Ottobre 2019 - Volume XXXVIII - numero 8

Medico e Bambino


Pagine elettroniche

Sincope come prima manifestazione della malattia reumatica: il caso di una adolescente

Akamin Raymond, Ettore Pedretti, Cristina Cicero, Giuseppina Privitera, Giacomo Biasucci

UO di Pediatria e Neonatologia, Ospedale “Guglielmo da Saliceto”, Piacenza

Indirizzo per corrispondenza: raykamin@yahoo.com

Syncope as the first manifestation of acute rheumatic fever: report of an adolescent case

Key words: Acute rheumatic fever, Complete AV block, Syncope, Temporary pacemaker

Background - Acute rheumatic fever (ARF) is an autoimmune disorder following group A streptococcal pharyngitis that can lead to arthritis, carditis with mitral and/or aortic valve insufficiency, chorea and skin manifestations (erythema marginatum and/or subcutaneous nodules). It is known that the majority of ARF patients have abnormalities of the conduction system, mostly prolongation of the PR interval. In a paucity of subjects a complete atrioventricular (AV) block can occur and these patients may present with dramatic symptoms such as syncope.
Case presentation - The article reports the case of a 14-year-old girl who was referred to the Emergency Room because she presented with 2 episodes of syncope while at school. The electrocardiogram revealed a complete AV block. The first echocardiogram on 1st day was normal but subsequent echocardiograms on 2nd and 3rd days showed pancarditis with mitral insufficiency, aortic insufficiency, pericardial effusion and reduction of the ejection fraction. A temporary pacemaker was implanted and medical therapy for ARF was started.
Conclusion - ARF should be considered in the diagnostic work-up of patients with complete AV block, especially those in paediatric age. An echocardiogram should be performed in all cases of acquired AV block and should be repeated. In rare cases ARF patients present with complete AV block. Although it is usually transient, it may lead to dramatic symptoms such as syncope. In these cases a temporary pacemaker implantation must be considered.

Vuoi citare questo contributo?

A. Raymond, E. Pedretti, C. Cicero, G. Privitera, G. Biasucci Sincope come prima manifestazione della malattia reumatica: il caso di una adolescente. Medico e Bambino 2019;38(8):533 https://www.medicoebambino.com/?id=1908_533.pdf

Pagine elettroniche

Dal sapore al rossore… al sudore: la sindrome di Frey

Luisa Cortellazzo Wiel1, Laura Badina2, Irene Berti2, Egidio Barbi1,2

1Università di Trieste
2IRCCS Materno-Infantile “Burlo Garofolo”, Trieste

Indirizzo per corrispondenza: cortellazzo_w@hotmail.it

Frey syndrome: a case report

Key words: Maculopapular rash, Sweating, Weaning, Food allergy, Frey syndrome

Frey syndrome consists of a synkinesis characterised by the onset of flushing and/or sweating in response to a gustatory stimulus and is due to the presence of aberrant parasympathetic fibers from the auricolotemporal nerve. Although they are rare among children and usually secondary to trauma or surgery, idiopathic and familiar forms have been described: in these cases the appearance of the phenomenon with the introduction of solid and savory foods may erroneously raise the suspicion of a food allergy. If there is no flushing without tasting forget allergy and think of synkinesis!

Vuoi citare questo contributo?

L. Cortellazzo Wiel, L. Badina, I. Berti, E. Barbi Dal sapore al rossore… al sudore: la sindrome di Frey. Medico e Bambino 2019;38(8):533 https://www.medicoebambino.com/?id=1908_533.pdf

Pagine elettroniche

Le complicanze neurologiche dell’influenza: la neuroinfluenza

Adriana Fumarola*, Paolo Ricciardelli1, Claudia Guiducci*, Patrizia Cenni2, Giuliana Turlà1, Federico Marchetti1

1UOC di Pediatria e Neonatologia, 2SSD di Neuroradiologia, Ospedale di Ravenna, AUSL della Romagna
*Scuola di specializzazione in Pediatria, Università di Ferrara

Indirizzo per corrispondenza: adriana.fumarola@gmail.com

Vuoi citare questo contributo?

A. Fumarola, P. Ricciardelli, C. Guiducci, P. Cenni, G. Turlà, F. Marchetti Le complicanze neurologiche dell’influenza: la neuroinfluenza. Medico e Bambino 2019;38(8):533 https://www.medicoebambino.com/?id=1908_533.pdf


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