Case Reports in Pediatrics最新文献

{"title":"Proteinuria as an Unusual Presentation of Pheochromocytoma in Pediatric Patient With Single Kidney.","authors":"Jacob Miller, Nycole Hidalgo, Maria Eleni Nikita, Teresa York, Bakri Alzarka","doi":"10.1155/crpe/1761397","DOIUrl":"10.1155/crpe/1761397","url":null,"abstract":"<p><p>Pheochromocytoma is a rare catecholamine-secreting tumor, particularly in pediatric populations, and often presents with sustained hypertension. We report the case of a 17-year-old male with a solitary kidney who presented with asymptomatic hypertension and unexpected nephrotic-range proteinuria. Imaging and biochemical workup confirmed a right adrenal pheochromocytoma. The patient underwent a successful laparoscopic adrenalectomy, after which his blood pressure normalized and proteinuria resolved. This case highlights a rare presentation of pheochromocytoma with heavy proteinuria, likely related to glomerular hyperfiltration secondary to hypertension and exacerbated by a solitary kidney. This case underscores the importance of considering pheochromocytoma in pediatric patients with unexplained hypertension, even in the presence of significant proteinuria.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"1761397"},"PeriodicalIF":0.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Antenatal Treatment Using IVIG and Steroids in Managing Subsequent Pregnancy Following a Case of Neonatal Alloimmune Thrombocytopenia in Sibling.","authors":"Naheed Abedin, Ahmad Abdulkader, Tiffany Nguyen, Mansi Ranasaria","doi":"10.1155/crpe/5244463","DOIUrl":"10.1155/crpe/5244463","url":null,"abstract":"<p><p>Neonatal alloimmune thrombocytopenia (NAIT) can present as severe thrombocytopenia in an otherwise healthy neonate and may lead to serious bleeding, intracranial hemorrhage, and even death. This report presents two siblings affected by NAIT. The first sibling was diagnosed when the infant presented after birth with petechial hemorrhages and a profoundly low platelet count. During the subsequent pregnancy, the mother was treated with a protocol of IVIG and steroid. This resulted in a higher platelet count at birth in the second sibling, although still severely thrombocytopenic, without physical signs or symptoms of thrombocytopenia. In this case, the infant responded rapidly to an antigen-matched platelet transfusion. This case series calls attention to the importance of close follow-up and optimum management of NAIT.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"5244463"},"PeriodicalIF":0.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crohn's Disease Presenting as an Abdominal Wall Abscess in an Adolescent With Autism Spectrum Disorder.","authors":"Kohsuke Hitomi, Shuichi Katayama, Soichi Nakada, Shojiro Hanaki","doi":"10.1155/crpe/8225541","DOIUrl":"10.1155/crpe/8225541","url":null,"abstract":"<p><p>Crohn's disease (CD) is a subtype of inflammatory bowel disease characterized by discontinuous lesions and transmural inflammation. Delayed diagnosis may lead to fistula formation between the intestine and adjacent organs. However, most CD-associated fistulas are enteroenteric or perianal, and abdominal wall abscesses are rarely reported in pediatric patients. We report a case of CD presenting as an abdominal wall abscess in a 15-year-old girl with autism spectrum disorder. Contrast-enhanced computed tomography revealed a fistulous communication between the abscess cavity and the transverse colon. Percutaneous drainage and antibiotic therapy were performed to control the infection. Colonoscopy demonstrated skip lesions with longitudinal ulcers, cobblestone-like mucosa, and inflammatory polyps. Histopathological examination showed active chronic colitis compatible with inflammatory bowel disease. Remission induction therapy consisting of elemental diet, 5-aminosalicylic acid, and corticosteroids was initiated after infection control. Her clinical condition gradually improved, and she was discharged on hospital Day 37. During follow-up, her appetite improved and she gradually gained weight. At 18 months after discharge, contrast-enhanced computed tomography showed no recurrence of the abdominal wall fistula, and her clinical condition remained stable. In pediatric patients, CD may present with nonspecific systemic symptoms, which can delay diagnosis. In patients with autism spectrum disorder, communication difficulties may further obscure gastrointestinal symptoms. Clinicians should consider underlying inflammatory bowel disease when children present with unexplained abdominal wall abscesses accompanied by systemic symptoms such as growth failure or malnutrition.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"8225541"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Mycoplasma pneumoniae-</i>Triggered Inflammatory Arthritis and Vasculitis in an Adolescent due to <i>Mycoplasma pneumoniae</i> Following an Orthopedic Procedure: A Case Report.","authors":"Madeleine Robertson, Gueorgui Dubrocq","doi":"10.1155/crpe/9122947","DOIUrl":"10.1155/crpe/9122947","url":null,"abstract":"<p><p><i>M</i>. <i>pneumoniae</i> is an atypical bacterium that commonly presents with pneumonia, but is also associated with extrapulmonary manifestations including dermatologic, CNS, gastrointestinal, rheumatologic, cardiac, and renal disease. We report a case of inflammatory arthritis with vasculitis of the lower extremities caused by <i>Mycoplasma pneumoniae</i> in a 17-year-old female who presented 6 weeks after left knee medial quadriceps tendon femoral ligament (MQTFL) reconstruction and patellar osteochondral allograft (OCA), with positional discoloration of her leg and clear drainage from the incision.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"9122947"},"PeriodicalIF":0.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Drug-Resistant Epilepsy and Severe Feeding Difficulties in Miller-Dieker Syndrome: The Role of Enteral Ketogenic Diet.","authors":"Perrone Michela, Porro Matteo, Piemontese Pasqua, Roggero Paola, Gangi Silvana, Fumagalli Monica","doi":"10.1155/crpe/8660691","DOIUrl":"10.1155/crpe/8660691","url":null,"abstract":"<p><p>Miller-Dieker syndrome (MDS) is a rare genetic disorder characterized by classical lissencephaly, severe neurodevelopmental impairment, and early-onset drug-resistant epilepsy. Feeding difficulties and aspiration pneumonia significantly contribute to morbidity and mortality. Evidence regarding ketogenic diet (KD) therapy in patients with severe neurological impairment requiring exclusive enteral nutrition is limited. We report the case of an infant with MDS and pharmacoresistant epilepsy complicated by severe feeding intolerance and recurrent aspiration pneumonia. KD was initiated via postpyloric enteral feeding and subsequently administered through percutaneous endoscopic jejunostomy using a low ketogenic ratio (1.25:1). The diet was well tolerated and associated with seizure freedom maintained until the child's death from an unrelated surgical complication (volvulus), improved nutritional status, and several months of clinical stability. This case highlights the feasibility of enteral KD therapy as part of a multidisciplinary, palliative-oriented approach for managing drug-resistant epilepsy in children with MDS.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"8660691"},"PeriodicalIF":0.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interspinous Bursitis due to <i>Staphylococcus aureus</i> in an Adolescent.","authors":"Florine Foré, Yasmine Lamrous, Antoine Delval, Audrey Vanrenterghem, Djamal Djeddi","doi":"10.1155/crpe/7740167","DOIUrl":"https://doi.org/10.1155/crpe/7740167","url":null,"abstract":"<p><strong>Background: </strong>Interspinous bursitis is exceptionally rare in children, contrasting with degenerative forms in adults.</p><p><strong>Case presentation: </strong>A 16-year-old male presented with acute severe low back pain, fever (39°C), and focal L3-L5 tenderness. CRP was 233 mg/L; blood cultures grew methicillin-susceptible <i>Staphylococcus aureus</i>. Imaging progression (US, CT-scan, MRI, PET-CT) confirmed L3-L4 interspinous bursitis without bone/disc involvement, distinguishing it from spondylodiscitis.</p><p><strong>Management: </strong>Cefazolin IV (10 days) followed by oral ciprofloxacin (4 weeks), a lumbar brace, and rehabilitation yielded complete recovery.</p><p><strong>Conclusions: </strong>Pediatric interspinous bursitis presents as febrile back pain via hematogenous dissemination. MRI is diagnostic, excluding spondylodiscitis. Conservative management with early antibiotic switch is effective when imaging excludes bone/disc involvement. This case highlights distinguishing features and optimal management of this rare pediatric entity.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"7740167"},"PeriodicalIF":0.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supracardiac Total Anomalous Pulmonary Venous Return With Extrinsic Compression of the Vertical Vein by the Left Pulmonary Artery: A Case Report.","authors":"Abdolla Alnaqshi, Idriss Wakaa Al Ahmad, Bishr Al-Abdulrazzak, Hanady Nabel Zwaraa, Lorieh Edmon Domat, Jean Domat, Mouhammed Sleiay, Mohammad Younes","doi":"10.1155/crpe/5873152","DOIUrl":"10.1155/crpe/5873152","url":null,"abstract":"<p><strong>Background: </strong>Supracardiac total anomalous pulmonary venous return (TAPVR) is a rare congenital heart defect. An anatomical variant where the vertical vein courses posterior to the left pulmonary artery, causing extrinsic compression and severe pulmonary venous obstruction, is exceptionally uncommon and life-threatening.</p><p><strong>Case presentation: </strong>We describe the case of a male infant aged 2.5 months who exhibited severe central cyanosis, respiratory distress, and right heart failure. In the absence of computed tomography (CT), diagnosis was based exclusively on 2D echocardiography, which effectively detected obstructed supracardiac TAPVR with a vertical vein compressed behind the left pulmonary artery, as well as a secundum atrial septal defect (ASD). A small pulmonary venous confluence was discovered intraoperatively. A customized surgical method was used, making use of the cut vertical vein to enhance a broad anastomosis between the confluence and the left atrium. The postoperative course was complicated by severe respiratory failure and neurological events, such as a generalized seizure accompanied by a 3-min asystole and subsequent periventricular leukomalacia. Even with these serious challenges, thorough medical management resulted in complete recovery. At the 7-month follow-up, the patient demonstrated stability, with unobstructed pulmonary venous flow and normalized cardiac geometry.</p><p><strong>Conclusion: </strong>In settings with limited resources, echocardiography alone can provide an accurate diagnosis of atypical and severely obstructed TAPVR. Even in the presence of serious neurological and respiratory complications during the perioperative phase, it is possible to obtain excellent long-term results by means of adaptive surgical methods aimed at widening a small venous confluence and thorough postoperative intensive care.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"5873152"},"PeriodicalIF":0.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Early Therapy With Sirolimus for an Infant With Primary Intestinal Lymphangiectasia.","authors":"Shungo Yamamoto, Yoshihiko Sugino, Takahiro Yamashita, Kei Honda, Yugo Takaki","doi":"10.1155/crpe/7717714","DOIUrl":"https://doi.org/10.1155/crpe/7717714","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying the cause of protein-losing enteropathy (PLE) is crucial for appropriate treatment. Primary intestinal lymphangiectasia (PIL) is a cause of PLE, and low-strict fat diet with medium-chain triglyceride (MCT) supplementation may be insufficient. Sirolimus has shown efficacy in refractory PIL; however, its use in infants remains uncommon, and the optimal timing of initiation has not been established.</p><p><strong>Case presentation: </strong>A previously healthy 7-month-old Japanese male infant presented with convulsions, generalized edema, and diarrhea. Laboratory findings revealed severe hypoproteinemia (serum albumin: 1.3 g/dL), lymphopenia (absolute lymphocyte count: 822/μL), and electrolyte abnormalities. Scintigraphy using ^99mTc-labeled human serum albumin showed tracer exudate in the small intestine, leading to the diagnosis of PLE. Upper endoscopy revealed snowflake-like white spots in the duodenum, and pathological examination confirmed lymphatic dilation, leading to a PIL diagnosis. Despite treatment with a low-strict fat diet with MCT supplementation and corticosteroids, hypoproteinemia persisted. Lymphatic scintigraphy and magnetic resonance lymphangiography confirmed ongoing protein leakage. Sirolimus was initiated at 0.5 mg/day on Day 23. Subsequently, serum albumin began to increase within 1-2 weeks and ultimately reached 4.1 g/dL, and absolute lymphocyte count, 1917/μL immediately before sirolimus initiation, increased to 3843/μL. Lymphatic scintigraphy on Day 74 of sirolimus treatment showed complete resolution of protein leakage. Sirolimus was continued for 121 days and discontinued thereafter. At 17 months of follow-up, no recurrence was observed, with sustained normalization of serum albumin to 4.0 g/dL and absolute lymphocyte count to 4739/μL.</p><p><strong>Discussion: </strong>This case suggests one of the earliest reported responses to sirolimus in the treatment of PIL, with improvement observed within a few weeks of initiation. Early introduction of sirolimus in patients with persistent protein leakage resistant to low-strict fat diet with MCT supplementation may be associated with rapid improvement in PIL, though this hypothesis warrants further case accumulation.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"7717714"},"PeriodicalIF":0.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteomyelitis Secondary to Infected Cephalhematoma in a Female Neonate: A Case Report and Clinical Insights.","authors":"Mahnoor Khan, Nimra Rabbani, Yasser Masood, Gohar Javed, Jumana Aljbour","doi":"10.1155/crpe/5285153","DOIUrl":"10.1155/crpe/5285153","url":null,"abstract":"<p><p>Cephalhematomas are subperiosteal collections of blood resulting from birth trauma. Usually benign, they tend to resolve spontaneously within a few weeks; however, on rare occasions, they may develop an infection, which can lead to complications such as sepsis, meningitis, and osteomyelitis. Patients present with nonspecific symptoms, making it difficult and crucial to diagnose and treat them promptly. Across literature, there have been limited reports of infected cephalhematomas leading to osteomyelitis, and all such cases have mentioned the involvement of the parietal bone. We present the case of osteomyelitis secondary to an infected cephalhematoma in a female neonate, along with detailed insights into the diagnosis, treatment, and prognosis of the patient. This case highlights the importance of early recognition of the disease, which, in our patient, was first noted on the 5th day of life and properly diagnosed on the 29th day of life, and multidisciplinary treatment in preventing possibly fatal complications.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"5285153"},"PeriodicalIF":0.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Exchange Transfusion in Critical Pertussis: A Case Report Supporting Timely Intervention.","authors":"Eiman Al-Hashemi, Osama Shalaby, Fajer Altammar","doi":"10.1155/crpe/7016973","DOIUrl":"10.1155/crpe/7016973","url":null,"abstract":"<p><strong>Background: </strong>Critical pertussis is a rapidly progressive, life-threatening illness in infants, often presenting with hyperleukocytosis, respiratory failure, and hemodynamic instability. Mortality remains high despite supportive advances, and no standardized guidelines exist to guide the use of exchange transfusion in this setting.</p><p><strong>Objective: </strong>To describe the outcomes of early exchange transfusion in infants with critical pertussis managed in a high-acuity tertiary PICU in Kuwait and to advocate for the development of a standardized national protocol.</p><p><strong>Methods: </strong>This prospective case report includes three infants with PCR-confirmed <i>Bordetella pertussis</i> infection admitted between January and December 2024 to the Pediatric Intensive Care Unit (PICU) of New Jahra Hospital, Kuwait's busiest tertiary-level center. The decision to initiate exchange transfusion was based on consensus clinical assessment integrating clinical status and laboratory progression. Once the decision to proceed was made, double-volume exchange transfusion was performed according to a unit-specific procedural protocol developed within our institution. Clinical data, laboratory trends, and short-term outcomes were reviewed.</p><p><strong>Results: </strong>All infants presented with severe respiratory failure, marked hyperleukocytosis (> 30-60 × 10⁹/L), and evolving hemodynamic instability. Exchange transfusion performed within 2-4 days of admission led to prompt leukoreduction, improved perfusion, and clinical stabilization. All survived to discharge and remained well at 6-week follow-up. Thrombocytopenia occurred following exchange transfusion and resolved with supportive care. Seizures and iatrogenic opioid withdrawal occurred during the PICU course in Cases 1 and 2 and were not considered complications directly attributable to exchange transfusion. National feedback from PICU unit heads highlighted broad support for protocol standardization.</p><p><strong>Conclusion: </strong>Early exchange transfusion, guided by evolving clinical severity and laboratory trends, may contribute to favorable outcomes in infants with critical pertussis when considered before refractory pulmonary hypertension develops. These cases support timely recognition and intervention while underscoring the need for standardized national practice, maternal Tdap immunization, and strengthened disease surveillance.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"7016973"},"PeriodicalIF":0.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}