Quistes del rafe medio escrotal / Median raphe cyst of the scrotum

Los quistes del rafe medio escrotal son lesiones producidas por un defecto de cierre del rafe durante la embriogénesis. A pesar de tratarse de alteraciones congénitas, su curso silente determina su diagnóstico infrecuente durante la infancia y, por tanto, su desconocimiento por gran parte de los pediatras que, en ocasiones, los confunden con otras lesiones de origen quístico, tumoral o infeccioso. Debido a su naturaleza benigna y su carácter silente, no precisan ningún tratamiento. En los casos en que produzcan sintomatología, generalmente desencadenada por traumatismos o infecciones, es recomendable la exéresis quirúrgica de los quistes. Con el objetivo de facilitar el diagnóstico y el manejo de dichas lesiones, presentamos el caso de un varón que a los 8 meses de vida presentaba tres lesiones en el rafe medio escrotal, compatibles con quistes del rafe medio, uno de los cuales se complicó 5 años más tarde con la formación de un absceso(AU)

The scrotal median raphe cysts are injuries produced because of a default in the process of fusion of the raphe during embryogenesis. Despite of being congenital anomalies, its silent progress makes its diagnosis infrequent during childhood and, therefore, the ignorance of a lot of pediatricians who sometimes mistake these anomalies with others cystic, tumor or infectious damages. Because of its benign nature and that they are usually asymptomatic, it isn’t necessary any treatment. In symptomatic cases, usually produced because of trauma or infection, it is advisable to remove the cysts. In order to facilitate the diagnosis and management of these lesions, we present the case of an 8 months old male who had three injuries in median raphe of the scrotum consistent with median raphe cysts, one of which complicated five years later with the formation of an abscess(AU)

Intoxicación por vitamina D en hijos de inmigrantes latinoamericanos. Serie de 3 casos / Vitamin D intoxication in infants born from Latin-American immigrants. Series of 3 cases

La intoxicación por vitamina D es una causa bien conocida de hipercalcemia infantily puede tener serias consecuencias (renales, cardiacas y neurológicas fundamentalmente). El empleo de suplementos nutricionales enriquecidos con vitaminas, de venta sin receta, conlleva un importante riesgo de que esto ocurra. La clínica de la hipercalcemia es inespecífica y, unida al hecho de que con frecuencia se niega la ingesta de dichos suplementos, el diagnóstico de intoxicación por vitamina D se demora y el número de pruebas complementarias realizadas es amplio. Exponemos una serie de 3 casos de hijos de inmigrantes latinoamericanos que estaban recibiendo suplementos nutricionales traídos de los países de origen de sus padres. Los 3 se presentaron en nuestro centro en un intervalo de 5 meses. Tras el antecedente de un primer caso, el diagnóstico de los 2 siguientes fue más rápido, así como la instauración del tratamiento para la hipercalcemia. Los niveles iniciales de calcio y 25-hidroxivitamina D fueron, respectivamente, para cada caso: 17,9 mg/dl y 504 ng/ml, 14,46 mg/dl y 505 ng/ml, y 14,2 mg/dl y530 ng/ml. Recibieron tratamiento con sueroterapia, furosemida y corticoides, y en uno de los casos con calcitonina subcutánea. La evolución clínica de todos ellos fue óptima, normalizándosela calcemia y la función renal (AU)

Vitamin D intoxication is a well-known cause of hypercalcemia in children and can have serious consequences (renal, cardiac and neurologic mainly). The use of the so-called over the-counter (OTC) supplements involves a high risk in this taking place. The clinical expression of hypercalcaemia is unspecific, and, together with the fact that the administration of such supplements is frequently denied, the diagnosis of vitamin D intoxication is often delayed and the number of complementary tests performed is high. We here-for expose a series of 3 cases all of which are infants born from Latin-American immigrants who were receiving supplements that came from their parents originary countries. All 3 cases were admitted in our hospital within a period of 5 months. After the first preceding case, the diagnosis of the 2 latter ones was performed promptly and so was the instauration of the treatment for hypercalcemia. The initial levels of serum calcium and of 25-hydroxy vitamin D where, respectively for each case: 17.9 mg/dl and 504 ng/ml; 14.46 mg/dl and 505 ng/ml; 14.2 mg/dl and 530 ng/ml. All 3 patients received intravenous treatment with serum, furosemide and corticoids and in one case with subcutaneous calcitonine as well. The clinical outcome was optimal for them all, with normalization of the calcium levels and of the renal function (AU)

[Vitamin D intoxication in infants born from Latin-American immigrants. Series of 3 cases]. / Intoxicación por vitamina D en hijos de inmigrantes latinoamericanos. Serie de 3 casos.

Vitamin D intoxication is a well-known cause of hypercalcemia in children and can have serious consequences (renal, cardiac and neurologic mainly). The use of the so-called over-the-counter (OTC) supplements involves a high risk in this taking place. The clinical expression of hypercalcaemia is unspecific, and, together with the fact that the administration of such supplements is frequently denied, the diagnosis of vitamin D intoxication is often delayed and the number of complementary tests performed is high. We here-for expose a series of 3 cases all of which are infants born from Latin-American immigrants who were receiving supplements that came from their parents originary countries. All 3 cases were admitted in our hospital within a period of 5 months. After the first preceding case, the diagnosis of the 2 latter ones was performed promptly and so was the instauration of the treatment for hypercalcemia. The initial levels of serum calcium and of 25-hydroxy vitamin D where, respectively for each case: 17.9 mg/dl and 504 ng/ml; 14.46 mg/dl and 505 ng/ml; 14.2mg/dl and 530 ng/ml. All 3 patients received intravenous treatment with serum, furosemide and corticoids and in one case with subcutaneous calcitonine as well. The clinical outcome was optimal for them all, with normalization of the calcium levels and of the renal function.