{"title":"The clinical manifestation and diagnostic features of Kawasaki-like phenotypes in pediatric multisystem inflammatory syndrome: a comparative retrospective study in Ukraine.","authors":"Nataliia Bodnarchuk-Sokhatska, Halyna Pavlyshyn, Kateryna Kozak, Iryna Avramenko","doi":"10.3389/fped.2025.1593190","DOIUrl":"10.3389/fped.2025.1593190","url":null,"abstract":"<p><strong>Background: </strong>The clinical overlap syndrome between multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD), particularly in the context of SARS-CoV-2 infection, presents diagnostic challenges. The presence of both complete and incomplete Kawasaki-like phenotypes (KLP) further complicates differentiation. This study aimed to analyze Kawasaki-like phenotype of MIS-C, its clinical features, and improve diagnostic accuracy, patient outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 48 pediatric patients diagnosed with MIS-С between 2020 and 2022. All cases met the MIS-C diagnostic criteria established by the Council of State and Territorial Epidemiologists (2022) and were classified according to the American Heart Association Kawasaki disease criteria (2017). Patients were grouped as non-Kawasaki-like or Kawasaki-like MIS-C phenotypes, with the latter subdivided into complete and incomplete subtypes. Clinical and echocardiographic features were compared using appropriate statistical methods.</p><p><strong>Results: </strong>Among the 48 MIS-C cases analyzed, 22 patients (46%) met the Kawasaki disease criteria, equally divided between complete and incomplete Kawasaki-like phenotypes. btion was longest in the complete phenotype (9.7 days) and shortest in the incomplete phenotype (5.5 days). Patients with neurological involvement experienced longer febrile periods (8.3 vs. 5.4 days). All 100% patients with the complete phenotype exhibited neurological symptoms vs. 46% of incomplete cases. Half of the Kawasaki-like phenotype patients demonstrated echocardiographic abnormalities vs. 15% of non-Kawasaki-like (NKL); highest in the incomplete phenotype (91%) compared to 15% in non-Kawasaki-like and 9% in complete KLP. The highest incidence of coronary dilatation was recorded in the incomplete phenotype (73%) vs. 9% in the complete and 15% in the non-Kawasaki-like MIS-C.</p><p><strong>Discussion: </strong>Kawasaki-like MIS-C phenotypes display distinct clinical and cardiovascular profiles. Accurate phenotypic identification is crucial for risk stratification and optimizing patient management. Further research is necessary to refine classification criteria and establish effective long-term monitoring strategies for affected children.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1593190"},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in PediatricsPub Date : 2025-07-03eCollection Date: 2025-01-01DOI: 10.3389/fped.2025.1598448
Chen ZongLi, Luo KeYong, Jiang Liang
{"title":"Value of single-center fecal calprotectin in the early diagnosis and assessment of necrotizing enterocolitis in premature infants.","authors":"Chen ZongLi, Luo KeYong, Jiang Liang","doi":"10.3389/fped.2025.1598448","DOIUrl":"10.3389/fped.2025.1598448","url":null,"abstract":"<p><strong>Objective: </strong>To explore the value of fecal calprotectin (FC) in the early diagnosis of necrotizing enterocolitis (NEC) in premature infants.</p><p><strong>Methods: </strong>From September 2021 to June 2024, 84 premature infants with NEC were selected as the NEC group, and 84 premature infants with feeding intolerance (feeding intolerance group) and 168 healthy premature infants (healthy group) were selected at the same time. ROC curves were used to analyze the value of FC in the early diagnosis and condition evaluation of NEC in premature infants, and Spearman correlations were used to analyze the relationships between FC and the occurrence and severity of NEC in premature infants.</p><p><strong>Results: </strong>FC levels in the NEC group were greater than those in the feeding intolerance group and healthy group (<i>P</i> < 0.05), and there was no significant difference between the feeding intolerance group and the healthy group (<i>P</i> > 0.05). The FC level of premature infants with NEC III was greater than that of premature infants with NEC Ⅰ and Ⅱ, and the FC level of premature infants with NEC II was greater than that of premature infants with NEC Ⅰ (<i>P</i> < 0.05). ROC curve analysis revealed that the best diagnostic values of FC for premature infants with NEC and their conditions were 8.40 μg/g and 53.50 μg/g, respectively, and the AUCs were 0.651 and 0.901, respectively, with sensitivities of 42.86% and 85.71%, specificities of 89.23% and 82.61%, respectively. Spearman correlation analysis revealed that FC was positively correlated with the occurrence and severity of NEC in premature infants (<i>r</i> <sub>s</sub> = 0.401, 0.853; <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The level of FC in premature infants with NEC is abnormally high, and FC has high clinical value for early diagnosis and condition evaluation of premature infants with NEC, which is worthy of further investigation.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1598448"},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in PediatricsPub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fped.2025.1573544
Yang Yang, Qiong Chen
{"title":"Juvenile polyposis syndrome in a child with von Willebrand disease: a case report and literature review.","authors":"Yang Yang, Qiong Chen","doi":"10.3389/fped.2025.1573544","DOIUrl":"10.3389/fped.2025.1573544","url":null,"abstract":"<p><strong>Background: </strong>Juvenile polyposis syndrome (JPS) is a rare autosomal dominant genetic disorder characterized by multiple gastrointestinal juvenile polyps. Endoscopic polypectomy is the primary therapeutic approach, minor post-polypectomy bleeding is the most common complication. We report an exceptional case of massive hemorrhage (approximately 400 ml) in a child with JPS.The cause of the post-polypectomy bleeding was relatively rare and was ultimately diagnosed as von Willebrand disease (VWD).</p><p><strong>Case presentation: </strong>A six-year-old girl with JPS and no prior bleeding history underwent endoscopic polypectomy for 11 colorectal polyps.Laboratory tests showed normal platelet count, activated partial thromboplastin time (APTT), prothrombin time (PT), and plasma fibrinogen levels. However, approximately 70 hours after endoscopic polypectomy, she developed hematochezia with significant blood loss (approximately 400 ml). Emergent endoscopic findings did not support technical complications (e.g., clip dislodgement) as the primary etiology of the post-polypectomy hemorrhage.Genetic testing identified a mutation in the von Willebrand factor (VWF) gene [c.1707(exon14)delC, heterozygous], leading to a diagnosis of type 1 von Willebrand disease, which subsequently led to the unexpected post-polypectomy bleeding.</p><p><strong>Conclusion: </strong>The rare case of juvenile polyposis syndrome with von Willebrand disease in a child underscores the necessity of taking extrinsic gastrointestinal factors into account when delayed post-polypectomy bleeding arises following endoscopic polypectomy. Clinicians ought to be watchful for coagulation disorders, such as VWD, which might be manifested through atypical clinical symptoms. Timely identification of the cause of delayed post-polypectomy bleeding can improve prognosis.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1573544"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Case Report: Intra-articular injection of tocilizumab for arthritis treatment in chronic graft-vs.-host disease.","authors":"Mingyu Xie, Qin Liu, Huiting Yuan, Yumei Chen, Xian Zou, Zhenhong Zhang, Baimao Zhong, Huasong Zeng, Haisheng Zeng","doi":"10.3389/fped.2025.1515706","DOIUrl":"10.3389/fped.2025.1515706","url":null,"abstract":"<p><strong>Background: </strong>Chronic graft-vs.-host disease (cGVHD) is a major complication of allogeneic hematopoietic cell transplantation. It is a leading cause of long-term morbidity, non-relapse mortality, and impaired health-related quality of life. cGVHD is a multifactorial syndrome that can manifest with articular involvement. Approximately 50% of cGVHD survivors do not respond to glucocorticoid therapy used for arthritis. Subsequently, we shall present a case of a juvenile patient with arthritis and cGVHD, who responded well to intra-articular injection of tocilizumab, after bone marrow transplantation.</p><p><strong>Case pressentation: </strong>A male adolescent with acute myeloid leukemia successfully underwent marrow stem cell transplantation. However, he developed arthritis in the elbow and knee joints and had difficulty walking more than 3 months after transplantation. He was administered anti-rejection drugs with cyclosporine, ruxolitinib, and methylprednisolone by his physician, which did not work. He was subsequently treated with intravenous tocilizumab under the supervision of his rheumatologist. Although his clinical symptoms showed remission at early stages, his knee joints were more swollen, and he could not stand after being infected with COVID-19. Both of his knee joints was injected with tocilizumab at 0, 2, 4, 6, 7, 11, and 19 weeks. Interleukin (IL)-6 levels in the peripheral blood continuously decreased. After treatment for 4 months, the patient could walk a few hundred meters with minimal exertion.</p><p><strong>Conclusion: </strong>An intra-articular injection of tocilizumab could be a viable treatment option for arthritis; however, large-scale clinical trials are warranted to confirm its efficacy.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1515706"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction: Third generation sequencing transforms the way of the screening and diagnosis of thalassemia: a mini-review.","authors":"Lixia Zhan, Chunrong Gui, Wei Wei, Juliang Liu, Baoheng Gui","doi":"10.3389/fped.2025.1637415","DOIUrl":"https://doi.org/10.3389/fped.2025.1637415","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fped.2023.1199609.].</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1637415"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in PediatricsPub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fped.2025.1621500
Libor Svoboda, Sabine Mank, Sabine Meier, Marcel Vollroth, Alexandra Kiess, Christian Schürer
{"title":"Case Report: Neonatal right atrial mass of uncertain etiology.","authors":"Libor Svoboda, Sabine Mank, Sabine Meier, Marcel Vollroth, Alexandra Kiess, Christian Schürer","doi":"10.3389/fped.2025.1621500","DOIUrl":"10.3389/fped.2025.1621500","url":null,"abstract":"<p><strong>Background: </strong>Neonatal intracardiac masses are rare and pose significant diagnostic and therapeutic challenges, particularly in differentiating thrombi from tumors.</p><p><strong>Case summary: </strong>We present the case of a preterm neonate with a right atrial mass of uncertain etiology. Multimodal imaging, including echocardiography and cardiac MRI, suggested the presence of a thrombus-consistent with thrombi being the most common type of intracavitary cardiac mass. As a result, primary anticoagulation therapy was initiated. However, after 16 days without significant change in the mass and given the high risk of embolization and the possibility of a benign tumor, surgical excision was performed. Histopathological analysis of the excised tissue could not definitively distinguish between an organized thrombus and a regressed benign neoplasm, although no malignant cells were identified.</p><p><strong>Conclusions: </strong>This case highlights the diagnostic uncertainty surrounding neonatal intracardiac masses and the limitations of imaging and pathology in achieving definitive diagnosis. A multidisciplinary approach and long-term follow-up are essential, particularly when the true nature of the mass remains unclear.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1621500"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Global, regional, and national epidemiology of otitis media in children from 1990 to 2021.","authors":"HanYu Wang, XiaoYu Zeng, Xin Miao, BoWen Yang, ShiPeng Zhang, QinWei Fu, QinXiu Zhang, Mi Tang","doi":"10.3389/fped.2025.1513629","DOIUrl":"10.3389/fped.2025.1513629","url":null,"abstract":"<p><strong>Background: </strong>Otitis media(OM) is a prevalent ear condition, particularly among children, with a significant impact on quality of life. This study aimed to elucidate the global prevalence and disability-adjusted life years (DALYs) associated with OM in the 0-14 age group from 1990-2021, using data from the 2021 Global Burden of Disease (GBD) study.</p><p><strong>Methods: </strong>Our study conducted a comprehensive analysis of OM data from the GBD 2021 report, examining the prevalence and DALYs related to OM across 204 countries and territories over a 32-year period. Data were stratified by age, sex, year, geographic region, and sociodemographic index (SDI). Temporal trends were evaluated using estimated annual percent change (EAPC) calculations. Additionally, a global risk attribution analysis for childhood OM was conducted, and a Bayesian age-period-cohort (BAPC) model was applied to project the global burden of childhood OM from 2021-2035.</p><p><strong>Results: </strong>In 2021, the global burden of OM in children remained significant, with an incidence of 297,243,470 cases and an age-standardized prevalence of 14,775 cases per 100,000 population. OM resulted in 1,035,749 DALYs globally, with an age-standardized DALY rate of 51.48 per 100,000 population. Regionally, the highest age-standardized prevalence of OM was observed in Eastern Sub-Saharan Africa, South Asia, and Western Sub-Saharan Africa, while Central Europe, East Asia, and High-income Asia Pacific exhibited the lowest prevalence. Key risk factors identified include secondhand smoke, particulate matter pollution, low birth weight, and short gestation. Additionally, a significant inverse association was found between the SDI and the burden of OM, with age-standardized DALY rates decreasing markedly as SDI increased.</p><p><strong>Conclusion: </strong>OM in children represents an escalating global health challenge, marked by a rising incidence. Although there has been a global decline in DALYs, the burden of DALYs associated with OM in children remains significant, particularly in regions with a low SDI. A more comprehensive understanding of the epidemiology of OM in children could enhance prevention and control efforts.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1513629"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Case Report: Two children with factor XII deficiency caused by novel <i>F12</i> compound heterozygous variants.","authors":"Rui-Xue Ma, Hai-Yan Li, Yi-Hang Zhang, Xue-Min Zhang, Yan-Juan Chen, Yi-Lin Dai, Gui-Xian Li, Wen-Hai Luo, Jie Zhang, Yun-Fen Tian","doi":"10.3389/fped.2025.1555426","DOIUrl":"10.3389/fped.2025.1555426","url":null,"abstract":"<p><strong>Background: </strong>Factor XII (FXII) deficiency (OMIM 234000) is a rare hereditary coagulation disorder caused by pathogenic variants within the <i>F12</i> gene. It causes prolonged activated partial thromboplastin time without bleeding diathesis. Most patients have no obvious clinical symptoms, so the disease is difficult to be detected.</p><p><strong>Case presentation: </strong>Here, we reported two pediatric cases with FXII deficiency from Kunming, China. Patient 1 was a 10-year-old girl who was hospitalized with a fever and cough for one week and diagnosed with pneumonia. Auxiliary coagulation function examination suggested that the activated partial thrombin time (APTT) was significantly prolonged, while both the coagulation factor XII activity (FXII:C) and coagulation factor XII antigen (FXII:Ag) were decreased. Whole exome sequencing (WES) revealed this patient carries <i>F12</i> compound heterozygous variants with NM_000505.4:c.509G>A (p.Cys170Tyr) and NM_000505.4:c.800+1G>C. Patient 2 was a newborn boy with prolonged coagulation of the umbilical cord and difficult hemostasis after birth. A prolonged APTT and a decreased ratio of FXII:C were observed. WES revealed this patient carries <i>F12</i> compound heterozygous variants with NM_000505.4:c.583del (p.His195Thrfs*56) and NM_000505.4:c.805C>T (p.Pro269Ser). <i>In vivo</i> RT-PCR assays demonstrated c.800+1G>C intron mutation resulted to a 166-bp deletion (exon 8 skipping) for patient 1. Bioinformatics analysis confirmed the pathogenicity of all four variants.</p><p><strong>Conclusions: </strong>We presented two pediatric cases with FXII deficiency caused by novel <i>F12</i> compound heterozygous variants. Pediatricians should raise awareness of this rare and underdiagnosed disorder and improve diagnostic and intervention strategies.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1555426"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in PediatricsPub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fped.2025.1596199
San Zhu, Can Luo, Bing Luo, Yaoyao Zhang, Qiang Wei
{"title":"Mechanical tricuspid valve thrombosis in pregnancy: a case report and literature review on anticoagulation challenges and fetal protection strategies.","authors":"San Zhu, Can Luo, Bing Luo, Yaoyao Zhang, Qiang Wei","doi":"10.3389/fped.2025.1596199","DOIUrl":"10.3389/fped.2025.1596199","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy in women with mechanical heart valves (MHVs) poses significant challenges in balancing maternal thromboprophylaxis and fetal safety. Anticoagulation strategies must simultaneously prevent life-threatening valve thrombosis and minimize fetal risks, yet optimal management remains controversial. While warfarin offers effective thromboprophylaxis, its embryotoxicity at higher doses (>5 mg/day) contrasts with low molecular weight heparin (LMWH), which lacks consensus on thrombotic efficacy despite fetal safety advantages.</p><p><strong>Case presentation: </strong>We report a case of a 30-year-old woman with mechanical mitral and tricuspid valves. She was maintained on low-dose warfarin (target INR 2.5-3.0) during early pregnancy. At 26-28 weeks of gestation, she developed exertional dyspnea; initial imaging showed stable valve function. At 33 + 2 weeks, worsening symptoms and echocardiographic evidence of tricuspid valve dysfunction prompted anticoagulation transition from warfarin to LMWH combined with vitamin K. After achieving an INR <1.4, cesarean delivery was performed at 33 + 3 weeks under general anesthesia, resulting in a live male infant without cardiac anomalies. Three days postpartum, mechanical tricuspid valve thrombosis with severe regurgitation was confirmed, necessitating bioprosthetic valve replacement on postoperative day 4. Maternal and neonatal outcomes were favorable.</p><p><strong>Conclusions: </strong>This case highlights the importance of individualized anticoagulation management, multidisciplinary coordination, and vigilant monitoring in optimizing outcomes for pregnant patients with MHVs. Tailored pharmacologic strategies represent key modifiable prenatal factors influencing both maternal safety and child health.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1596199"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in PediatricsPub Date : 2025-07-02eCollection Date: 2025-01-01DOI: 10.3389/fped.2025.1454139
Weihua Ye, Guanghui Zhu, Zheng Liu
{"title":"Rib osteochondroma with intraspinal extension and cord compression in chlidren: case report and literature review.","authors":"Weihua Ye, Guanghui Zhu, Zheng Liu","doi":"10.3389/fped.2025.1454139","DOIUrl":"10.3389/fped.2025.1454139","url":null,"abstract":"<p><strong>Objective: </strong>To report a rare case of costal osteochondroma resulting in spinal cord compression in a 5-year-old patient, and to review the existing literature on costal osteochondromas.</p><p><strong>Methods: </strong>A retrospective review was conducted on a case involving a 5-year-old male patient with hereditary multiple exostoses (HME), presenting with acute paraparesis due to a costal osteochondroma. The tumor's origin within the rib, associated myelopathic symptoms, and extensive erosion and fusion of vertebral elements were notable. The patient underwent total laminectomy, resection of the tumor, and thoracic fixation and fusion. A comprehensive literature review was performed using the keywords \"Rib Osteochondroma\" and \"Spinal cord compression\" to search the PubMed database.</p><p><strong>Results: </strong>A dumbbell-shaped bony tumor originating from the left seventh rib at the costovertebral junction was identified, causing intraspinal and extraforaminal mass effect and spinal cord compression. Surgical intervention included total laminectomy and tumor excision, followed by thoracic fixation and fusion. Histopathological analysis confirmed the diagnosis of osteochondroma. Postoperative recovery was uneventful, with significant improvement in neurological symptoms and complete resolution of lower extremity weakness at the ten-month follow-up. A mere nine cases of such presentation have been documented in the corpus of English-language literature.</p><p><strong>Conclusion: </strong>This case highlights the rarity and clinical significance of costal osteochondromas causing spinal cord compression, particularly in a young pediatric patient. Early recognition and surgical intervention are crucial for favorable outcomes. Comprehensive imaging and careful surgical planning are essential to ensure complete tumor excision and maintain spinal stability.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1454139"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}