RESUMO
Central precocious puberty (CPP) is fairly common in girls. In most girls, the etiology for the CPP is unknown. Among the more rare causes of CPP in girls are central nervous system tumors and hamartomas. Osteolipoma of the tuber cinereum, which is the most commonly diagnosed at autopsy, has been reported as a cause of CPP. We describe an 8-year-old girl with central precocious puberty in whom MRI demonstrated a lesion compatible with osteolipoma. Her symptom was breast development that begun at age 7 years and 9 months. Her case history, laboratory studies and imaging are presented. Her puberty was rapidly progressive. She was treated successfully with a GnRHa (Triptorelin 3.75 mg IM q 4 weeks). Her case brings to the forefront the need to perform an MRI in children with rapidly progressing puberty.
Assuntos
Neoplasias Hipotalâmicas/diagnóstico , Lipoma/diagnóstico , Puberdade Precoce/diagnóstico , Túber Cinéreo/patologia , Neoplasias das Glândulas Suprarrenais/diagnóstico , Algoritmos , Criança , Diagnóstico Diferencial , Feminino , Displasia Fibrosa Óssea/diagnóstico , Hormônio Liberador de Gonadotropina/análogos & derivados , Hormônio Liberador de Gonadotropina/uso terapêutico , Humanos , Neoplasias Hipotalâmicas/complicações , Neoplasias Hipotalâmicas/tratamento farmacológico , Lipoma/complicações , Lipoma/tratamento farmacológico , Imageamento por Ressonância Magnética , Cistos Ovarianos/diagnóstico , Neoplasias Ovarianas/diagnóstico , Puberdade Precoce/tratamento farmacológico , Puberdade Precoce/etiologia , Resultado do TratamentoRESUMO
Exhaled nitric oxide has become a new diagnostic tool in pediatric daily practice. It provides valuable information on the nature of the underlying inflammation, being useful to establish the diagnosis and to differentiate which patients could benefit more from the anti-inflammatory treatment. As well, it can be useful in predicting asthmatic exacerbations and be used as a guide to make therapeutic modifications. Taking everything to account, the pediatrician has to know its interpretation and its applications. This manuscript reviews the main applications of exhaled nitric oxide in pediatric asthma.
Assuntos
Asma/diagnóstico , Óxido Nítrico/análise , Algoritmos , Asma/metabolismo , Testes Respiratórios , Criança , Humanos , Óxido Nítrico/metabolismo , Valores de ReferênciaRESUMO
El óxido nítrico exhalado se ha convertido en una nueva arma diagnóstica en la práctica clínicadiaria en pediatría. En este sentido, la medición del óxido nítrico proporciona una valiosa información acerca de la naturaleza de la inflamaciónsubyacente; puede tener utilidad tantopara el diagnóstico de asma como para distinguir qué pacientes se pueden beneficiar más del tratamiento antiinflamatorio. Además, puede serútil en la predicción de exacerbaciones y como guía para efectuar modificaciones terapéuticas.Por todo ello, el pediatra debe conocer su interpretación y aplicaciones. Este artículo revisa sus principales aplicaciones en el asma pediátrico.
Exhaled nitric oxide has become a new diagnostic tool in pediatric daily practice. It provides valuable information on the nature of the underlying inflammation, being useful to establish the diagnosis and to differentiate which patients could benefitmore from the anti-inflammatory treatment. As well, it can be useful in predicting asthmatic exacerbations and be used as a guide to make therapeutic modifications. Taking everything toaccount, the pediatrician has to know its interpretation and its applications. This manuscript reviews the main applications of exhaled nitric oxide in pediatric asthma.
