RESUMO
The development of nephrotic syndrome in concomitance with Hashimoto's thyroiditis is an in frequent association in the pediatric age. OBJECTIVE: To report an infrequent complication of au toimmune thyroiditis, such as the appearance of nephrotic syndrome. CLINICAL CASE: A 10-year-old patient presenting with nephrotic syndrome and goiter. A history of autoimmune thyroiditis and un treated hypothyroidism was detected. Corticosteroid and hormone replacement therapy (levothyro- xine) is started, achieving a good clinical and laboratory response. CONCLUSION: Autoimmune thyroi ditis impacts renal physiology through immunological and non-immunological mechanisms. At the same time, renal repercussions can affect thyroid function. The importance of this communication lies in reporting an infrequent complication of autoimmune thyroiditis, such as the appearance of nephrotic syndrome.
Assuntos
Doença de Hashimoto , Hipotireoidismo , Síndrome Nefrótica , Tireoidite Autoimune , Humanos , Criança , Tireoidite Autoimune/complicações , Síndrome Nefrótica/complicações , Síndrome Nefrótica/diagnóstico , Doença de Hashimoto/complicações , Doença de Hashimoto/diagnóstico , Hipotireoidismo/complicações , RimRESUMO
Resumen: Cada vez es más frecuente la atención médica en la Unidad de Cuidados Intensivos (UCI) de niños o adolescentes inmigrantes como también de aquellos nacidos en nuestro país con padres en tal condición. Esto ha ocasionado, en la actualidad, que el equipo de salud se deba enfrentar con problemas diagnósticos derivados del escaso conocimiento de condiciones genéticas propias de esta población y/o el desarrollo de diversas patologías infrecuentes en nuestro país, algunas resultantes de su condi ción sanitaria. En esta revisión se abordan diversos aspectos de la patología hematológica, infecciosa, parasitaria, respiratoria y cardiovascular, todos tópicos relevantes de conocer durante su estadía en la UCI. Es un deber del equipo de salud actualizarse sobre patologías de baja prevalencia en nuestro país, algunas de ellas muy poco conocidas hasta hace una década, pero que, actualmente, están cada vez más presentes en las UCI del sistema de salud público chileno.
Abstract: It is increasingly common to provide medical care in the Intensive Care Unit (ICU) for immigrant children and adolescents as well as those born in Chile with parents in such condition. Currently, this has caused that the health team has to face diverse infrequent pathologies in our country and/ or diagnostic problems derive from the poor knowledge of genetic conditions of this population, some resulting from their health conditions. This review addresses several aspects of hematological, infectious, parasitic, respiratory, and cardiovascular pathologies, all relevant topics to know during their stay in the ICU. It is a duty of the health team to be updated on pathologies of low prevalence in our country, some of them very little known until a decade ago, but which are currently increasingly present in the ICUs of the Chilean public health system.
Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/etnologia , Doenças Respiratórias/terapia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/terapia , Cuidados Críticos/métodos , Emigrantes e Imigrantes , Doenças Hematológicas/diagnóstico , Doenças Hematológicas/etnologia , Doenças Hematológicas/terapia , Infecções/diagnóstico , Infecções/etnologia , Infecções/terapia , Unidades de Terapia Intensiva , Chile/epidemiologia , PrevalênciaRESUMO
La glomerulonefritis aguda desencadenada por Streptococcus pneumoniae es una patología de baja prevalencia. Existen diversos reportes que comunican distintas cepas nefritogénicas; sin embargo, la 6C ha sido escasamente señalada como tal.Se presenta el caso de un paciente de 4 años, quien ingresó a Terapia Intensiva con pleuroneumonía por Streptococcus pneumoniae serotipo 6C y desarrolló, de modo concomitante, edemas, hipertensión arterial, hematuria, proteinuria, disminución del filtrado glomerular y del nivel de complemento C3. Se diagnosticó glomerulonefritis aguda. Su evolución fue satisfactoria en un breve plazo. Esta patología, por lo general, es de curso transitorio y benigno; sin embargo, en ocasiones, puede complicar la evolución de un paciente críticamente enfermo, por lo cual se hace necesario tenerla entre los diagnósticos diferenciales para considerar.
Acute glomerulonephritis caused by Streptococcuspneumoniaeis a low prevalence pathology. There are several reports communicating different nephritogenic serotypes, however, 6C has been scarcely indicated as such. It is presented the case of a 4-year-old patient who entered Intensive Therapy Unit with pleuropneumonia due to Streptococcuspneumoniae serotype 6C and concomitantly developed edemas, arterial hypertension, hematuria, proteinuria, decreased glomerular filtration rate and C3 complement level. Acute glomerulonephritis was diagnosed. His evolution was satisfactory in a short time. This pathology is usually of a transitory and benign course; however, sometimes it can potentially complicate the evolution of a critically ill patient, so it is necessary to have it among the differential diagnoses to consider.
Assuntos
Humanos , Masculino , Pré-Escolar , Pleuropneumonia/diagnóstico , Glomerulonefrite , Pleuropneumonia/tratamento farmacológico , Streptococcus pneumoniae , Diagnóstico DiferencialRESUMO
Acute glomerulonephritis caused by Streptococcus pneumoniae is a low prevalence pathology. There are several reports communicating different nephritogenic serotypes, however, 6C has been scarcely indicated as such. It is presented the case of a 4-year-old patient who entered Intensive Therapy Unit with pleuropneumonia due to Streptococcus pneumoniae serotype 6C and concomitantly developed edemas, arterial hypertension, hematuria, proteinuria, decreased glomerular filtration rate and C3 complement level. Acute glomerulonephritis was diagnosed. His evolution was satisfactory in a short time. This pathology is usually of a transitory and benign course; however, sometimes it can potentially complicate the evolution of a critically ill patient, so it is necessary to have it among the differential diagnoses to consider.
La glomerulonefritis aguda desencadenada por Streptococcus pneumoniae es una patología de baja prevalencia. Existen diversos reportes que comunican distintas cepas nefritogénicas; sin embargo, la 6C ha sido escasamente señalada como tal. Se presenta el caso de un paciente de 4 años, quien ingresó a Terapia Intensiva con pleuroneumonía por Streptococcus pneumoniae serotipo 6C y desarrolló, de modo concomitante, edemas, hipertensión arterial, hematuria, proteinuria, disminución del filtrado glomerular y del nivel de complemento C3. Se diagnosticó glomerulonefritis aguda. Su evolución fue satisfactoria en un breve plazo. Esta patología, por lo general, es de curso transitorio y benigno; sin embargo, en ocasiones, puede complicar la evolución de un paciente críticamente enfermo, por lo cual se hace necesario tenerla entre los diagnósticos diferenciales para considerar.
Assuntos
Glomerulonefrite/diagnóstico , Pleuropneumonia/diagnóstico , Infecções Pneumocócicas/diagnóstico , Streptococcus pneumoniae/isolamento & purificação , Doença Aguda , Pré-Escolar , Glomerulonefrite/microbiologia , Humanos , Masculino , Pleuropneumonia/microbiologiaRESUMO
It is increasingly common to provide medical care in the Intensive Care Unit (ICU) for immigrant children and adolescents as well as those born in Chile with parents in such condition. Currently, this has caused that the health team has to face diverse infrequent pathologies in our country and/ or diagnostic problems derive from the poor knowledge of genetic conditions of this population, some resulting from their health conditions. This review addresses several aspects of hematological, infectious, parasitic, respiratory, and cardiovascular pathologies, all relevant topics to know during their stay in the ICU. It is a duty of the health team to be updated on pathologies of low prevalence in our country, some of them very little known until a decade ago, but which are currently increasingly present in the ICUs of the Chilean public health system.