Efficacy of Adenosine in the Differential Diagnosis of Narrow QRS Complex Tachyarrhythmia: A Case Diagnosed with Atrial Flutter After Adenosine

The most common tachyarrhythmias in childhood are narrow QRS complex tachyarrhythmias. The majority of these are supraventricular tachycardia (SVT). If electrocardiography is inconsistent with typical SVT, another underlying arrhythmia should be considered. In this case, a patient with narrow complex tachycardia who was diagnosed with atrial flutter after adenosine was presented to increase awareness on the subject

Pulmonary Toxicity Secondary to Amiodarone Use

Amiodarone is an antiarrhythmic medication used for the treatment of ventricular tachycardia. In addition to unwanted effects in many tissues, one of the most important side effects of the drug is pulmonary toxicity. Toxicity may develop at any time after administration to the drug, and the risk increases depending on the dose and duration of the treatment. Clinical and laboratory findings are non-specific. In treatment, amiodarone is discontinued. In severe cases, corticosteroid therapy can be started. Here, we present the case of a patient who was followed up for two years for hypertrophic cardiomyopathy and presented to the pediatric emergency department with hemoptysis, dizziness clouding of consciousness and numb tongue. Amiodarone was used for two years to treat ventricular arrhythmia. The findings of the patient at presentation were thought to be due to amiodarone pulmonary toxicity. Amiodarone was stopped and corticosteroid therapy was initiated. Non-invasive mechanical ventilation was applied for 3 days. On the 8th day of hospitalization, the patient was transferred to the ward. The aim of this case report was to draw attention to pulmonary toxicity due to amiodarone administration

Morning Glory Syndrome and Autism: A Case Report

Autism is a developmental neuropsychiatric disorder that starts in early years of life, lasts lifelong, and characterized by the triad of impaired social skills, delayed speech, and repetitive or unusual behaviours. Morning glory syndrome (MGS) is a congenital anomaly of the optic disc, first described in 1970 and named by Kindler due to a resemblance to the flower of the same name. Congenital anomalies are more common in autistics compared to normal population. Among all types of congenital anomalies, the frequency of autism is higher with brain and/or eye anomalies. In this paper, we reported a 2-year-old female, who was diagnosed to have morning glory syndrome when she was 14-months old and admitted to our clinic because of delayed speech and lack of communication. Although congenital eye anomalies and autism comorbidity is high, there is only one case diagnosed to have MGS with autism reported in the literature. We aimed to report this case because of the difference in visual impairment than previous case and to impress on the relationship between MGS and autism, which stems from the early development phase of embryological life, when there is increased sensitivity for genetic and environmental factors

Two cases with normocomplementhemic urticarial vasculitis: The other reasons should be determined

Ürtiker, deride aniden ortaya çıkan, kaşıntılı, kızarık ve deriden kabarık lezyonlarla giden bir hastalıktır. Akut ürtiker genellikle bir besin ya da ilaç alımını takiben ortaya çıkarken kronik ürtikerde daha uzun süreli, inatçı kaşıntıyla giden, deri lezyonları daha belirgin bir tablodan söz edilebilir. Ürtikeryal vaskülit ise, lezyonların en az 24 saat devam ettiği, kaşıntıdan çok ağrı ve yanmanın ön planda olduğu, histopatolojik olarak etkilenmiş damar yapıları ile basit ürtikerden ayrılan bir klinik durumdur. Biz burada iki adet normokomplementemik ürtikeryal vaskülit hastası sunduk.Urticaria is mainly a fast consisting, scabious, erythematous and swelling lesions of the skin. Acute urticaria usually occurs after having a medicine or food. On the other hand, in the chronic urticaria, the process is longer, more scabious, and the skin lesions are more dramatic. In urticarial vasculitis, the lesions exist longer than 24 hours with pain or swelter instead of itchiness. It can be distinguished from basic urticaria with the damage of the small vessels by histopathologically. Here we present two normocomplementhemic urticarial vasculitis cases

Severe Troponin I Elevation and Myocardia Dysfunction in a Child with Scorpion Sting

WOS: 000449419100010Background Scorpion sting is a common medical problem and major cause of mortality and morbidity in many countries. The symptoms of envenomation are more severe in the pediatric population. The clinical manifestations of scorpion envenomation appear by activation of sympathetic and parasympathetic nervous system. Envenomation can cause multiorgan dysfunction and death. Case Presentation and Findings In this case report, we present a pediatric patient from Adana, Southeast Anatolia, with severe scorpion envenomation with Leiurus abdullahbayrami which is an especially dangerous species for children. Severe systolic dysfunction was detected by echocardiography. Troponin I levels elevated significantly and rapidly responded to three doses of antivenom therapy. Conclusion Early echocardiographic examination is an important procedure for patients with scorpion envenomation. Troponin I is a significant parameter to monitor the degree of cardiac injury. Antivenom therapy is the only recommended specific therapy for children with severe scorpion envenomation due to Leiurus abdullahbayrami. Abnormal echocardiography findings may require repeated doses of scorpion antivenom

One-Year Follow-Up Results of MIS-C Patients with Coronary Artery Involvement: A Multi-center Study

Multisystem inflammatory syndrome (MIS-C) in children is a rare complication of SARS-CoV-2 infection. Knowing the course of the affected or unaffected coronary arteries in the patients under follow-up is important in terms of defining the long-term prognosis of the disease and determining the follow-up plan. This is a multicenter and retrospective study. The data were obtained from nine different centers. Between May 2020 and August 2022, 68 of 790 patients had coronary artery involvement. One-year echocardiographic data of 67 of 789 MIS-C patients with coronary artery involvement were analyzed. Existing pathologies of the coronary arteries were grouped as increased echogenicity, dilatation and aneurysm according to Z scores, and their changes over a 1-year period were determined. The data of all three groups are defined as frequency. SPSS Statistics version 22 was used to evaluate the data. In our study, aneurysm was observed in 16.4%, dilatation in 68.7% and increased echogenicity in 13.4% of the patients. All of the patients with involvement in the form of increased echogenicity recovered without sequelae by the end of the first month. No progression to aneurysm was observed in any of the patients with dilatation. No new-onset involvement was observed in patients with previously healthy coronary arteries during the convalescent period. In addition, from the sixth month follow-up period, there was no worsening in the amount of dilatation in any of the patients. At least 94% of the patients who completed the 12th month control period returned to normal

Multisystem inflammatory syndrome in children associated with COVID-19 in 101 cases from Turkey (Turk-MISC study)

Aim Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey. Methods The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients' medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis. Results The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 mu g/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died. Conclusion The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management

COVID-19 associated multisystemic inflammatory syndrome in 614 children with and without overlap with Kawasaki disease-Turk MIS-C study group.

Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells x mu L, p = 0.028; platelet count 166 vs. 216 cells x 10(3)/mu L, p 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559)