Maggio 2018 - Volume XXXVII - numero 5
Pagine elettroniche
1IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
2Università di Trieste
Indirizzo per corrispondenza: paolapascolo@gmail.com
Key words: Crohn’s disease, Inflammatory bowel disease, Immunological anomalies
Crohn’s disease is an inflammatory bowel disease diagnosed in paediatric age, especially during adolescence, in approximately one third of the cases. Pathogenesis is unknown but growing evidence suggests that immunological anomalies due to monogenic or more frequently polygenic multifactorial alterations play a pivotal role. Classic symptoms such as abdominal pain, diarrhoea and blood in stools may be absent while systemic non-abdominal disturbances like fatigue, poor growth, anaemia and intestinal complication requiring surgery may be the first manifestation of the disease. Through the described three cases, the paper proposes some synthetic summaries on the presentation, the pathogenesis and the therapy of Crohn’s disease in children.
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Pagine elettroniche
1UOC di Pediatria, 2UOC di Medicina Interna e Reumatologia, Ospedale degli Infermi, Rimini, AUSL della Romagna
3UOC di Pediatria II, Ospedale “Gaslini”, Genova
Indirizzo per corrispondenza: gianluca.vergine@auslromagna.it
Key words: Takayasu’s arteritis, Persistent fever, Chest pain
Takayasu’s arteritis (TA) is an extremely rare vasculitis that presents in paediatric age that typically affects adolescents. Clinical manifestations of TA are polymorph and in the fists stage of the disease systemic aspecific symptoms such as fever, asthenia, chest pain, sweating and athromyalgias prevail. Only in late stages do specific signs due to the occlusion of the vessels appear. Therefore, early diagnosis is a real diagnostic challenge. It is necessary to keep a high suspicion index in adolescents especially in females that present with aspecific symptoms such as fever, uneasiness, anaemia, loss of weigh, and chest pain associated with an increase in the inflammation indexes without signs of localisation. In the early stages of the disease, when the clinical diagnosis may be often difficult, total-body PET may be of help. The paper describes the case of a 14-year old girl who presented with persistent fever, chest pain associated with a remarkable increase in the inflammation indexes. After a long diagnostic process, the focus on the patient’s chest pain made it possible to suspect first and then to diagnose Takayasu’s arteritis.
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