scholarly journals A Case Series of Cyclic Vomiting Syndrome in Children at Pediatric Gastroenterology Clinic in Benghazi Medical Center

2021 ◽  
pp. 56-62
Author(s):  
Omelkhir I. Elbanoni ◽  
Ahlam A. Snaalla ◽  
Huda A. Elabbud ◽  
Tahani A. Asnedel
Keyword(s):  
Pediatric Patients ◽  
Medical Center ◽  
Case Series ◽  
Sudden Onset ◽  
Response To Treatment ◽  
Cyclic Vomiting Syndrome ◽  
Pediatric Gastroenterology ◽  
Prodromal Symptoms ◽  
Duration Of Symptoms ◽  
Cyclic Vomiting

Background: Cyclic vomiting syndrome (CVS) is a functional disorder characterized by repeated episodes of sudden onset of intense vomiting that is followed by symptom-free periods. The diagnosis is based on the fulfillment of Rome IV criteria. The Cyclic vomiting syndrome shares similar features to migraine headaches. It is under-recognized and often misdiagnosed with significant delays in therapy. Aims: To evaluate the clinical characteristic of pediatric patients diagnosed with cyclic vomiting syndrome in our institution and their response to treatment. Patients and Methods: A prospective case series of 13 pediatric patients with cyclic vomiting syndrome seen between period of November 2018 to November 2020 at pediatric gastroenterology outpatient’s clinic in Benghazi medical center. All relevant data including; age and sex, age of presentation, duration of symptoms, age at diagnosis, presence of aura or prodromal symptoms, patient or family history of headache, treatment and their response to treatment were collected. Results: The mean age for diagnosis was 112.2 ± 37.7 months. 46.2% of patients had recognizable prodromal symptoms. Patients with CVS had intense nausea and persistent vomiting that requiring hospitalization. In 44.4% of patients had stopped the episodes as a response to propranolol. Conclusion: Cyclic Vomiting Syndrome (CVS) is a functional, an under-recognized, and misdiagnosed episodic. The illness is characterized by stereotypical pattern of vomiting leading to frequent hospitalizations.

scholarly journals Cyclic vomiting syndrome: a case series and review of the literature

2016 ◽  
Vol 9 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Jessica Shearer ◽  
Pavit Luthra ◽  
Alexander C Ford
Keyword(s):  
Medical Records ◽  
Tricyclic Antidepressants ◽  
Case Series ◽  
Response To Treatment ◽  
Cyclic Vomiting Syndrome ◽  
Review Of The Literature ◽  
Duration Of Symptoms ◽  
History Of ◽  
Cannabis Smoking ◽  
Cyclic Vomiting

ObjectiveCyclic vomiting syndrome (CVS) is under-recognised. Treatment is difficult as the pathophysiology is incompletely understood. We report our experience of treating patients with amitriptyline, and review the literature to summarise symptoms and associated features, epidemiology, potential pathophysiological mechanisms, differential diagnoses and treatment.DesignConsecutive adult patients with CVS were identified during a 5-year period from January 2010 until December 2015. Medical records were reviewed retrospectively, and age and sex of the patient, symptoms, associated features and response to treatment with amitriptyline were recorded.SettingA luminal gastroenterology clinic at a teaching hospital.ResultsSeventeen patients were identified (mean age 29.8 years, 13 (76.5%) female). Five had a history of cannabis use. Duration of symptoms prior to diagnosis ranged from 5 months to 15 years. Fourteen patients commenced amitriptyline, and in eight (57.1%) symptoms either ceased entirely or improved. Review of the literature suggested the prevalence of CVS was 0.5%. Symptoms are stereotypical, with acute episodes of nausea and vomiting, interspersed by periods when the patient is symptom-free. Proposed pathophysiologies include neuroendocrine dysfunction, mutations in mitochondrial DNA and re-intoxication effects from cannabis stored in fat tissues. Treatment during the acute phase is supportive, with rehydration, sedation and antiemetics. Prophylaxis to prevent future attacks with antihistamines, antimigraine drugs, antiepileptics and tricyclic antidepressants may be beneficial. Complete cessation of cannabis smoking should be advised.ConclusionsDiagnosis of CVS is often delayed in adults. Once identified, patients respond well to amitriptyline.

Treatment of Mycoplasma pneumoniae-Induced Rash and Mucositis With Cyclosporine

2019 ◽  
Vol 23 (6) ◽  
pp. 608-612 ◽  
Author(s):  
Heidi Oi-Yee Li ◽  
Sophia Colantonio ◽  
Michele L. Ramien
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Pediatric Patients ◽  
Therapeutic Option ◽  
Case Series ◽  
Supportive Therapy ◽  
Standards Of Care ◽  
Prodromal Symptoms ◽  
Potential Efficacy ◽  
Effective Therapeutic Option ◽  
Evidence Based Guidelines

Background Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a relatively newly recognized clinical entity that typically presents with predominant mucositis accompanied by variable cutaneous involvement 7-9 days after the onset of prodromal symptoms. There are no evidence-based guidelines for treatment, and current standards of care may include supportive therapy, antibiotics, corticosteroids, and intravenous immunoglobulin . Objective This case series aims to describe the potential efficacy of cyclosporine A (CsA) in the treatment of MIRM. Methods The present case series details our use of CsA early in the course of MIRM in 3 pediatric patients. Results Rapid clinical resolution was observed following CsA therapy. Conclusions We suggest that early initiation of CsA may be an effective therapeutic option for MIRM.

scholarly journals Arthroscopic Management of Pigmented Villonodular Synovitis of the Hip in Children and Adolescents

2018 ◽  
Vol 6 (3) ◽  
pp. 232596711876311 ◽  
Author(s):  
S. Clifton Willimon ◽  
Tim Schrader ◽  
Crystal A. Perkins
Keyword(s):  
Pediatric Patients ◽  
Case Reports ◽  
Pediatric Population ◽  
Case Series ◽  
Pigmented Villonodular Synovitis ◽  
Villonodular Synovitis ◽  
Arthroscopic Synovectomy ◽  
Duration Of Symptoms ◽  
Pigmented Villonodular

Background: Pigmented villonodular synovitis (PVNS) is a benign proliferative synovial disorder most commonly described to affect the knee in adults. Literature describing PVNS in the pediatric population is limited to 2 small case series and a handful of single-patient case reports. Within these studies, only 2 patients with PVNS of the hip are described. Purpose: To describe the presentation, management, and outcomes of a single-center series of pediatric patients with PVNS of the hip treated with arthroscopic synovectomy. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of consecutive pediatric patients treated for PVNS at a single institution was performed. Inclusion criteria consisted of patients younger than 19 years with surgically treated PVNS of the hip. Results: Five pediatric patients with a mean age of 11.0 years were treated for PVNS of the hip from 2011 to 2016. The mean duration of symptoms from onset to surgical treatment was 247 days (range, 3-933 days). Upon review of magnetic resonance imaging (MRI) results, radiologists included PVNS in their differential in 3 patients. Seven surgeries were performed in 5 patients. All therapeutic procedures were arthroscopic synovectomies. Nodular PVNS was present in 4 patients, and diffuse disease was present in 1 patient. At a mean 32-month follow-up (range, 12-63 months), all patients were considered to be free of recurrence based on clinical examination and/or follow-up MRI. Four patients were asymptomatic and returned to all of their previous sports activities. Conclusion: Young age at the time of diagnosis is a point to be highlighted in this cohort, and symptoms may be present for many months prior to diagnosis due to the failure to consider PVNS in children. Therefore, for patients with “atypical” presentations or lack of improvement with treatment for rheumatologic, bleeding, or infectious disorders, PVNS should be strongly considered. MRI with gradient echo sequences is the diagnostic imaging study of choice. One patient with diffuse involvement and preoperative degenerative changes showed progressive changes postoperatively. This type of PVNS may have a worse prognosis, but more diffuse cases are needed before the prognosis can be determined. Arthroscopic synovectomy following a timely diagnosis of PVNS produces good outcomes in nodular cases, with no evidence of symptomatic or radiographic disease persistence among these patients.

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