RESUMO
This is a case of an 11-year-old female who was admitted with respiratory failure, requiring intubation while testing positive for SARS-CoV-2. During her recovery, she had new onset fevers and uptrending inflammatory markers. After an evaluation of infectious causes, the diagnosis of MIS-C was made approximately 1 month after her initial symptoms.
Assuntos
Infecções por Coronavirus/fisiopatologia , Pneumonia Viral/fisiopatologia , Síndrome do Desconforto Respiratório/virologia , Síndrome de Resposta Inflamatória Sistêmica/virologia , Betacoronavirus/isolamento & purificação , COVID-19 , Criança , Infecções por Coronavirus/terapia , Feminino , Febre/virologia , Humanos , Pandemias , Pneumonia Viral/terapia , Síndrome do Desconforto Respiratório/fisiopatologia , Síndrome do Desconforto Respiratório/terapia , Insuficiência Respiratória/virologia , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica/fisiopatologia , Síndrome de Resposta Inflamatória Sistêmica/terapiaAssuntos
Anemia/etiologia , Deficiência de Glucosefosfato Desidrogenase/complicações , Deficiência de Glucosefosfato Desidrogenase/diagnóstico , Hipóxia/etiologia , Icterícia/etiologia , Dor Abdominal/etiologia , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Ácido Ascórbico/farmacologia , Ácido Ascórbico/uso terapêutico , Pré-Escolar , Tosse/etiologia , Citocromo-B(5) Redutase/farmacologia , Citocromo-B(5) Redutase/uso terapêutico , Diagnóstico Diferencial , Serviço Hospitalar de Emergência/organização & administração , Cefaleia/etiologia , Humanos , Unidades de Terapia Intensiva/organização & administração , Masculino , Metemoglobinemia/etiologia , Azul de Metileno/farmacologia , Azul de Metileno/uso terapêutico , Marrocos/etnologia , Oxigenoterapia/métodos , Estados Unidos , Vicia faba/efeitos adversosRESUMO
Increased blood pressure variability (BPV) is correlated with adverse cardiovascular (CV) events in adults. However, there has been limited research on its effect in the pediatric population. Additionally, BPV differences between primary and secondary hypertension (HTN) are not known. Children with primary and secondary HTN underwent 24-hour ambulatory blood pressure monitoring and echocardiography studies. BPV measures of standard deviation (SD), average real variability (ARV), and range were calculated for the 24-hour, daytime, and nighttime periods. Seventy-four patients (median age, 13.5 years; 74% boys) were examined, 40 of whom had primary HTN. Body mass index z score and age were independent predictors of systolic ARV (R(2) =0.14) and SD (R(2) =0.39). There were no statistically significant differences in overall or wake period BPV measures between secondary or primary HTN groups, but sleep period diastolic SD was significantly greater in the secondary HTN group (9.26±3.8 vs 7.1±2.8, P=.039). On multiple regression analysis, secondary HTN was associated with increased sleep period diastolic SD (P=.025). No metrics of BPV in the overall, wake, and sleep periods were found to be significantly associated with left ventricular hypertrophy (LVH). The results of this study do not show a strong relationship between overall or wake BPV with primary vs secondary HTN, but the association of secondary HTN with sleep period diastolic BPV deserves further exploration. Contrary to expectation, the findings of this study failed to indicate a relationship between BPV and LVH for all patients as well for primary hypertensive and secondary hypertensive patients.
