodes of hypoglycemia, with hereditary lactose intolerance which represented a challenge in establishing the diagnosis.

Cuvinte cheie: Clostridium difficile, child, gastroenteritis, hereditary lactose intolerance

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Andreea Dinca

ACUTE GASTROENTERITIS WITH CLOSTRIDIUM DIFFICILE IN A SMALL CHILD WITH HEREDITARY LACTOSE INTOLERANCE

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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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HIGHLIGHTS

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

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

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

ACUTE GASTROENTERITIS WITH CLOSTRIDIUM DIFFICILE IN A SMALL CHILD WITH HEREDITARY LACTOSE INTOLERANCE

Andreea Dinca, Cristina Oana Mărginean, Lorena Elena Melit, Maria Oana Marginean and Raluca Damian

ABSTRACT

Acute gastroenteritis with Clostridium difficile is insufficiently studied in the specialty literature due to its small incidence at this age, with increased rates of morbidity and mortality. We present the case of a 1 year and 10 month-old child, diagnosed with hereditary lactose intolerance in the neonatal period, admitted in the Pediatrics Clinic I, Targu-Mures, for vomiting, loss of appetite, decreased consistency stools, with a bed smell, with bacterial infection signs in the blood tests and slowly favorable evolution under treatment with cephalosporin. The patient is readmitted after 1 day from discharge with the reappearance of bad smell stools and loss of appetite, with unfavorable evolution after administering a 3rd generation cephalosporin, thus we raise the suspicion of infection with Clostridium difficile, confirmed by the identification of toxins in the stools, with favorable evolution under treatment for anaerobe germs (metronidazole). The particularity of the case consists in the development of a gastroenteritis with Clostridium difficile in a small child (1 year and 10 months), known with retardation in the neuro-psychomotor and language development, repeated episodes of hypoglycemia, with hereditary lactose intolerance which represented a challenge in establishing the diagnosis.

Keywords: Clostridium difficile, child, gastroenteritis, hereditary lactose intolerance

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Andreea Dinca

POSIBILITATI SI LIMITE DE TERAPIE INTR-UN CAZ DE SINDROM ADRENOGENITAL

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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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HIGHLIGHTS

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

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

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

POSIBILITATI SI LIMITE DE TERAPIE INTR-UN CAZ DE SINDROM ADRENOGENITAL

Alexandra Latcu, Alina Grama, Lenuţa Popa, Lorena Elena Melit, Mihaela Chincesan and Oana Marginean

REZUMAT

Introducere. Sindromul adrenogenital cu debut neonatal se poate manifesta prin vărsături repetate, deshidratare şi dezechilibru hidro-electrolitic sever. Abordarea diagnostică, reechilibrarea metabolică şi menţinerea balanţei electrolitice în limite normale prin tratament cronic pot fi însoţite de dificultăţi.
Obiectiv. Este prezentat un caz de sindrom adrenogenital cu debut neonatal sever, evoluţie însoţită de diferite complicaţii, dar cu prognostic ameliorat de tratament cronic adecvat.
Material şi metodă. Copil de sex masculin, cu greutate mică la naştere, s-a internat în Clinica Pediatrie I, Târgu-Mureş la vârsta de 3 săptămâni, cu un sindrom clinico-biologic sever prin vărsături cronice şi deshidratare severă şi aparentă macrogenitososmie. S-a efectuat o paletă largă de investigaţii în puseu acut, dar şi ulterior pentru elaborarea diagnosticului diferenţial.
Rezultate. S-au evidenţiat hiponatremie şi hipokaliemie persistente, o valoare crescută a 17-OH progesteron (44,96 ng/ml) şi cortizol sub limita normală (3 ug/dl). S-au înregistrat concentraţii semnificativ crescute ale ACTH (103 pg/ml matinal) şi testosteronului seric total (186,72 ng/dl). Analiza moleculară a evidenţiat genotipul heterozigot pentru următoarele mutaţii: 12G, R356W, P453S. Tratamentul cronic cortizonic adecvat a ameliorat prognosticul; la vârsta de 1,5 ani prezenta o dezvoltare staturo-ponderală şi psiho-motorie adecvată.
Concluzii. Au fost întrunite condiţiile diagnosticului de sindrom adrenogenital cu debut neonatal la un heterozigot. Vârsta mică şi simptomatologia necaracteristică pot îngreuna stabilirea unui diagnostic precoce în sindromul adrenogenital.

Cuvinte cheie: vărsături, nou-născut, hiponatremie

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Alexandra Latcu

POSSIBILITIES AND THERAPY LIMITATIONS IN A CASE OF ADRENOGENITAL SYNDROME

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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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HIGHLIGHTS

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

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

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

POSSIBILITIES AND THERAPY LIMITATIONS IN A CASE OF ADRENOGENITAL SYNDROME

Alexandra Latcu, Alina Grama, Lenuţa Popa, Lorena Elena Melit, Mihaela Chincesan and Oana Marginean

ABSTRACT

Introduction. The adrenogenital syndrome with neonatal onset can manifest by repeated vomiting, dehydration and severe hydro-electrolytic disequilibria. The diagnostic approach, the metabolic reequilibration and the maintenance of the electrolytic balance in normal ranges by chronic treatment can be associated with difficulties.
Objective. We present a case of adrenogenital syndrome with severe neonatal onset, evolution accompanied by different complications, but with a prognosis improved by the adequate chronic treatment.
Material and method. A male child with small birth weight, was admitted in the Pediatrcs Clinic I, Targu-Mures, at the age of 3 weeks, with a severe clinic-biological syndrome by chronic vomiting and severe dehydration, and apparent macrogenitosomia. We performed a wide spectrum of investigations in acute phase, but also afterwards for the elaboration of the differential diagnosis.
Results. We identified persistent hyponatremia and hypopotassemia, an increased level of 17-OH progesterone (44.96 ng/ml) and the cortisol under the normal limit (3 ug/dl). We discovered significantly increased concentrations of ACTH (103 pg/ml in the morning) and total serum cholesterol (186.72 ng/dl). The macromolecular analysis pointed out the heterozygote genotype for the following mutations: 12G, R356W, P453S. The adequate chronic treatment with cortisone improved the prognosis; at the age of 1 years and 5 months, he presents an adequate height, weight and psychomotor development.
Conclusions. We fulfilled the conditions of the diagnosis of adrenogenital syndrome with neonatal onset in a heterozygote child. The small age the uncharacteristic symptomatology can be a burden for establishing an early diagnosis of adrenogenital syndrome.

Keywords: vomiting, newborn, hyponatremia

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Alexandra Latcu

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