RESUMEN
A one-year-old girl visited the hospital due to limb torsion and developmental regression for one month after hand, foot and mouth disease. At the age of 11 months, she visited a local hospital due to fever for 5 days and skin rash with frequent convulsions for 2 days and was diagnosed with severe hand, foot and mouth disease, viral encephalitis, and status epilepticus. Brain MRI revealed symmetric abnormal signals in the bilateral basal ganglia, bilateral thalamus, cerebral peduncle, bilateral cortex, and hippocampus. She was given immunoglobulin, antiviral drugs, and anticonvulsant drugs for 2 weeks, and the effect was poor. Blood and urine screening for inherited metabolic diseases were performed to clarify the etiology. The analysis of urine organic acids showed significant increases in glutaric acid and 3-hydroxyglutaric acid, which suggested glutaric aciduria type 1, but her blood glutarylcarnitine was normal, and free carnitine significantly decreased. After the treatment with low-lysine diets, L-carnitine, and baclofen for 1 month, the patient showed a significant improvement in symptoms. Hand, foot and mouth disease is a common viral infectious disease in children, and children with underlying diseases such as inherited metabolic diseases and immunodeficiency may experience serious complications. For children with hand, foot and mouth disease and unexplained encephalopathy, inherited metabolic diseases should be considered.
Asunto(s)
Discapacidades del Desarrollo/etiología , Enfermedad de Boca, Mano y Pie/complicaciones , Anomalía Torsional/etiología , Errores Innatos del Metabolismo de los Aminoácidos/etiología , Encefalopatías Metabólicas/etiología , Femenino , Glutaril-CoA Deshidrogenasa/deficiencia , Humanos , LactanteAsunto(s)
Ataxia Cerebelosa/cirugía , Enfermedades Cerebelosas/cirugía , Encefalocele/cirugía , Hueso Petroso/cirugía , Complicaciones Posoperatorias/cirugía , Prótesis e Implantes , Anomalía Torsional/cirugía , Temblor/cirugía , Grasa Abdominal/trasplante , Adulto , Ataxia Cerebelosa/etiología , Enfermedades Cerebelosas/etiología , Vías Eferentes/fisiopatología , Encefalocele/etiología , Parálisis Facial/etiología , Ataxia de la Marcha/etiología , Ataxia de la Marcha/cirugía , Tumor del Glomo Yugular/cirugía , Perdida Auditiva Conductiva-Sensorineural Mixta/etiología , Humanos , Masculino , Hueso Petroso/patología , Polimetil Metacrilato , Puente/patología , Complicaciones Posoperatorias/etiología , Recuperación de la Función , Anomalía Torsional/etiología , Trasplante Autólogo , Trasplante Heterotópico , Temblor/etiologíaRESUMEN
Middle lobe torsion after right upper lobectomy is a rare but serious complication. Simple lobar shift may also lead to a bronchial plication, causing iterative pneumopathies. The preventive fixation of middle lobe to lower lobe is indicated to avoid these complications in case of complete major fissure. We performed this fixation, by using a resorbable anti-adhesive membrane, usually indicated in preventing postoperative pleural adhesion. This procedure is simple, effective, quick, and easy to perform without any risk of air leaks.