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2.
Medicine (Baltimore) ; 102(43): e35776, 2023 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-37904468

RESUMO

RATIONALE: The manuscript aimed to show that an unmeasurable capillary C-reactive protein (CRP) should be a red flag that can indicate a possible severe hematological pathology. PATIENTS CONCERNS AND DIAGNOSES: The authors present 3 case reports of children with fever examined at the pediatric emergency department. Fever is among the most frequently exhibited symptoms of acute pediatric infectious diseases. However, sometimes fever can be the manifestation of other serious noninfectious diseases. CRP is a marker widely used in clinical pediatric practice to help us evaluate inflammation and possible bacterial infection. All mentioned patients had unmeasurable CRP from capillary blood, even though venous CRP ranged from 14 to 21 mg/L. All of the patients were consequently diagnosed with severe hemato-oncological disease. Possible explanations are that a change in blood viscosity or an elevation of circulating immune complexes in the blood of patients with leukemia leads to malfunctioning immunoturbidimetry measurement. LESSON: Although these findings are very interesting and could lead to faster recognition of acute leukemia in pediatric clinical practice, further prospective study is needed for their confirmation.


Assuntos
Infecções Bacterianas , Leucemia , Criança , Humanos , Proteína C-Reativa/análise , Infecções Bacterianas/diagnóstico , Febre/etiologia , Leucemia/complicações , Estudos Prospectivos
3.
J Pediatr Hematol Oncol ; 45(8): e1010-e1013, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37703450

RESUMO

Paroxysmal cold hemoglobinuria (PCH) is a rare condition in childhood characterized by complement-mediated premature destruction of red blood cells. PCH is associated with intravascular hemolysis causing hemoglobinuria, which may result in acute kidney injury of various severity. We aimed to retrospectively analyze clinical and laboratory features of children with PCH-associated acute kidney injury received at tertiary Pediatric Hematology and Nephrology Center, University Motol Hospital, Prague, Czech Republic during the period 2016 to 2022. We present here 3 children with PCH-associated acute kidney failure requiring renal replacement therapy. We highlight the association of PCH with kidney disease. Renal parameters and urine examination should be regularly tested in all children with PCH.


Assuntos
Injúria Renal Aguda , Hemoglobinúria Paroxística , Humanos , Criança , Hemoglobinúria Paroxística/complicações , Hemoglobinúria Paroxística/diagnóstico , Estudos Retrospectivos , Eritrócitos , Injúria Renal Aguda/complicações , Hemólise , Temperatura Baixa
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