scholarly journals An Underlooked Cause of Periodic Fever (PFAPA) in an Adult Patient with No Response to Tonsillectomy

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Fiaz Alam ◽  
Mohammed Hammoudeh

Periodic fever with aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is an autoinflammatory disease manifested as recurrent febrile episodes associated with one of the following cardinal features: aphthous ulceration, pharyngitis, and cervical adenitis. It was initially described in children and thought to be a disease of pediatric age group. Few adult cases were also reported in the literature. We describe the case of a 39-year-old female affected by PFAPA who presented with a history of febrile episodes associated with aphthous ulceration, stomatitis, and tonsillitis for 4 years. The febrile episodes occurred at a regular interval of 4 weeks and resolved within 5 days. The patient underwent tonsillectomy without any significant improvement. The patient responded only to a single high dose of steroid during the attack. Although PFAPA was initially thought to be a disease of pediatric age group, it should be considered in patients with recurrent febrile illness in all age groups.

Author(s):  
Mohammad O AL fattani ◽  
Asmaa M Al Refaie ◽  
Shuruq Hassan Alsulami ◽  
Najia Al Hojaili

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a rear disease in pediatric age group which constitute a unique manifestation associated with obsessive-compulsive disorder (OCD) and tic disorder in children. However, this diagnosis has carried a lot of controversies, related mainly to its management. Here we are presenting one case of PANDAS syndrome who was treated successfully with full coarse of antibiotic for 10 days, where all his symptoms disappeared completely in subsequent days including suicidal attempts. PANDAS should be considered in children with neuropsychiatric disorders (tics, obsessive behavior etc.) especially if symptoms associated within a period of infection such as febrile illness or sore throats.


1980 ◽  
Vol 08 (01n02) ◽  
pp. 26-36 ◽  
Author(s):  
Suzanne Chan Ho ◽  
Kwok Chan Lun ◽  
W. K. Cheng Hin Ng

A retrospective study of 672 sampled records of patients of a major institutions providing Chinese traditional medicine in Singapore reveals that 97.3% of the patients were Chinese, with a dialect group distribution following closely that of the Singapore Chinese. The male-to-female patient ratio was 1.0:1.13. There were fewer patients of the pediatric age group and more of those from age 30 upwards. Some 43% of the patients sought treatment for ''infective'' and ''internal, emotional and weakness'' diseases. The prevalent disease conditions seen among patients from the different age groups are also analyzed and discussed in this paper.


2020 ◽  
Vol 27 (4) ◽  
pp. 281-287
Author(s):  
Felice FAIZAL ◽  
Alka KALGUTKAR ◽  
Vandana DAHAKE

Germ cell tumors (GCT) are rare neoplasms which are seen in all age groups and both sexes. Gcts in the pediatric age group show considerable variation from their adult counterparts in relation to site, histological type, clinical and radiological features and response to treatment. Extragonadal gcts are much more common in the pediatric age group with the most common sites being sacrococcygeal region, head and neck, retroperitoneum and mediastinum. Unusual sites like the vagina and urinary bladder have also been reported. Therefore, the varied presentations and different treatment options should be considered.


2018 ◽  
Vol 15 (02/03) ◽  
pp. 087-093
Author(s):  
Swarup Sohan Gandhi ◽  
Manish Mann ◽  
Shashikant Jain ◽  
Ugan Singh Meena ◽  
Virendra Deo Sinha

Abstract Background and Aim of Study Coagulopathy is a common occurrence following traumatic brain injury (TBI). Various studies have reported the incidence and risk factors of coagulopathy and their correlation with poor outcome in adult as well as pediatric age group. In our study, we aim to analyze trauma-induced coagulopathy in adult and pediatric patients. Methods Adult (> 18 years) and pediatric (< 18 years) patients of TBI admitted in the intensive care unit of a trauma center of a tertiary care center had been studied from August 2015 to March 2018. Patients were further subdivided into moderate and severe TBI based on Glasgow Coma Scale (GCS) of 9 to 12 and < 9, respectively. Coagulation profile (prothrombin time [PT], activated partial thromboplastin time [APTT], thrombin time, fibrinogen, and D-dimer) and arterial blood gas (ABG) analysis were done on day of admission and on days 3 and 7. Coagulation profiles were analyzed in both the age groups, and risk factors were studied and correlated with the mortality and morbidity based on the Glasgow outcome score. Results Two hundred patients including 143 adults and 57 pediatric patients were included. Mean age among the adult and pediatric population was 31.51 ± 16.83 and 11.5 ± 5.90 years, respectively. In adults, 96 (83.62%) out of 116 in severe TBI group and 20 (74.07%) out of 27 in moderate TBI group developed coagulopathy, and in pediatric age group, 14 (70%) out of 20 in moderate TBI and 30 (81.08%) out of 37 in severe TBI developed coagulopathy. Midline shift was significantly associated with coagulopathy in both the age groups (p value < 0.039). Mortality was not significantly different in patients with coagulopathy between the age groups, but improved status as per the Glasgow outcome score was more in pediatric age group. Conclusion The development of coagulopathy is a frequent complication in patients with moderate to severe TBI in both age groups. Even though it is not closely associated with death in this study, it may be regarded as a marker of injury severity.


2021 ◽  
Vol 27 (1) ◽  
pp. 63-71
Author(s):  
Maria Consiglia Trotta ◽  
Roberto Alfano ◽  
Giovanna Cuomo ◽  
Ciro Romano ◽  
Antonietta Gerarda Gravina ◽  
...  

OBJECTIVE To compare the timing of serum anti-drug antibodies in adult and pediatric age groups, males and females, treated for inflammatory bowel disease or arthritis with adalimumab or infliximab by retrospectively combining data collected during a 2-year therapeutic drug monitoring period. METHODS Four hundred thirty sera were divided in groups collected at 0, 3, 6, 12, and 24 months (T0, T3, T6, T12, and T24) after initiation of therapy and assayed for drug and relative anti-drug antibodies levels. At each time point, the percentage of sera presenting anti-drug antibodies, as well as the drug concentrations, were calculated and correlated with patient age and sex. RESULTS Anti-drug antibodies were present in 31.5% of sera and were significantly higher in the pediatric age group than in the adult age group, through all time points. The percentages of sera showing anti-drug antibodies were significantly different as early as 3 months and were sera from pediatric female group. The percentages of sera showing anti-drug antibodies reached the highest value at 6 months in the pediatric age group and at 12 months in the adult age group. CONCLUSIONS Sera from pediatric had an earlier presence of anti-drug antibodies than adults. In particular, pediatric females sera showed the fastest anti-drug antibodies development.


2016 ◽  
Vol 12 (01) ◽  
pp. 22
Author(s):  
Gregory P Forlenza ◽  
David Maahs ◽  
◽  

Recent data from the Type 1 Diabetes Exchange has highlighted the urgent need for better glycemic control in the pediatric age group. Fortunately, ongoing research on insulin pumps, continuous glucose monitors, and artificial pancreas systems continues to improve our ability to manage type 1 diabetes in all age groups, while reducing the burden of care at the same time. Here we discuss the status of diabetes technology research as well as future directions and goals of these projects.


2021 ◽  
Vol 8 (9) ◽  
pp. 1590
Author(s):  
Ananya Roy ◽  
Dhiraj Chandra Biswas

Since the end of December 2019, corona virus disease (COVID-19) has spread globally. Though the majority of COVID-19 cases in pediatric age group have not been critical, a novel disease named as multisystem inflammatory syndrome in children (MIS-C) have been emerging as the pandemic progresses. A systemic review of the literature was performed in the principle medical databases including Pubmed, Embase and Google Scholar between December 2019 and March 2021. A total of 40 articles were identified in the described database. Altogether 12 articles met the inclusion criteria and were eligible. The critical and severe case were more in infant age group, also the number of hospitalization was more in infant age group than other pediatric age groups. A number of case reports reflected that infants with COVID-19 positive may present with shock and sepsis. The mean age of MIS-C COVID-19 positive children was 1.1 year emphasizing the vulnerability of infant age group to this novel disease MIS-C. MIS-C is a new type of presentation of COVID-19 infection. Special emphasis should be given in infant age group with COVID-19 who are vulnerable to develop MIS-C. 


PEDIATRICS ◽  
1971 ◽  
Vol 47 (3) ◽  
pp. 548-557
Author(s):  
John R. Lilly ◽  
Geoffrey Giles ◽  
Richard Hurwitz ◽  
Gerhard Schroter ◽  
Hiroshi Takagi ◽  
...  

Fifty-seven patients were treated with renal homotransplantation from 1½ to 7⅔ years ago; 23 patients were 12 years or younger and the other 34 patients were 13 to 18. Family members (usually parents) were the primary donors in 45 cases. Unrelated volunteers or cadavers donated the other 12 homografts. Immunosuppression was with azathioprine and prednisone, and in some cases also with ALG. Forty-two of the 57 recipients survived for at least 1 year. Additional deaths occurred at 17½ and 19 months leaving 40 recipients (70.2%) alive. Six survivors had successful retransplantation following late failure of their original homografts. Control of rejection was not particularly different than in adult cases. "Homograft glomerulonephritis" was found in chronically tolerated transplants, but no more frequently than in older patients. Many postoperative problems in the pediatric age group were the consequence of retardation of growth caused either by pre-existing uremia or by the need for high dose postoperative steroid therapy, orthopedic accidents such as femoral and vertebral fractures, and psychiatric complications which led to two suicides. In spite of these difficulties, the meaningful rehabilitation that was obtained in the chronic survivors makes us regard pediatric patients as favorable candidates for therapy with renal transplantation.


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