RESUMO
Hypercalcemia is an infrecuent complication in pediatric oncology, with an incidence between 0,5 and 3 percent. It can occur at diagnosis, during the disease course or at relapse, and it is resolved by treating the underlying pathology, requiring in some cases the use of specific therapy such as calcitonin and biphosphonates. This article presents 3 cases of children with cancer and hypercalcemia during their illness, analyzing its clinical presentation, pathophysiology and treatment.
La hipercalcemia es una complicación infrecuente en niños con cáncer, con una incidencia que oscila entre 0,5 y 3 por ciento. Se puede presentar al diagnóstico, durante el tratamiento o en la recaída de una neoplasia, se resuelve al tratar la enfermedad de base, pudiendo además, requerir el uso de terapia específica como calcitonina y bifosfonatos. En el presente artículo se revisan 3 casos clínicos de niños con cáncer que presentaron hipercalcemia en algún momento de su enfermedad, se discute su forma de presentación, fisiopatología y manejo.
Assuntos
Humanos , Masculino , Feminino , Criança , Hipercalcemia/etiologia , Neoplasias/complicações , Síndromes Paraneoplásicas , Diagnóstico Diferencial , Hipercalcemia/fisiopatologia , Hipercalcemia/terapia , Oncologia , PediatriaRESUMO
Acute retinal necrosis (ARN) is a serious condition that can impair vision. It mostly occurs in adult patients, especially those severely immunocompromised, in association with a reactivation of a herpes virus infection. We present a 4 years old patient with high risk acute leukemia, whom during a course of intense chemotherapy acquired chickenpox with visceral involvement that affected the retina, causing unilateral blindness. Varicella-zoster virus was detected by PCR in the vitreous humor, in spite of previous acyclovir treatment. The contralateral vision remained undamaged.
Assuntos
Varicela/complicações , Hospedeiro Imunocomprometido , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/virologia , Antivirais/uso terapêutico , Varicela/diagnóstico , Varicela/tratamento farmacológico , Pré-Escolar , Humanos , Masculino , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológicoRESUMO
La necrosis retinal aguda (NRA) es una afección grave que amenaza la visión. Se describe en adultos, en especial aquellos profundamente inmunocompro-metidos, como consecuencia de la reactivación de virus del grupo herpes. Presentamos un paciente de 4 años de edad, con una leucemia de alto riesgo, que durante una quimioterapia intensa desarrolló una varicela con compromiso visceral, incluyendo la retina, lo que le causó ceguera unilateral. En el humor vitreo se detectó ADN de virus varicela-zoster, pese al tratamiento con aciclovir. La visión del ojo contralateral permaneció indemne.
Acute retinal necrosis (ARN) is a serious condition that can impair vision. It mostly occurs in adult patients, especially those severely immunocompromised, in association with a reactivation of a herpes virus infection. We present a 4 years old patient with high risk acute leukemia, whom during a course of intense chemotherapy acquired chickenpox with visceral involvement that affected the retina, causing unilateral blindness. Varicella-zoster virus was detected by PCR in the vitreous humor, in spite of previous acyclovir treatment. The contralateral vision remained undamaged.
