1
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Peri F, Badina L, Berti I, Barbi E, Gortani G. 2-year-old girl with severe eczema and brittle hair. J Paediatr Child Health 2022. [PMID: 35848683 DOI: 10.1111/jpc.16126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Francesca Peri
- Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy
| | - Laura Badina
- Pediatric Department, Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Irene Berti
- Pediatric Department, Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Egidio Barbi
- Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.,Pediatric Department, Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Giulia Gortani
- Pediatric Department, Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
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2
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Cortellazzo Wiel L, Conversano E, Carlone G, Di Leo G, Gortani G, Zanchi C, Barbi E. Unarousable child with a short bowel. Arch Dis Child Educ Pract Ed 2022; 107:196-198. [PMID: 33122261 DOI: 10.1136/archdischild-2020-318826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 10/07/2020] [Indexed: 11/03/2022]
Abstract
Unarousable child with short bowelA 4-year-old boy was admitted with progressive lethargy of a few hours' duration and no other symptoms. His medical history was relevant for short bowel syndrome (SBS), following neonatal volvulus, with residual bowel length of 23 cm and intact ileocecal valve. He had similar self-limiting episodes in the past, after weaning parenteral nutrition, especially after eating large meals. The day before, he had consumed a large amount of apples.Arterial blood gas (ABG) analysis showed metabolic acidosis with normal lactacidaemia (pH 7.09, pCO2 19 mm Hg, pO2 101 mm Hg, HCO3 5.8 mmol/L, BE -24, anion gap 29.4, chloride 116 mmol/L, L-lactate level 4 mmol/L).On admission, the child could be awakened, but he was confused with slurred speech (Glasgow Coma Scale 14), with a body temperature of 37 C°, a heart rate of 125 beats/min and a respiratory rate of 38 breaths/min. The abdomen was distended, without guarding and with normal bowel sounds. Blood glucose levels were normal, as well as white blood cell count, liver and kidney function test and C reactive protein. An abdominal ultrasound ruled out an intussusception. An abdominal X-ray was performed too (see figure 1).
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Affiliation(s)
- Luisa Cortellazzo Wiel
- Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy
| | - Ester Conversano
- Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy
| | - Giorgia Carlone
- Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy
| | - Grazia Di Leo
- Paediatrics, IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy
| | - Giulia Gortani
- Paediatrics, IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy
| | - Chiara Zanchi
- Paediatrics, IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy
| | - Egidio Barbi
- Paediatrics, IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy
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Cortellazzo Wiel L, Spezzacatene A, Gortani G, Saccari A, Taddio A, Barbi E. Acute Acalculous Cholecystitis: Think of Hepatitis A Infection and Do Not Underestimate Pain. Pediatr Emerg Care 2022; 38:304-306. [PMID: 35477693 DOI: 10.1097/pec.0000000000002735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
ABSTRACT A 14-year-old adolescent girl presented with severe abdominal pain, tenderness, and guarding in the right upper quadrant associated with nonbilious vomiting, scleral icterus, and fever. Laboratory tests were consistent with acute hepatitis A virus-related cholestatic hepatitis. A point-of-care ultrasound showed mild gallbladder wall thickening with increased color Doppler flow and pericholecystic fluid collection, in the absence of gallstones or biliary ducts dilatation, thus suggesting acute acalculous cholecystitis. Both the clinical symptoms and the point-of-care ultrasound findings completely resolved within 1 week after admission with conservative treatment.
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Affiliation(s)
| | - Anita Spezzacatene
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Giulia Gortani
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Alessia Saccari
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
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4
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Udina C, Lanzetta MA, Celsi F, Barbi E, Gortani G, Bramuzzo M, Di Leo G. Ferric Carboxymaltose in the Treatment of Iron-Deficiency Anaemia in Paediatric Patients with Anastomotic Ulcers. Children 2022; 9:children9030378. [PMID: 35327750 PMCID: PMC8947454 DOI: 10.3390/children9030378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
Abstract
Objectives: The aim of this paper is to describe a case series of paediatric patients affected by anastomotic ulcers (AU), a late complication of bowel resection in infancy, focusing on the treatment of iron-deficiency anaemia (IDA) with ferric carboxymaltose (FC). Methods: Patients with a diagnosis of AU, treated at the Paediatric Department of the Institute for Maternal and Child Health IRCCS “Burlo Garofolo” from February 2012 to December 2020 were included. Haemoglobin (Hb) values, IDA related symptoms, the need for blood transfusions, for oral or intravenous (iv) iron supplementation and for surgical resections were compared before and after treatment with FC. Adverse effects of FC were recorded. Results: Ten patients with an established diagnosis of AU were identified; eight (8 out of 10) received at least one administration of FC. Lower and higher Hb values increased significantly after treatment (4.9 g/dL vs. 8.2 g/dL, p = 0.0003; 9.9 g/dL vs. 13.5 g/dL, p = 0.0008 respectively), with a significant reduction of the need for blood transfusions (p = 0.0051) and for oral and iv iron supplementation. While receiving standard therapies, seven patients (7 out of 8) complained of asthenia; this symptom resolved in all cases after FC administration. Before FC treatment, two patients (2 out of 8) required surgical resection of AU, with a recurrence of anaemia after a few weeks; after at least one FC infusion, no children needed further bowel resection for IDA. FC caused mild asymptomatic hypophosphatemia in one case. Conclusion: FC appears to be effective and safe in the paediatric population for the treatment of IDA resulting from AU.
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Affiliation(s)
- Chiara Udina
- Department of Medicine, Surgery and Medical Sciences, University of Trieste, 34127 Trieste, Italy;
| | - Maria Andrea Lanzetta
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (M.A.L.); (F.C.); (G.G.); (M.B.); (G.D.L.)
| | - Fulvio Celsi
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (M.A.L.); (F.C.); (G.G.); (M.B.); (G.D.L.)
| | - Egidio Barbi
- Department of Medicine, Surgery and Medical Sciences, University of Trieste, 34127 Trieste, Italy;
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (M.A.L.); (F.C.); (G.G.); (M.B.); (G.D.L.)
- Correspondence: ; Tel.: +39-3335838780; Fax: +39-0403785290
| | - Giulia Gortani
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (M.A.L.); (F.C.); (G.G.); (M.B.); (G.D.L.)
| | - Matteo Bramuzzo
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (M.A.L.); (F.C.); (G.G.); (M.B.); (G.D.L.)
| | - Grazia Di Leo
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (M.A.L.); (F.C.); (G.G.); (M.B.); (G.D.L.)
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5
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De Nardi L, Lanzetta MA, Ghirigato E, Barbi E, Gortani G. Approach to the child with fatigue: A focus for the general pediatrician. Front Pediatr 2022; 10:1044170. [PMID: 36533226 PMCID: PMC9755349 DOI: 10.3389/fped.2022.1044170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/16/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Fatigue is a common, nonspecific complaint commonly used to describe various conditions, ranging from a vague, subjective sense of weariness to muscular weakness, fatigability, exercise intolerance or excessive daytime somnolence. Despite its high frequency in the general population, literature addressing the approach to the child with fatigue from a general pediatrician perspective is poor. We herein propose a review of the available evidence on the topic, providing a practical framework to assist physicians in dealing with the issue. METHODS Data were identified by searches of MEDLINE, UpToDate, Google Scholar and references from relevant articles. Articles published between 1990 and 2021 were considered, prioritizing systematic reviews and meta-analyses. Then, an empirically-based model of approaching the tired child was proposed according to our center experience. RESULTS To correctly characterize the meaning of fatigue reporting, specific clues from history and physical examination should be emphasized. Duration, severity, and the age at onset are to be considered. Then, specific queries about everyday activities, sleep hygiene and social domain could be useful in reaching a specific diagnosis and offering an appropriate treatment. CONCLUSIONS We suggest a pragmatic approach to fatigue in children based on age assessment, targeted questions, physical examination clues, and some laboratory first-level tests. This could provide pediatricians with a useful tool to discriminate the broad etiology of such a complaint, disentangling between psychological and organic causes. Further studies are needed to investigate the predictive value, specificity and sensitivity of this diagnostic workflow in managing the child with fatigue.
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Affiliation(s)
- Laura De Nardi
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy
| | - Maria Andrea Lanzetta
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy.,Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Elena Ghirigato
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy
| | - Egidio Barbi
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy.,Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giulia Gortani
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
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6
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Trombetta A, Genovese MRL, Gortani G, Barbi E. An adolescent with recurrent ankle swelling. Arch Dis Child Educ Pract Ed 2021; 106:344-346. [PMID: 32122955 DOI: 10.1136/archdischild-2019-318096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 02/03/2020] [Indexed: 11/04/2022]
Abstract
A 14-year-old girl was admitted to our institute with a history of intermittent bilateral ankle swelling, and moderate but progressively worsening pain which has lasted for 2 years.The patient's history was unremarkable. She did not take medications and was not involved in any sports activity. She reported no fever, gastrointestinal symptoms, fatigue, weight loss, travels abroad or previous infections. She reported moderate pain at night, associated with a sense of heaviness, tightness and general discomfort, and with no response to ibuprofen.Physical examination was remarkable only for bilateral ankle non-pitting oedema, more evident on the left leg, with a thickened skinfold at the base of the second toe, and without redness, swelling or skin warming.The patient had been previously examined, and her foot and ankle X-rays, ultrasound (US) and MRI were all negative. Blood tests (white cell count, C reactive protein, erythrocyte sedimentation rate, albumin, antinuclear antibodies, creatinine, transaminase, creatine kinase, lactate dehydrogenase, thyroid function and glucose) and urinalysis were in the normal range. Her ocular assessment and echocardiogram were also normal.
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Affiliation(s)
- Andrea Trombetta
- IRCSS Burlo Garofolo, Universita degli Studi di Trieste, Trieste, Italy
| | | | - Giulia Gortani
- Clinical department of Pediatrics, Institute for Maternal and Child Health, Burlo Garofolo, Trieste, Italy
| | - Egidio Barbi
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
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7
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Caddeo G, Paganin P, Gortani G, Carbone M, Gregori M, Barbi E. Six-year-old boy with a slow-onset persistent back pain. Arch Dis Child Educ Pract Ed 2021; 106:286-288. [PMID: 31744808 DOI: 10.1136/archdischild-2018-316648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 11/07/2019] [Indexed: 11/03/2022]
Abstract
A 6-year-old boy was evaluated for a 6-week history of low back pain. Initially, the pain was exacerbated by movements, eventually showing a milder and fluctuating trend. History was unremarkable for previous traumatic events, fever or nocturnal pain. Physical examination revealed localised pain at palpation of the spinous processes at the lumbosacral level. Blood tests showed a normal blood count, negative C reactive protein (CRP) and erythrocyte sedimentation rate, normal lactic acid dehydrogenase (LDH) and creatine phosphokinase. A posterior-anterior radiograph of the lumbar spine resulted normal. An MRI scan revealed a lumbosacral transitional vertebra with bone oedema of the posterior arch until the spinous process. For better bone definition, a CT scan was performed ( figure 1 ).
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Affiliation(s)
- Giulia Caddeo
- University of Trieste, Trieste, Friuli Venezia Giulia, Italy
| | - Paola Paganin
- Dipartimento di Scienze Mediche e Chirurgiche e della Salute, Universita degli Studi di Trieste, Trieste, Italy
| | - Giulia Gortani
- Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', University of Trieste, Trieste, Italy
| | - Marco Carbone
- Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', University of Trieste, Trieste, Italy
| | - Massimo Gregori
- Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', University of Trieste, Trieste, Italy
| | - Egidio Barbi
- Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', University of Trieste, Trieste, Italy
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8
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Benvenuto S, Gortani G, Bussani R, Poropat F, Murru FM, Carrozzi M, Tommasini A, Taddio A. Severe onset of inflammatory myositis in a child: think to paraneoplastic myositis. Ital J Pediatr 2021; 47:146. [PMID: 34210321 PMCID: PMC8252287 DOI: 10.1186/s13052-021-01098-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 06/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background Juvenile idiopathic inflammatory myopathies (JIIMs) are a group of heterogenous, acquired, autoimmune disorders that affect the muscle. While the association between IIMs and malignancy has been widely reported in adults, cancer-associated myositis (CAM) is rare in children, so that routine malignancy screening is not generally performed. This report shows a case of severe CAM in a child. Case presentation An 11-years-old girl presented with worsening dyspnea after a 3-weeks history of progressive proximal weakness, myalgia, dysphagia, and weight loss. Her past history was remarkable for a type I Arnold-Chiari malformation associated with an anterior sacral meningocele. Physical examination showed severe hypotony and hypotrophy. Pulse oximetry and blood test showed a type II respiratory failure (SpO2 88%, pCO2 68 mmHg) and increased muscle enzyme levels (CPK 8479 U/L, AST 715 U/L, ALT 383 U/L, LDH 1795 U/L). The patient needed invasive mechanical ventilation. Inflammatory myositis was considered and treatment with intravenous methylprednisolone (30 mg/Kg/day for 3 days followed by 2 mg/Kg/day) and IVIG (1 g/kg/day for 2 days) was started. Muscle biopsy showed endomysial and perimysial necrosis and inflammation. The presence of serum anti-TIF1-γ antibody positivity led to a malignancy screening. Whole-body MRI showed a mature teratoma underneath sacral meningocele and both lesions were surgically removed. Given the histological and clinical severity of the myopathy, mycophenolate (500 mg twice a day) and rituximab (360 mg/m2, 4 weekly infusions) were added. Due to extreme muscular wasting, severe malnutrition and intolerance to enteral feeding the patient needed a transient tracheostomy and parenteral nutrition, followed by physiotherapy, speech therapy and nocturnal non-invasive ventilation. A complete remission was achieved 3 months after. Conclusions Among cancer-associated autoantibodies (CAAs) in adult patients, anti-TIF1-γ carries the highest risk of CAM, which recognizes with a high likelihood a paraneoplastic pathogenesis. In children, anti-TIF1-γ antibody has been associated with severe cutaneous disease, lipodystrophy, and chronic disease course, but not with CAM, which is overall rare in younger patients. Severe onset of a JIIM, especially if anti-TIF1-γ antibody positive, should prompt suspect of a CAM and lead to a screening for malignancy.
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Affiliation(s)
| | - Giulia Gortani
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Federico Poropat
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Flora Maria Murru
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Marco Carrozzi
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Alberto Tommasini
- University of Trieste, Via dell'Istria 65/1, Trieste, Italy.,Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Andrea Taddio
- University of Trieste, Via dell'Istria 65/1, Trieste, Italy.,Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
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Cortellazzo Wiel L, Gortani G, Zanon D, Bramuzzo M, Pennesi M, Barbi E. A child with green urine after a diagnostic enema: Answers. Pediatr Nephrol 2021; 36:2717-2718. [PMID: 33730278 PMCID: PMC8370930 DOI: 10.1007/s00467-021-05035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 02/25/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Giulia Gortani
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Davide Zanon
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Matteo Bramuzzo
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Marco Pennesi
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Egidio Barbi
- University of Trieste, Trieste, Italy ,Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
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10
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Cortellazzo Wiel L, Gortani G, Zanon D, Bramuzzo M, Pennesi M, Barbi E. A child with green urine after a diagnostic enema: Questions. Pediatr Nephrol 2021; 36:2715-2716. [PMID: 33730277 PMCID: PMC8370939 DOI: 10.1007/s00467-021-05028-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 02/25/2021] [Indexed: 12/05/2022]
Affiliation(s)
| | - Giulia Gortani
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Davide Zanon
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Matteo Bramuzzo
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Marco Pennesi
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Egidio Barbi
- University of Trieste, Trieste, Italy ,Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
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11
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Morabito G, Cosentini D, Tornese G, Gortani G, Pastore S, Genovese MRL, Cozzi G. Case Report: Somatic Symptoms Veiling Gender Dysphoria in an Adolescent. Front Pediatr 2021; 9:679004. [PMID: 34123974 PMCID: PMC8192849 DOI: 10.3389/fped.2021.679004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/29/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Somatic symptom disorder is common in children and adolescents; usually, it is an expression of a mental health problem or other conditions that lead to psychosocial impairment and suffering. Among these, in pubertal age, gender dysphoria should be considered. Case Presentation: We present the case of a 15-year-old girl admitted to the hospital because of a 2-month history of scattered arthralgia and myalgia, headache, and fatigue, with repeated visits to the emergency room. The physical exam was unremarkable, except for step walking and pain. Repeated diagnostic tests were normal, and consecutive psychological interviews disclosed intense suffering due to a gender incongruence. Referral to the hospital gender service was offered and refused by the parents. Conclusions: In pubertal age, gender dysphoria may be expressed through somatoform symptoms. Diagnosis is challenging to accept for the parents even in the presence of adequate multi-disciplinary hospital services.
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Affiliation(s)
- Giuliana Morabito
- Department of Pediatrics, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Dora Cosentini
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Gianluca Tornese
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giulia Gortani
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Serena Pastore
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Giorgio Cozzi
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
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12
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Gesuete V, Salis S, Gortani G, Barbi E. Child presenting with breathlessness 1 month after cardiac surgery. Arch Dis Child Educ Pract Ed 2020; 105:225-226. [PMID: 30709940 DOI: 10.1136/archdischild-2018-316156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/11/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Valentina Gesuete
- Cardiology Service, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo' - Trieste, Trieste, Italy
| | - Simona Salis
- School of Medicine, University of Trieste, Trieste, Italy
| | - Giulia Gortani
- Pediatric Emergency Department, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo' - Trieste, Trieste, Italy
| | - Egidio Barbi
- School of Medicine, University of Trieste, Trieste, Italy.,Pediatric Emergency Department, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo' - Trieste, Trieste, Italy
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13
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Favaretto E, Gortani G, Simonini G, Pastore S, Di Mascio A, Cimaz R, Taddio A. Preliminary data on prednisone effectiveness in children with Sydenham chorea. Eur J Pediatr 2020; 179:993-997. [PMID: 31965299 DOI: 10.1007/s00431-020-03574-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/07/2020] [Accepted: 01/10/2020] [Indexed: 12/01/2022]
Abstract
The objective of the study is to evaluate the efficacy of corticosteroids in Sydenham chorea. This is a retrospective observational study. Clinical information of children with Sydenham chorea were collected. Outcome of Sydenham chorea was evaluated in consideration of presence or absence of corticosteroid therapy. Thirty patients were enrolled. A total of 15 were treated with prednisone, 15 received symptomatic drugs or no treatment. Patients who were treated with prednisone showed faster improvement (4 vs 16 days; p = 0.002) and shorter median time of remission (30 vs 135 days; p < 0.001).Conclusion: Our study showed that corticosteroid therapy is an effective treatment of Sydenham chorea.What is Known:• Steroid treatment in Sydenham chorea is widely used but it is not standardized.• Few manuscript report a beneficial use of steroids in Sydenham chorea if compared with no treatment.What is New:• Steroid treatment seems to be effective in both clinical remission and clinical improvement of symptoms among patients with Sydenham chorea.• Steroid treatment seems to be superior to conventional treatment.
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Affiliation(s)
- Elena Favaretto
- University of Trieste, Piazzale Europa 2, 34100, Trieste, Italy
| | - Giulia Gortani
- Institute for Maternal and Child Health-IRCCS, "Burlo Garofolo"-Via dell'Istria 65/1, 34100, Trieste, Italy
| | - Gabriele Simonini
- Rheumatology Unit, Anna Meyer Children's Hospital, University of Florence, Viale Pieraccini 24, 50139, Florence, Italy
| | - Serena Pastore
- Institute for Maternal and Child Health-IRCCS, "Burlo Garofolo"-Via dell'Istria 65/1, 34100, Trieste, Italy
| | | | - Rolando Cimaz
- Rheumatology Unit, Anna Meyer Children's Hospital, University of Florence, Viale Pieraccini 24, 50139, Florence, Italy
| | - Andrea Taddio
- University of Trieste, Piazzale Europa 2, 34100, Trieste, Italy. .,Institute for Maternal and Child Health-IRCCS, "Burlo Garofolo"-Via dell'Istria 65/1, 34100, Trieste, Italy.
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Tamaro G, Pastore S, Gortani G, Gregori M, Taddio A. A fascinating rheumatologic association. Rheumatology (Oxford) 2020; 59:1463. [DOI: 10.1093/rheumatology/kez560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Serena Pastore
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” – Trieste, Italy
| | - Giulia Gortani
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” – Trieste, Italy
| | - Massimo Gregori
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” – Trieste, Italy
| | - Andrea Taddio
- Department of Life sciences, University of Trieste
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” – Trieste, Italy
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15
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Ghirardo S, Pastore S, Gortani G, Tommasini A, Taddio A. Hughes Stovin: Sustained remission and regression of pulmonary aneurysms with anti-tumor necrosis factor treatment. Pediatr Pulmonol 2019; 54:E13-E15. [PMID: 30938918 DOI: 10.1002/ppul.24298] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/10/2019] [Accepted: 02/09/2019] [Indexed: 12/25/2022]
Abstract
We report the first case of Hughes Stovin Syndrome successfully treated with long-lasting tumor necrosis factor α (TNF-α) blocker (infliximab) treatment. Because of the failure of the standard therapeutic regimen with steroids and cyclophosphamide, infliximab was started achieving a stable disease remission and a complete resolution of pulmonary aneurysms. Hughes Stovin Syndrome, although rare, is a life-threatening condition that needs to be timely identified and treated aggressively. Our report underlines the importance of TNF-α blocker treatment in Hughes Stovin Syndrome, suggesting its use as long-term safe and useful.
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Affiliation(s)
- Sergio Ghirardo
- Clinical Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Serena Pastore
- Department of Pediatrics, Institute for Maternal and Child Health (IRCCS) "Burlo Garofolo", Trieste, Italy
| | - Giulia Gortani
- Department of Pediatrics, Institute for Maternal and Child Health (IRCCS) "Burlo Garofolo", Trieste, Italy
| | - Alberto Tommasini
- Department of Pediatrics, Institute for Maternal and Child Health (IRCCS) "Burlo Garofolo", Trieste, Italy
| | - Andrea Taddio
- Clinical Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy.,Department of Pediatrics, Institute for Maternal and Child Health (IRCCS) "Burlo Garofolo", Trieste, Italy
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16
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Gortani G, Pederiva F, Ammar L, Miorin E, Tonin G, Dobbiani G, Marcuzzi E, Barbi E. Ogilvie syndrome in a 8 year old girl after laparoscopic appendectomy. BMC Pediatr 2019; 19:82. [PMID: 30894155 PMCID: PMC6425584 DOI: 10.1186/s12887-019-1457-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 03/13/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Ogilvie's syndrome is described in the adult population, but rarely seen in children. CASE PRESENTATION We present a case of a girl who suffered acute colonic pseudo-obstruction after laparoscopic appendectomy. CONCLUSIONS Ogilvie's syndrome, although rare in the pediatric population, should be considered as possible diagnosis after a surgical procedure in presence of persisting subocclusive symptoms and radiological signs of massive colonic dilatation without mechanical obstruction.
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Affiliation(s)
- Giulia Gortani
- Pediatrics, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Federica Pederiva
- Pediatric Surgery, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy.
| | - Lydie Ammar
- Radiology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | | | | | | | - Elena Marcuzzi
- Pediatric Care Unit, Hospital of Palmanova, Udine, Italy
| | - Egidio Barbi
- Pediatrics, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.,University of Trieste, Trieste, Italy
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17
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Gortani G, Faletra F, Bruno I, Berti I, Ventura A. "Blaschkoid dyspigmentation" in a child: don't forget fibroblast chromosomal analysis. J Pediatr 2015; 166:490-90.e1. [PMID: 25433905 DOI: 10.1016/j.jpeds.2014.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 10/13/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Giulia Gortani
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", University of Trieste, Trieste, Italy
| | - Flavio Faletra
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", University of Trieste, Trieste, Italy
| | - Irene Bruno
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", University of Trieste, Trieste, Italy
| | - Irene Berti
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", University of Trieste, Trieste, Italy
| | - Alessandro Ventura
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", University of Trieste, Trieste, Italy
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Pastore S, Ferrara G, Sandrin C, Gortani G, Taddio A, Tommasini A, Lepore L. Chronic recurrent multifocal osteomyelitis: experience from a single pediatric rheumatology center over the past ten years. Pediatr Rheumatol Online J 2014. [PMCID: PMC4191437 DOI: 10.1186/1546-0096-12-s1-p256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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19
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Gortani G, Starc M, Tubaro M. Successful treatment of refractory hughes stovin syndrome with infliximab. Pediatr Rheumatol Online J 2014. [PMCID: PMC4191703 DOI: 10.1186/1546-0096-12-s1-p352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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20
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Pavan M, Gortani G, Rubinato E, Faletra F, Pastore S, Ventura A. A girl with photosensitivity and hepatic steatosis. J Pediatr 2014; 165:201-201.e1. [PMID: 24704299 DOI: 10.1016/j.jpeds.2014.02.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 02/25/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Matteo Pavan
- Department of Pediatrics, University of Trieste, Trieste, Italy
| | - Giulia Gortani
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Elisa Rubinato
- Department of Pediatrics, University of Trieste, Trieste, Italy
| | - Flavio Faletra
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Serena Pastore
- Department of Pediatrics, University of Trieste, Trieste, Italy; Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Alessandro Ventura
- Department of Pediatrics, University of Trieste, Trieste, Italy; Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
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21
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Rubinato E, Morgan A, D'Eustacchio A, Pecile V, Gortani G, Gasparini P, Faletra F. A novel deletion mutation involving TMEM38B in a patient with autosomal recessive osteogenesis imperfecta. Gene 2014; 545:290-2. [DOI: 10.1016/j.gene.2014.05.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 05/04/2014] [Accepted: 05/09/2014] [Indexed: 10/25/2022]
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Pastore S, Moressa V, Gortani G, Lepore L. PReS-FINAL-2101: Nitrous oxide analgesia for intra-articular injection in juvenile idiopathic arthritis: our experience. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043641 DOI: 10.1186/1546-0096-11-s2-p113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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23
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Gortani G, Anzini M, Berton E, Rabusin M, Murru F, Benettoni A. Abrupt intracardiac growth of a Wilms tumor. J Pediatr 2013; 163:918.e1. [PMID: 23628373 DOI: 10.1016/j.jpeds.2013.03.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 03/21/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Giulia Gortani
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
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Affiliation(s)
- Federico Poropat
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, University of Trieste, Trieste, Italy
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Affiliation(s)
- Giulia Gortani
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
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Berton E, Vitali-Serdoz L, Vallon P, Maschio M, Gortani G, Benettoni A. Young girl with apical ballooning heart syndrome. Int J Cardiol 2012; 161:e4-6. [PMID: 22464483 DOI: 10.1016/j.ijcard.2012.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 03/03/2012] [Indexed: 11/24/2022]
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27
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Affiliation(s)
- Serena Pastore
- Department of Pediatrics, IRCCS Burlo Garofolo, University of Trieste, Trieste, Italy
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Gortani G, Grasso D, Zennaro F, Marchetti F. If it was not a sinusitis? Case Reports 2011; 2011:bcr.02.2011.3809. [DOI: 10.1136/bcr.02.2011.3809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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