A magnetic ball, a popular toy for children, can cause physical harm if its use is not carefully supervised. Reports of urethral and bladder damage stemming from magnetic ball impacts are scarce.
Herein, we present a case of a 10-year-old boy who inserted 83 magnetic balls into his bladder on his own initiative. Initial assessment, employing a pelvic radiograph and bladder ultrasound, identified a preliminary diagnosis, and all magnetic spheres were removed using cystoscopy.
The presence of a foreign body in the child's bladder should be contemplated when faced with recurring bladder irritation in pediatric patients. Effective results are often achieved through surgical methods. Among patients with no major complications, cystoscopy serves as the gold standard for both diagnosis and treatment.
Recurrent bladder irritation in children necessitates assessment for the presence of a foreign body within the bladder. The efficacy of surgical methods is undeniable. In patients without any serious complications, cystoscopy is the established best practice for diagnosis and therapy.
Rheumatic diseases may find their symptoms indistinguishable from those presented by mercury (Hg) intoxication. Rodents displaying susceptibility to systemic lupus erythematosus (SLE)-like conditions are affected by mercury (Hg) exposure. This implicates mercury as a potential environmental trigger for human SLE. check details This case study showcases a patient with clinical and immunological features that suggested SLE, yet the actual diagnosis was confirmed as mercury poisoning.
A thirteen-year-old female patient, exhibiting symptoms including myalgia, weight loss, hypertension, and proteinuria, was referred to our clinic for a possible systemic lupus erythematosus diagnosis. The patient's physical examination, aside from a cachectic appearance and hypertension, yielded unremarkable results; laboratory tests uncovered positive anti-nuclear antibodies, dsDNA antibodies, and hypocomplementemia, accompanied by nephrotic-range proteinuria. Repeated exposure to an unknown, silvery, lustrous liquid for a month, mistaken for mercury, was a key finding in the investigation of toxic exposures. check details Because the patient fulfilled the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for Systemic Lupus Erythematosus, a percutaneous kidney biopsy was performed to evaluate whether proteinuria was induced by mercury exposure or represented a lupus nephritis exacerbation. The kidney biopsy, in examining the patient's kidney tissue, did not present any signs of SLE, despite high blood and 24-hour urine mercury levels. The patient's Hg intoxication, along with clinical and laboratory observations of hypocomplementemia, positive ANA, and anti-dsDNA antibody, prompted the use of chelation therapy which subsequently improved the patient's condition. check details No manifestations of systemic lupus erythematosus (SLE) were present during the patient's follow-up period.
Autoimmune features can be a consequence of Hg exposure, in addition to the already established toxic effects. This is the inaugural observation, as per our current knowledge, of Hg exposure being associated with both hypocomplementemia and the presence of anti-dsDNA antibodies in a single patient. This instance further underscores the problematic nature of employing classification criteria in diagnostic assessments.
Autoimmune features can arise from Hg exposure, alongside its well-documented toxic impact. So far as we understand, this is the initial instance of Hg exposure demonstrating an association with hypocomplementemia and the presence of anti-dsDNA antibodies in a patient. This example underscores the challenges and limitations of using classification criteria for diagnostic purposes.
A correlation between the use of tumor necrosis factor inhibitors and the occurrence of chronic inflammatory demyelinating neuropathy has been noted. The process of nerve harm brought about by the administration of tumor necrosis factor inhibitors is not yet completely understood.
We describe in this paper a 12-year-and-9-month-old girl who developed chronic inflammatory demyelinating neuropathy, a complication of juvenile idiopathic arthritis, after having etanercept treatment ceased. Due to the involvement of all four limbs, she could no longer move about. Treatment comprising intravenous immunoglobulins, steroids, and plasma exchange was implemented, but the response proved to be limited. Following the administration of rituximab, a slow but steady advancement in the patient's clinical presentation was observed. A return of ambulatory function was observed in her four months subsequent to rituximab treatment. Etanercept's potential to cause chronic inflammatory demyelinating neuropathy was a factor in our deliberation.
Eliciting demyelination, tumor necrosis factor inhibitors may be implicated in the development of chronic inflammatory demyelinating neuropathy, which might persist following treatment cessation. Immunotherapy's initial application might prove ineffective, as observed in our instance, necessitating a more assertive treatment approach.
The demyelinating process can be sparked by tumor necrosis factor inhibitors; chronic inflammatory demyelinating neuropathy might endure even after treatment is discontinued. First-line immunotherapy's efficacy might be compromised, similar to our case, leading to the need for more forceful therapeutic measures.
In childhood, a rheumatic disease known as juvenile idiopathic arthritis (JIA) can manifest with eye problems. Inflammatory cells and exacerbations are common features of juvenile idiopathic arthritis uveitis; however, hyphema, the presence of blood within the anterior eye chamber, is a relatively uncommon observation.
An eight-year-old girl's examination revealed a cell count of 3+ and inflammation within the anterior chamber. Topical corticosteroids were put into use. An examination of the affected eye, repeated 48 hours later, indicated the presence of hyphema. Past medical history was free of trauma or drug use, and no hematological disease was suggested by the laboratory results. A systemic evaluation performed by the rheumatology department ultimately resulted in a JIA diagnosis. The findings regressed under the combined effects of systemic and topical treatments.
Although trauma is the most typical cause of hyphema in children, anterior uveitis can exceptionally be linked to this condition. A key takeaway from this case is the importance of considering JIA-related uveitis in the differential diagnoses of childhood hyphema.
The most frequent cause of hyphema in childhood is trauma, though anterior uveitis presents as an infrequent cause. In the differential diagnosis of childhood hyphema, this instance emphasizes the necessity of recognizing JIA-related uveitis.
CIDP, a persistent inflammatory condition affecting the peripheral nervous system's nerve roots and the peripheral nerves, often displays a connection to polyautoimmunity.
A previously healthy 13-year-old boy, experiencing progressively worsening gait disturbance and distal lower limb weakness for six months, was referred to our outpatient clinic. The patient's upper extremities showed decreased deep tendon reflexes, contrasting with their complete absence in the lower extremities. This was further compounded by a reduction in muscle strength, affecting both the distal and proximal regions of the lower limbs, alongside muscle atrophy, a drop foot, and normal pinprick sensations. Electrophysiological studies, combined with thorough clinical examination, confirmed the patient's CIDP diagnosis. A study investigated autoimmune diseases and infectious agents as potential triggers of CIDP. Despite the sole clinical indication of polyneuropathy, a diagnosis of Sjogren's syndrome was made based on positive antinuclear antibodies, antibodies against Ro52, and the presence of autoimmune sialadenitis. Despite six months of monthly intravenous immunoglobulin and oral methylprednisolone, the patient was ultimately capable of dorsiflexing his left foot and walking without assistance.
Our investigation concludes that this pediatric case constitutes the first reported instance of Sjogren's syndrome and CIDP occurring concurrently. Consequently, an exploration of potential underlying autoimmune diseases, including Sjogren's syndrome, should be considered in children diagnosed with CIDP.
We believe this pediatric case represents the first instance of Sjögren's syndrome and CIDP simultaneously. Hence, we advocate for an investigation into children with CIDP, focusing on potential concurrent autoimmune conditions such as Sjögren's syndrome.
The unusual urinary tract infections, emphysematous cystitis (EC) and emphysematous pyelonephritis (EPN), are encountered infrequently. Their clinical manifestations encompass a wide range, exhibiting everything from asymptomatic states to the presentation of septic shock. Children experiencing urinary tract infections (UTIs) may, on rare occasions, develop EPN and EC. Their diagnosis is predicated on clinical manifestations, laboratory results, and characteristic radiological findings demonstrating the presence of gas within the collecting system, renal parenchyma, and/or perinephric tissue. Among radiological modalities, computed tomography is the preferred method for identifying and diagnosing EC and EPN. While medicinal and surgical interventions exist to treat these conditions, their life-threatening nature manifests in high mortality rates, potentially exceeding 70 percent.
In an 11-year-old female patient, experiencing lower abdominal pain, vomiting, and dysuria for two days, examinations detected a urinary tract infection. Radiographic imaging indicated air pockets within the bladder's wall structure. Upon abdominal ultrasound examination, EC was discovered. Computed tomography of the abdominal region revealed EPN presence, evidenced by bladder and renal calyx air formations.
The patient's overall health and the severity of EC and EPN should jointly determine the appropriate and individualized treatment approach.
Taking into account the patient's overall health and the severity of EC and EPN, customized treatment should be implemented.