Clinical note

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Clinical Note
Infection
A neonate infected with coronavirus disease 2019 with severe symptoms suggestive of multisystem inflammatory syndrome in childhood
Fatemeh Eghbalian, Ghazal Sami, Saeid Bashirian, Ensiyeh Jenabi
Clin Exp Pediatr. 2021;64(11):596-598.   Published online September 10, 2021
Question: Can multisystem inflammatory syndrome in childhood (MIS-C) occur in the neonate associated with coronavirus disease 2019 (COVID-19)?
Finding: A 9-day-old neonate infected with COVID-19 had fever, respiratory distress, and gastrointestinal symptoms suggestive of MIS-C. This neonate recovered after treatment with intravenous immunoglobulin (IVIG).
Meaning: IVIG successfully treated a rare case of a 9-day-old neonate with COVID-19 and severe symptoms suggestive of MIS-C.
Clinical note
Nephrology (Genitourinary)
Extracorporeal membrane oxygenation with systemic heparinization as a rescue therapy for acute life-threatening pulmonary thromboembolism complicating nephrotic syndrome
Kyusang You, So Mi Kim, Dongmin Kim, Kyoungmin Ryu, Mee Jeong Lee
Clin Exp Pediatr. 2021;64(8):430-432.   Published online November 16, 2020
Question: How would you treat acute life-threatening pulmonary thromboembolism occurring in nephrotic patients?
Finding: A 16-year-old woman with minimal change-associated nephrotic syndrome presented with cardiac arrest caused by an acute bilateral pulmonary thromboembolism. Her hemodynamics stabilized with resolution of thrombi while on venoarterial extracorporeal membrane oxygenation (ECMO) and systemic heparinization.
Meaning: In selected cases, ECMO with systemic heparinization may rescue patients from acute life-threatening pulmonary thromboembolism even without reperfusion therapy.
Neurology
Myelin oligodendrocyte glycoprotein antibody encephalitis following severe acute respiratory syndrome coronavirus 2 in a pediatric patient
Nusrat Ahsan, Saba Jafarpour, Jonathan D. Santoro
Clin Exp Pediatr. 2021;64(6):310-312.   Published online February 1, 2021
Question: Although neurologic complications have been reported during the acute phase of infection in children, less is known about the postinfectious phenomenon associated with the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) virus.
Finding: We present a case of a 7-year-old female with a prior asymptomatic infection with SARS-CoV-2 who subsequently developed encephalopathy and status epilepticus in association with myelin oligodendrocyte glycoprotein (MOG) antibody positivity.
Meaning: Here we present the first case of postinfectious of a MOG spectrum disorder associated with prior SARS-CoV-2 infection in a pediatric patient.
Infection
Coronavirus disease 2019 in a 13-year-old patient with acute lymphoblastic leukemia
Seyed Kamal Eshagh Hossaini, Zahra Movahedi, Ahmad Hormati, Hosein Heydari, Seyed Jalal Eshagh Hosseini, Fatemeh Khodadust, Mahboubeh Afifian, Sajjad Ahmadpour
Clin Exp Pediatr. 2021;64(5):247-250.   Published online March 8, 2021
Question: What should be considered in an immunocompromised child with coronavirus disease 2019 (COVID-19)?
Finding: Due to the importance of appropriately managing COVID-19 in children with cancer, the possibility of a fatal outcome should be considered in immunocompromised patients who receive chemotherapy agents.
Meaning: In all kinds of infections including COVID-19, disuse management and the development of international guidelines for children with cancer is challenging but important.
Clinical Note
Neonatology (Perinatology)
Secondary renal tubular dysgenesis in a newborn exposed to angiotensin Ⅱ receptor antagonist during gestation
Mi Hyeon Gang, Yong Wook Lee, Mea-young Chang
Clin Exp Pediatr. 2021;64(3):136-138.   Published online July 21, 2020
Question: The use of renin-angiotensin system (RAS) blockers during pregnancy causes lethal neonatal complications.
Finding: A neonate, whose mother took a RAS blocker during pregnancy, was diagnosed with renal tubular dysgenesis. He presented with respiratory failure, severe refractory hypotension, and anuria requiring continuous dialysis.
Meaning: Physicians should consider any degree of RAS fetopathy in a newborn born to a hypertensive mother who had use of RAS blockers during her pregnancy.
Clinical note
Immunology
Salivary and lacrimal gland enlargement with serum immunoglobulin G4 elevation
Jinseok Lee, Da-Eun Kim, Jeong-Hwan Yang, Misun Lim, Hye Yung Yum, JoongGon Kim
Clin Exp Pediatr. 2021;64(2):93-95.   Published online December 8, 2020
Question: What diseases should be considered in a 15-year-old girl presenting enlarged lacrimal and salivary glands?
Finding: Laboratory tests revealed elevated IgG4 levels. A submandibular gland biopsy showed lymphoplasmacytic infiltration and more than 40 immunoglobulin G4 (IgG4)-positive cells per high-power field. The patient was diagnosed with IgG4-related disease.
Meaning: Although rare in children, IgG4-related disease should be considered a differential diagnosis in children with enlarged salivary and lacrimal glands.
Infection
Coronavirus disease 2019 in a 2-month-old male infant: a case report from Iran
Hosein Heydari, Seyed Kamal Eshagh Hossaini, Ahmad Hormati, Mahboubeh Afifian, Sajjad Ahmadpour
Clin Exp Pediatr. 2020;63(12):499-502.   Published online September 21, 2020
Clinical Note
Allergy
Recurrent urticaria caused by specific cat serum albumin IgE cross-reacting with pork serum albumin
Cheon Kim, Sung Won Kim, Yoon Ha Hwang
Clin Exp Pediatr. 2020;63(11):451-453.   Published online April 6, 2020
Question: What should be considered in children who complain of pork allergies?
Finding: History of raising a cat, the onset of symptoms after the ingestion of pork and specific IgE tests to pork, cat, milk, and Alpha-gal are needed.
Meaning: Pork cat syndrome could be the cause of pork allergies.
Nephrology (Genitourinary)
First episode of nephrotic syndrome with acute abdominal pain
Samridhi Goyal, Rachita Singh Dhull, Bobbity Deepthi, Abhijeet Saha
Clin Exp Pediatr. 2020;63(10):411-414.   Published online July 21, 2020
Question: What are the likely causes of pain abdomen in Nephrotic syndrome?
Finding: Severe hypovolemia leading to mesenteric ischemia, spontaneous bacterial peritonitis, gastroenteritis, adverse effect of corticosteroids leading to gastritis, mesenteric ischemia due to thromboembolism, acute appendicitis, intussusception due to severe gut wall oedema and rarely Psoas abscess.
Meaning: Clinical suspicion and careful investigation is warranted to diagnose rare cause of pain abdomen like Psoas abscess.
Neonatology (Perinatology)
Management of the first newborn delivered by a mother with COVID-19 in South Korea
Eun-Kyung Lee, Won Duck Kim, Dong won Lee, Sang-Ah Lee
Clin Exp Pediatr. 2020;63(9):373-375.   Published online July 13, 2020
Question: How to manage the newborn born to the coronavirus disease 2019 (COVID-19) pregnant?
Finding: Medical staff managed the delivery and neonatal care of a COVID-19 pregnant patient was based on the “Guidelines for COVID-19 response.”
Meaning: We desire that our management will help treat for subsequent patients and there should be updated continuously the prevention and control consensus strategies for newborn COVID-19.
Allergy
Complement 4 levels of a 4-year-old girl with angioedema
Soyoung Shin, Yoon Tae Lee, Kyung Yil Lee, Joonhong Park, Jae Ho Lee, Eun Ae Yang
Clin Exp Pediatr. 2020;63(1):30-31.   Published online November 8, 2019
Clinical note
Neonatology (Perinatology)
Gray-brown skin discoloration following phototherapy for hyperbilirubinemia due to anti-E alloimmunization
Da Jeong Lee, Woo Sun Song, Seung Yeon Kim
Clin Exp Pediatr. 2019;62(11):428-430.   Published online September 18, 2019
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