RESUMEN
An 11-year-old girl experienced an episode of near-drowning. She was immediately rescued and was defibrillated. Transthoracic echocardiography and coronary computed tomographic angiography confirmed the diagnosis of anomalous left coronary artery from the pulmonary artery (ALCAPA). We report a rare description of this congenital coronary anomaly in a child, revealed after exercise-induced sudden cardiac arrest while swimming.
Asunto(s)
Síndrome de Bland White Garland/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Angiografía Coronaria , Ecocardiografía , Paro Cardíaco/etiología , Ahogamiento Inminente/etiología , Síndrome de Bland White Garland/complicaciones , Niño , Vasos Coronarios/diagnóstico por imagen , Femenino , Humanos , Arteria Pulmonar/anomalías , Arteria Pulmonar/diagnóstico por imagen , NataciónRESUMEN
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect often presenting with neonatal jaundice and/or hemolytic anemia. G6PD hemolytic events are linked with exposure to a pro-oxidant agent. We here report three cases of initial G6PD crises in breastfed children secondary to maternal consumption of a tonic drink which contains quinine. Quinine was found in breast milk of one of the mothers after she consumed tonic water. CONCLUSION: The amount of quinine that is transmitted through breast milk appears to be sufficient to induce G6PD crises in breastfed children. We hence recommend that consumption of quinine-containing sodas during breastfeeding should be avoided in populations with a high prevalence of G6PD deficiency. What is Known: ⢠G6PD hemolytic events are linked with exposure to a pro-oxidant agent. ⢠Ingestion of fava beans by a mother who was breastfeeding has been reported to induce a neonatal G6PD crisis. What is New: ⢠Maternal consumption of tonic drink which contains quinine appears to be sufficient to induce G6PD crises in breastfed children. ⢠Maternal consumption of quinine-containing sodas during breastfeeding should be avoided in populations with a high prevalence of G6PD deficiency.