ABSTRACT
An 8-month-old girl with a history of asphyxia and respiratory distress immediately after birth was hospitalized at her fourth month of age with the diagnosis of kidney infection and it was revealed that she had a unilateral multicystic dysplastic kidney. In recent admission, she presented to emergency room with fever, hyperpnea, and apnea. In appearance, she was a hypotonic girl with broad forehead, hypertelorism, depressed nasal bridge and bitemporal regions, rapid vertical and horizontal nystagmus, and open mouth with salivation. In spite of normal physical growth, she had delayed developmental milestones. Blood gas O 2 saturation dropped after she received phenobarbital. Her urinary and blood tests were normal; however, her cranial magnetic resonance imaging (MRI) revealed vermis agenesis and molar tooth sign. These physical and para-clinical findings suggested Joubert syndrome.
Subject(s)
Apnea/etiology , Cerebellar Diseases/diagnosis , Eye Abnormalities/diagnosis , Kidney Diseases, Cystic/diagnosis , Multicystic Dysplastic Kidney/etiology , Muscle Hypotonia/etiology , Abnormalities, Multiple , Cerebellar Diseases/complications , Cerebellum/abnormalities , Eye Abnormalities/complications , Female , Humans , Infant , Kidney Diseases, Cystic/complications , Magnetic Resonance Imaging , Retina/abnormalitiesABSTRACT
OBJECTIVE: To determine catheter-associated thrombosis by color Doppler ultrasound and to detect duration of catheter placement as a risk factor for thrombosis. METHODS: All newborn infants with umbilical vascular catheterization for more than 6 h duration were included in this study. Color Doppler ultrasound examination was performed within 24-48 h of catheter insertion, 48-72 h after its withdrawal and weekly until hospital discharge or clot resolution. RESULTS: Portal vein thrombosis (PVT) was determined in five cases (3.04%) of 164 infants received umbilical vascular catheterization. The mean duration of catheter placement in patients with PVT was 3.4 ± 1.94 days, which was not significantly different from infants without thrombosis (3.5 ± 2.03). Thrombosis was completely recanalized and resolved after 3-6 weeks in three survived neonates. There was history of exchange transfusion for hyperbilirubinemia via umbilical vein in two neonates with PVT. CONCLUSIONS: Catheter-associated portal venous thrombosis was uncommon in our study. The duration of catheter placement was not longer in patients with portal vein thrombosis than those without thrombosis.