Sarcoidosis presenting as bilateral lacrimal gland swelling: a pediatric case report

Abstract Background To describe a case of pediatric sarcoidosis which initially presented as papillary conjunctivitis before manifesting as bilateral lacrimal gland swelling without other known systemic involvement. Case presentation A 10-year-old female presented to the pediatric ophthalmology clinic with complaints of bilateral eyelid swelling, tearing and itching for approximately 1 month. Her history and exam were most consistent with allergic conjunctivitis, for which she was started on a standard topical regimen. Despite initial improvement, she re-presented with significantly worsened eyelid swelling and minimal allergic symptoms. Enlargement of the lacrimal glands were palpable at this time. Lacrimal gland biopsy was obtained which demonstrated noncaseating granulomas. Systemic workup did not reveal evidence of disease involvement elsewhere. Conclusions Sarcoidosis in the pediatric population may present in a myriad of ways and is well-known to mimic other disease entities. We present a case of pediatric sarcoidosis which presented initially as papillary conjunctivitis before manifesting as bilateral lacrimal gland swelling without systemic involvement.

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Indeterminate Cell Histiocytosis of the Spine: A Case Report

Pediatric Neurosurgery ◽

10.1159/000517331 ◽

2021 ◽

pp. 1-6

Author(s):

Dallas Louis Sheinberg ◽

Jean-Paul Bryant ◽

Roberto J. Perez-Roman ◽

Toba N. Niazi

Keyword(s):

Dendritic Cells ◽

Pediatric Population ◽

Surgical Excision ◽

Mass Effect ◽

Giant Cells ◽

Neoplastic Disease ◽

Case Presentation ◽

Systemic Involvement ◽

Lower Back ◽

Ct And Mri

Introduction: Indeterminate cell histiocytosis is a rare neoplastic disease characterized by proliferation of dendritic cells that share morphologic and immunophenotypic features of Langerhans cells and non-Langerhans histiocytes. ICH lesions are typically restricted to the skin; however, there have been rare reports of extracutaneous and systemic involvement. Case Presentation: We describe a case of a 13-year-old female presenting with complaints of worsening lower back pain for 1 year. CT and MRI of the lumbar spine demonstrated a well-defined bony, lytic, expansile lesion of the posterior and mid-endplate of the L4 vertebra with mass effect on the thecal sac. The patient underwent L3–L5 decompression and fusion with surgical excision of the vertebral body tumor. Microscopic examination of the lesion showed benign fibrohistiocytic proliferation with giant cells, and immunohistochemical staining revealed a phenotype consistent with indeterminate cell histiocytosis (S100+ CD1a+ langerin−). Discussion/Conclusion: ICH is an extraordinarily rare neoplastic disease of dendritic cells that has a poorly understood pathogenesis. This case expands the spectrum of potential ICH extracutaneous involvement to now include the spine, a location previously undocumented in the literature in the pediatric population.

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Pediatric P-ANCA Vasculitis following COVID-19

10.22541/au.162055806.69831997/v1 ◽

2021 ◽

Author(s):

Yaron Fireizen ◽

Cyrus Shahriary ◽

Maria Imperial ◽

Inderpal Randhawa ◽

Nastasia Nianiaris ◽

...

Keyword(s):

Pediatric Population ◽

Kidney Injury ◽

The Body ◽

Pediatric Case ◽

Case Presentation ◽

Necrotizing Glomerulonephritis ◽

History Of ◽

Complex Deposition ◽

Inflammatory Syndrome ◽

Pulse Steroids

Background: Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA), a subset of ANCA, are associated with a multisystem vasculitis affecting small blood vessels in the body. A handful of adult patients who developed vasculitis post-COVID-19 infection have been reported. Although COVID-19 infection has been shown to drive an exaggerated immune response in the pediatric population, such as MIS-C (multisystem inflammatory syndrome in children), only one case of vasculitis following COVID-19 infection has been reported previously in children. Case presentation: Seventeen-year-old male with a past medical history of COVID-19 pneumonia two months prior presented with acute kidney injury/failure and diffuse alveolar hemorrhage (DAH). Rheumatologic workup revealed P-ANCA and Myeloperoxidase (MPO) positivity. Kidney biopsy showed necrotizing glomerulonephritis with limited immune complex deposition. Subsequently, he was treated with pulse steroids, plasmapheresis, and ultimately started on cyclophosphamide. Conclusions: To our knowledge, this report presents the second reported pediatric case of P-ANCA / MPO vasculitis following COVID-19 infection.

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Recurrent schwannoma of the tongue in a pediatric patient—report of a rare case with an updated review of literature

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00101-0 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Anup Singh ◽

Vaisakh Kuzhikkali ◽

Arvind Kumar Kairo

Keyword(s):

Pediatric Population ◽

Surgical Excision ◽

Review Of Literature ◽

Case Presentation ◽

Nerve Sheath Tumors ◽

Peripheral Nerve Sheath Tumors ◽

Nerve Sheath ◽

Cervical Sympathetic ◽

Mobile Tongue

Abstract Background Head and neck is a relatively common site of occurrence for the peripheral nerve sheath tumors, and majority of these tumors are seen involving neck, involving vagus nerve, and cervical sympathetic chain. Schwannomas involving mobile tongue are rarely encountered, especially in the pediatric population Case presentation We present a case of recurrent tongue schwannoma in a 13-year-old female successfully managed with transoral excision. At a follow-up of 3 years, no recurrence is observed. Conclusion Surgical excision is the recommended modality of treatment for lingual schwannomas, and when excised adequately, recurrences are not expected. A clear margin of surrounding normal tissue should be aimed for to avoid possible recurrence.

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Concurrent Pseudomonas Periorbital Necrotizing Fasciitis and Endophthalmitis: A Case Report and Literature Review

Pathogens ◽

10.3390/pathogens10070854 ◽

2021 ◽

Vol 10 (7) ◽

pp. 854

Author(s):

Yu-Kuei Lee ◽

Chun-Chieh Lai

Keyword(s):

Soft Tissue ◽

Literature Review ◽

Necrotizing Fasciitis ◽

Subcutaneous Tissue ◽

Superficial Fascia ◽

Upper Eyelid ◽

Case Presentation ◽

Phthisis Bulbi ◽

Eyelid Swelling ◽

The Rich

(1) Background: Necrotizing fasciitis (NF) is an infection involving the superficial fascia and subcutaneous tissue. Endophthalmitis is an infection within the ocular ball. Herein we report a rare case of concurrent periorbital NF and endophthalmitis, caused by Pseudomonas aeruginosa (PA). We also conducted a literature review related to periorbital PA skin and soft-tissue infections. (2) Case presentation: A 62-year-old male had left upper eyelid swelling and redness; orbital cellulitis was diagnosed. During eyelid debridement, NF with the involvement of the upper Müller’s muscle and levator muscle was noted. The infection soon progressed to scleral ulcers and endophthalmitis. The eye developed phthisis bulbi, despite treatment with intravitreal antibiotics. (3) Conclusions: Immunocompromised individuals are more likely than immunocompetent hosts to be infected by PA. Although periorbital NF is uncommon due to the rich blood supply in the area, the possibility of PA infection should be considered in concurrent periorbital soft-tissue infection and endophthalmitis.

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Spine Metastasis of Thymic Carcinoma in a Pediatric Patient: A Case Report and Comprehensive Literature Review

Pediatric Neurosurgery ◽

10.1159/000510471 ◽

2020 ◽

Vol 55 (5) ◽

pp. 289-294

Author(s):

Kadir Oktay ◽

Ebru Guzel ◽

Okay Baykara ◽

Mevlana Akbaba ◽

Ibrahim Sari ◽

...

Keyword(s):

Pediatric Patients ◽

Thymic Carcinoma ◽

Tumor Resection ◽

Treatment Protocol ◽

Spinal Column ◽

Spinal Instability ◽

Pediatric Case ◽

Case Presentation ◽

Intrathoracic Tumor ◽

History Of

Introduction: Thymic carcinoma metastases of the spinal column are very rare, especially in pediatric patients. To our knowledge, this is the first such pediatric case in the literature. Case Presentation: We report the case of a 14-year-old male patient with T12 and L1 metastases of thymic carcinoma. He had history of thymectomy and intrathoracic tumor resection 7 months previously. The patient’s neurological condition deteriorated; therefore, tumor resection and decompression of the spinal canal were performed. He underwent instrumentation and fusion procedures to prevent spinal instability. Conclusion: The main purpose of the treatment is gross total resection of the thymic carcinoma. However, adjuvant methods such as radiotherapy and chemotherapy should be added to the treatment protocol in patients who have higher stage diseases or those in whom total tumor resection cannot be achieved.

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A Unique Case of Multiple Sites of Pneumatization of the Sinonasal Bony Framework in a Pediatric Patient

Ear Nose & Throat Journal ◽

10.1177/014556131008901103 ◽

2010 ◽

Vol 89 (11) ◽

pp. E10-E11 ◽

Cited By ~ 2

Author(s):

Georgios Giourgos ◽

Elina Matti ◽

Paolo Carena ◽

Fabio Pagella

Keyword(s):

Pediatric Patient ◽

Pediatric Population ◽

Inferior Turbinate ◽

Anatomic Variations ◽

Concha Bullosa ◽

Unique Case ◽

Pediatric Case

Anatomic variations of the sinonasal bony framework in the pediatric population are quite common. In children with such variations, however, bony pneumatization is uncommon. Moreover, pneumatization of the inferior turbinate in children is extremely rare; to the best of our knowledge, only 3 cases have been previously reported in the literature–none of which involved additional pneumatization variations of the sinonasal skeleton. Herein we present a new pediatric case that was unique in that an inferior concha bullosa coexisted with rarely seen pneumatized anatomic structures.

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Familial oral lichen planus in a 3-year-old boy: a case report with eight years of follow-up

BMC Oral Health ◽

10.1186/s12903-020-01333-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Fang Wang ◽

Ya-Qin Tan ◽

Jing Zhang ◽

Gang Zhou

Keyword(s):

Lichen Planus ◽

Oral Mucosa ◽

Buccal Mucosa ◽

Oral Lichen Planus ◽

Familial Aggregation ◽

Pediatric Population ◽

Case Presentation ◽

Oral Lichen

Abstract Background Oral lichen planus (OLP) is a chronic mucocutaneous disease characterized by adult predominance and a prolonged course. However, it is rare in the pediatric population with familial aggregation. Case presentation A 3-year-old boy presented with pain and irritation on the oral mucosa while contacting spicy food for 2 months. Oral examination showed widespread whitish reticular and papular lesions on the lips, the dorsum of the tongue, and bilateral buccal mucosa, with diffuse erosions covered with pseudomembrane on the buccal mucosa. The boy’s parents were examined to exhibit white reticular and plaque-like lesions on their oral mucosa. The three patients were clinically diagnosed as affected by OLP and histopathologically confirmed. The boy underwent topical treatment with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel, and oral lesions gradually resolved and healed. Neither of his parents received treatment. During the subsequent follow-ups, none of three patients underwent any medical treatment. Fortunately, their lesions had almost faded over 8 years. Conclusions Our case emphasizes that pediatric OLP should be recorded with family history. Besides, long-term periodic follow-up is recommended in pediatric patients with OLP for monitoring any changes in lesions.

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Spontaneous orbital subcutaneous emphysema mimicking lacrimal duct obstruction after sneezing: A case report

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918797530 ◽

2018 ◽

Vol 27 (3) ◽

pp. 176-179

Author(s):

Hung-Yen Chan ◽

Chon-Fu Lio ◽

Chang-Ching Yu ◽

Nan-Jing Peng ◽

Hung-Pin Chan

Keyword(s):

Case Report ◽

Subcutaneous Emphysema ◽

Relevant Information ◽

Lacrimal Duct ◽

Case Presentation ◽

Duct Occlusion ◽

Painful Sensation ◽

Eyelid Swelling ◽

Visual Problems ◽

The Right

Introduction: Orbital subcutaneous emphysema after trauma has been carefully reported, but its development in the absence of trauma is rare. Case presentation: We report on a 70-year-old patient who developed unilateral orbital subcutaneous emphysema, mimicking lacrimal duct occlusion, after this man sneezed, and presented with right crepitant eyelid swelling and progressive ptosis. Orbital subcutaneous emphysema develops when air can get into the periorbital soft tissue, which presents as a result of facial bone trauma, iatrogenic procedures, and gas-forming infectious microorganisms, as seen in many published articles. It is very uncommon to see this kind of case report after sneezing; however, in our case, spontaneous orbital subcutaneous emphysema occurred after sneezing that resolved slowly after a few weeks without surgical intervention. Our patient denied any painful sensation over the right orbital area, including no visual problems with the right eye but right eyeball limited movements. It can be stressful to patients due to its symptoms but is not a true emergency. Conclusion: In this article, we should bring awareness to physicians of the possibility of a spontaneously orbital subcutaneous emphysema with complications after sneezing, yielding relevant information for patients to be informed about avoid excessive nose blowing or occluding the nose, creating controlled symptoms.

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Penetrating eye injuries in pediatric population: An epidemiological study and visual outcome

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i4.14690 ◽

2016 ◽

Vol 7 (4) ◽

pp. 84-87

Author(s):

Kabindra Bajracharya ◽

Salma KC Rai ◽

Arjun Malla Bhari ◽

Hari Bahadur Thapa ◽

Anjita Hirachan ◽

...

Keyword(s):

Visual Acuity ◽

Pediatric Population ◽

Visual Outcome ◽

Eye Injury ◽

Pediatric Ophthalmology ◽

Eye Injuries ◽

Penetrating Eye Injury ◽

Wooden Stick ◽

One Year ◽

Better Than

Introduction: Penetrating eye injury is an important cause of visual impairment in pediatric population.Aims and Objectives: To study the epidemiology and visual outcome of penetrating eye injuries in pediatric population presented to Lumbini Eye Institute, the tertiary eye hospital of western Nepal.Materials and Methods: This retrospective study was conducted at the Department of Pediatric Ophthalmology and Strabismus, Lumbini Eye Institute over a period of one year from June 2014 to May 2015. All patients of penetrating eye injuries up to the age of 15 years were included in the study. The demographics of the patient, cause and duration of injury were recorded. The presenting and final best corrected visual acuity, anterior and posterior segment findings were recorded in specially designed proforma.Results: A total number of 127 children (127 eyes) presented with penetrating eye injuries during a year. The incidence of penetrating eye injury in one year was 127 out of 12927 new patients. Minimum age was 11 months, while the maximum age was 15 years with mean of 7.29 years (SD= ±3.49). Male and female patients were 99 (78%) and 28 (22%) respectively. Involvement of right eye was seen in 69 cases (54.33%) and left eye 58 (45.67%). The most common cause of injury was wooden stick in 55 cases (43.31%) followed by iron wire 12 (9.45%) and the stone 11 (8.66%). Corneal laceration was found in 102 cases (80.31%), scleral laceration in 10 (7.87%) and corneo-scleral laceration in 15 (11.81%). Seventy three percent patients were blind at the time of presentation whereas at discharge 37.63% were blind and 11.43% of patients had visual acuity better than 6/18 at presentation whereas 35.48% had visual acuity better than 6/18 after treatment.Conclusion: Penetrating eye injury is one of the common causes attending Pediatric Ophthalmology Department. Penetrating eye injury is common in male and majority of trauma is caused by wooden stick. The awareness of ocular trauma and its consequences should be increased to reduce incidence of childhood blindness.Asian Journal of Medical Sciences Vol.7(4) 2016 84-87

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Isolated fallopian tube torsion associated with hydrosalpinx in a 12-year-old girl: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02462-1 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Javier Martín-Vallejo ◽

Enrique E. Garrigós-Llabata ◽

Patricia Molina-Bellido ◽

Pedro A. Clemente-Pérez

Keyword(s):

Abdominal Pain ◽

Fallopian Tube ◽

Acute Abdominal Pain ◽

Pediatric Population ◽

Rare Condition ◽

Case Presentation ◽

Reactive Protein ◽

Clinical Case Study ◽

Caucasian Girl

Abstract Background Isolated fallopian tube torsion associated with hydrosalpinx is a rare condition in the pediatric population. We present this unusual clinical case study in a sexually inactive girl. Case presentation a12-year-old Caucasian girl presented symptoms of acute abdominal pain. Pelvic ultrasound revealed a normal looking uterus and ovaries and next to left ovary a imaging compatible with hydrosalpinx. She was discharged 48 hours later after clinical monitoring with oral analgesia and normal blood workup. At 3 weeks, she was readmitted for acute abdominal pain. Leukocytosis with left shift and raised C-reactive protein were observed. Her clinical condition worsened, and complication of the preexisting hydrosalpinx was suspected. Exploratory laparoscopy confirmed torsion of the fallopian tube. Left salpingectomy was performed. Histopathologic study confirmed a fallopian tube with hemorrhagic infarct. Conclusion Torsion of the fallopian tube must be considered in the event of acute abdominal pain. Early diagnosis and trying conservative management with a view to preserving fertility in this group of patients are essential.

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