RESUMEN
Midodrine hydrochloride is a potent peripherally-acting alpha1 agonist that is well absorbed and rapidly metabolized to its active metabolite. It has been used for the treatment of refractory syncope but has the important side effect of supine hypertension. A 10-year-old boy with severe symptomatic orthostatic hypotension was treated with midodrine. After therapy, syncope attacks ceased but he suffered nighttime headaches, nausea, transient rash and itchy/prickly scalp. Midodrine was discontinued when supine hypertension was noticed. However, his supine hypertension continued until day 19 after discontinuation. This case shows that patients receiving midodrine should be observed for supine hypertension for a prolonged period.
Asunto(s)
Agonistas alfa-Adrenérgicos/efectos adversos , Hipertensión/etiología , Hipotensión Ortostática/tratamiento farmacológico , Midodrina/efectos adversos , Agonistas alfa-Adrenérgicos/uso terapéutico , Niño , Humanos , Masculino , Midodrina/uso terapéutico , Factores de TiempoRESUMEN
In children, dilated coronary arteries are usually caused by Kawasaki's disease. We report four children with dilated coronary arteries and nephropathic cystinosis.
Asunto(s)
Enfermedad Coronaria/etiología , Cistinosis/complicaciones , Adolescente , Niño , Enfermedad Coronaria/diagnóstico por imagen , Dilatación Patológica , Ecocardiografía , Femenino , HumanosRESUMEN
Pericardial effusions and cardiac tamponade are rare and severe complications of leukemia. They often develop during the radiation therapy, chemotherapy, or infections in the course of leukemia. However, some cases present with pericardial effusion and tamponade. We report a three-year-old girl who was admitted with cardiac tamponade and needed urgent pericardiocentesis. Clinical evaluation and laboratory results revealed myeloid markered-T cell acute lymphoblastic leukemia (ALL) and pericardial invasion. She is the youngest patient with cardiac tamponade who was diagnosed acute lymphoblastic leukemia in the English-language literature.