BACKGROUND: A 16-year-old white male with a history of obstructive uropathy presented to a pediatric outpatient clinic with a first syncope. At presentation, he had a hemoglobin level of 220 g/l, a serum erythropoietin level of 27.4 U/l and a serum creatinine level of 200.7 micromol/l (2.27 mg/dl). INVESTIGATIONS: Physical examination, serum laboratory analysis, renal ultrasound, MRI, and 99mTc-MAG3 scintigraphy of the kidneys. DIAGNOSIS: Chronic renal insufficiency caused by obstructive hydronephrosis and accompanied by increased erythropoietin levels of renal origin and polycythemia. MANAGEMENT: Serial phlebotomies and laparoscopic removal of the right hydronephrotic kidney.
Erythropoietin/blood , Kidney Failure, Chronic/complications , Polycythemia/etiology , Adolescent , Biomarkers/blood , Follow-Up Studies , Hemoglobins/metabolism , Humans , Kidney Failure, Chronic/diagnosis , Kidney Failure, Chronic/surgery , Magnetic Resonance Imaging , Male , Nephrectomy , Polycythemia/blood , Severity of Illness Index
OBJECTIVE: To present an unpublished reason for an arrhythmic electrocardiogram (ECG) recording during kangaroo care in a preterm infant. DESIGN: Case report. PATIENT: Preterm infant. MEASUREMENTS AND MAIN RESULTS: A preterm infant exhibited cardiac arrhythmia on the ECG monitor during kangaroo care, leading to interruption of kangarooing. Arrhythmia disappeared after placing the baby back into the incubator. The most likely reasons for arrhythmia were excluded. However, arrhythmia reappeared upon continuation of kangaroo care. ECG monitoring revealed the reason for the monitoring error. CONCLUSIONS: ECG monitoring during kangaroo care should cause error because of superimposed electric activity from the parent. Oxygen saturation represents a more reliable method of monitoring during kangaroo care.
Cardiac Complexes, Premature/diagnosis , Electrocardiography , Infant Care , Infant, Premature , Cardiac Complexes, Premature/drug therapy , Follow-Up Studies , Humans , Infant, Newborn , Intensive Care Units, Neonatal , Male , Monitoring, Physiologic , Mother-Child Relations , Oxygen Consumption/physiology , Respiration, Artificial , Risk Assessment , Severity of Illness Index
