Aprile 2011 - Volume XXX - numero 4

Medico e Bambino


Pagine elettroniche ; Caso Contributivo

Interessamento cardiaco nella sindrome di Churg-Strauss

Alessandro Amaddeo1, Federico Marchetti1, Margherita Londero2, Massimo Maschio1, Alessandra Benettoni3, Alessandro Ventura1

1Clinica Pediatrica, IRCCS “Burlo Garofolo”, Università di Trieste
2UOC di Pediatria, PO “Sant’Antonio”, San Daniele del Friuli (Udine)
3Servizio di Cardiologia, IRCCS “Burlo Garofolo”, Università di Trieste

Indirizzo per corrispondenza: alessandro.amaddeo@gmail.com

CARDIAC INVOLVEMENT IN CHURG-STRAUSS SYNDROME

Key words: Churg-Strauss syndrome, Miocardial involvement, Clinic case

We report the case of a 15-year-old boy with asthenia, hypereosinophilia, a macular-papular rash in his hands and weight loss in the previous two months. Spirometry showed severe bronchial obstruction and transthoracic echocardiography revealed a peri-miocardial involvement. Churg-Strauss syndrome was diagnosed and appropriate treatment was initiated. Cardiac involvement it is not included in the official diagnostic criteria of CSS despite it is common (up to 60% of cases) and represents the major cause of mortality.

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A. Amaddeo, F. Marchetti, M. Londero, M. Maschio, A. Benettoni, A. Ventura Interessamento cardiaco nella sindrome di Churg-Strauss. Medico e Bambino 2011;30(4):259 https://www.medicoebambino.com/?id=1104_259.pdf

Pagine elettroniche ; Caso Contributivo

Grave deficit di vitamina B12 in una lattante

Franco Colonna1, Erika Moretto1, Paola Costa2, Floriana Zennaro3

1SC di Pediatria, PO di San Vito al Tagliamento (Pordenone), ASS 6 Friuli Occidentale
2Neuropsichiatria Infantile IRCCS “Burlo Garofolo”, Trieste
3Radiologia a Indirizzo Pediatrico IRCCS “Burlo Garofolo”, Trieste

Indirizzo per corrispondenza: franco.colonna@ass6.sanita.fvg.it

Severe vitamin B12 deficiency in a breast-fed child

Key words: Vitamin B12, Macrocytic anemia, Psychomotor impairment

An 11-month-old female was admitted to our hospital for anorexia, pallor and developmental regression. She had been exclusively breast-fed. Mother with thyroiditis, non vegetarian. Hemogram in the baby revealed macrocytic anaemia (8.4 g/dl Hb, MCV 99); serum folate level was normal, cobalamine level not measurable. Subsequently, cobalamine deficiency and autoimmune gastritis were diagnosed in her mother. Cerebral NMR revealed fronto-temporal subatrophy. Intramuscular cobalamine injections in daily dose of 1,000 µg were given. After few days of treatment, involuntary movements appeared (controlled by clonazepam). Later, favourable clinical course and slow but progressive improvement of neurological development were observed. Seven months later, serum haemoglobin and cobalamine level were normal and cerebral NMR almost completely normalized. We remark the importance of macrocytosis in the diagnosis of cobalamine deficiency.

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F. Colonna, E. Moretto, P. Costa, F. Zennaro Grave deficit di vitamina B12 in una lattante. Medico e Bambino 2011;30(4):259 https://www.medicoebambino.com/?id=1104_259.pdf


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