RESUMO
BACKGROUND: The aim of this study was to describe the incidence and contributory risk factors for thromboembolic complications in children with nephrotic syndrome (NS) and thrombosis. METHODS: Among 188 children with the diagnosis of NS (80 girls; mean age: 12.6 ± 5.4 years) followed up in our hospital for the last 5 years, 17 (9.0 %) children (16 boys) identified as having thromboembolic complications. All 17 children with NS and thrombosis were screened for laboratory risk factors for thrombosis. The diagnosis was confirmed by cranial magnetic resonance imaging, doppler ultrasonography, and echocardiography. RESULTS: Among 17 children with thrombosis, 14 (82.3 %) were found to have focal segmental glomerulosclerosis (FSGS) as underlying pathology by renal biopsy. The mean age of the thrombotic children was 4.5 ± 3.2 years at the diagnosis of NS and that was 7.1 ± 4.9 years at the time of thrombosis. The mean time from NS diagnosis to the first thrombosis development was 2.6 ± 2.3 years. Thrombosis occurred during the first year of NS in 9/17 (52.9 %) children. Most of the children (88.2 %) had venous thrombosis. Among the screened risk factors, high factor VIII level (64.7 %) was the leading factor followed by decreased antithrombin III level (29.4 %). Furthermore, 4 children had central venous catheters and 2 had infection as clinical risk factors for thrombosis. CONCLUSION: In this case series, subtype of FSGS, active disease state of NS, central venous catheters, and some inherited and acquired thrombotic risk factors have been identified as contributory factors for the development of thrombosis in children with NS.
Assuntos
Síndrome Nefrótica/complicações , Trombose Venosa/epidemiologia , Trombose Venosa/etiologia , Adolescente , Idade de Início , Antitrombina III/metabolismo , Aspirina/uso terapêutico , Infarto Encefálico/tratamento farmacológico , Infarto Encefálico/etiologia , Cateteres Venosos Centrais/efeitos adversos , Criança , Pré-Escolar , Fator VIII/metabolismo , Feminino , Fibrinolíticos/uso terapêutico , Seguimentos , Glomerulosclerose Segmentar e Focal/complicações , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Incidência , Lactente , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Mutação , Síndrome Nefrótica/sangue , Síndrome Nefrótica/diagnóstico , Fatores de Risco , Trombectomia , Fatores de Tempo , Turquia/epidemiologia , Trombose Venosa/sangue , Trombose Venosa/terapiaRESUMO
Patients with Hodgkin lymphoma (HL) usually present with lymphadenopathies. Osseous involvement at presentation is extremely rare. Occurrence of both eosinophilia and osseous involvement has not been reported frequently. We present an adolescent female complaining of lower back pain for 6 months, in whom, multifocal vertebral involvement and peripheral blood eosinophilia preceded the final diagnosis of HL.
Assuntos
Eosinofilia/complicações , Doença de Hodgkin/patologia , Neoplasias da Coluna Vertebral/patologia , Criança , Feminino , Doença de Hodgkin/complicações , Doença de Hodgkin/diagnóstico , Humanos , Neoplasias da Coluna Vertebral/diagnósticoRESUMO
Severe essential cryofibrinogenemia is rare in childhood, and both the diagnosis and the management are challenging for pediatricians. An 11-year-old male, who had already lost two digits following cold exposure, was referred after multiple visits to various hospitals and subsequently diagnosed as primary cryofibrinogenemia. His history revealed unresponsiveness to calcium channel blockers, acetyl salicylic acid, pentoxifylline, dextran, and steroids. Stanozolol (2 mg/day, orally) prophylaxis was initiated and no new skin lesions developed following starting this treatment. Some of the newly formed lesions at the onset of stanozolol healed.
