RESUMO
Although surgery is the standard treatment for native coarctation in neonates, it carries a high risk of complications. Percutaneous balloon angioplasty may be considered as an alternative treatment. The materials used in the intervention should be selected carefully to reduce complications. We recommended the use of non-compliant balloons in risky babies. They are more effective in the treatment of strick stenosis than compliant balloons.
Assuntos
Angioplastia com Balão , Coartação Aórtica , Coartação Aórtica/diagnóstico por imagem , Coartação Aórtica/cirurgia , Seguimentos , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Recidiva , Estudos RetrospectivosRESUMO
Diazoxide is the main therapeutic agent for persistent hyperinsulinemic hypoglycemia. Generally, it is tolerated well, but rarely it can cause severe life-threatening complications. We report a neonate who was treated with diazoxide for hyperinsulinemic hypoglycemia. On the 6th day of the treatment we observed sepsis-mimicking symptoms, mild pulmonary hypertension, and re-opening of the ductus arteriosus. All these findings resolved dramatically shortly after discontinuation of treatment. To our knowledge, this is the first reported case of re-opening of the ductus arteriosus due to diazoxide toxicity.
Assuntos
Diazóxido/efeitos adversos , Permeabilidade do Canal Arterial/induzido quimicamente , Hipertensão Pulmonar/induzido quimicamente , Diagnóstico Diferencial , Diazóxido/uso terapêutico , Humanos , Hiperinsulinismo/tratamento farmacológico , Hiperinsulinismo/fisiopatologia , Hipoglicemia/etiologia , Hipoglicemiantes/efeitos adversos , Hipoglicemiantes/uso terapêutico , Recém-Nascido , Masculino , Recidiva , Sepse/diagnóstico , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported.