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Situs inversus totalis in an asymptomatic adolescent-importance of patient education:A case report

World Journal of Clinical Pediatrics 2023年第5期12卷 359-364页

作者： Lauren C.Hayashi ratna acharya Department of Pediatrics University of Florida College of MedicineGainesvilleFL 32608United States Division of General Pediatrics Department of PediatricsUniversity of FloridaGainesvilleFL 32608United States

BACKGROUND Situs inversus totalis(SIT)may be an incidental finding in asymptomatic *** may not understand the implications of this condition and the importance of relaying the diagnosis to their healthcare *** SUMMARY We report an asymptomatic seventeen-year-old adolescent with previouslydiagnosed SIT who presented for a routine well-child *** history taking,he denied any past medical conditions,including cardiovascular *** when physical exam revealed point of maximal impulse and heart sounds on the right side,did he convey that he had been diagnosed with SIT incidentally at age of 12 *** was not aware of associated conditions or the potential implications of his diagnosis,nor did he realize it is pertinent medical history to be relayed to healthcare *** X-ray confirmed dextrocardia and abdominal X-ray showed right-sided *** sonogram showed left-sided liver and right-sided *** showed normal valvular structure and function.A comprehensive discussion was provided to address the patient’s lack of understanding that SIT is a medical diagnosis with potential *** While SIT is rare and mostly asymptomatic,affected patients may not comprehend the importance of the diagnosis and its potential *** of the patient’s lack of awareness allows the healthcare provider to educate the patient and hopefully can prevent potential medical and surgical complications.

关键词： Situs inversus Dextrocardia Adolescent Education Case report

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Efficacy and safety of local candida immunotherapy in recalcitrant warts in pediatric kidney transplantation:A case report

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World Journal of Transplantation 2023年第4期13卷 201-207页

作者： ratna acharya Rachel Bush Felicia Johns Kiran Upadhyay Department of Pediatrics University of FloridaGainesvilleFL 32610United States Department of Pediatric Nephrology University of FloridaGainesvilleFL 32610United States

BACKGROUND Warts are common in recipients of kidney transplantation(KT).Resistant warts which are not amenable to conventional therapies may lead to significant *** data exists on safety and efficacy of local immunotherapy among immunocompromised KT *** SUMMARY We report a seven-year-old child who presented with recalcitrant plantar periungual warts in the early KT *** consisted of tacrolimus,mycophenolate and *** to failure of conventional anti-wart therapies,he was treated with two sessions of intralesional(IL)candida immunotherapy along with liquid nitrogen cryotherapy leading to complete resolution of the ***,de novo BK viremia was seen about three weeks following the last candida *** required reduction of immunosuppression and other anti-BK viral *** function remained stable but there were donor specific antibodies *** also was elevated level of plasma donor derived cell-free DNA.A pneumocystis jirovecii pneumonia occurred ten months following completion of immunotherapy that was successfully treated with *** this ten-month follow-up period,there have been no recurrence of warts,and transplant kidney function has remained *** Stimulation of cell-mediated immunity against the human papilloma virus induced by the IL candida immunotherapy is thought to be a cause for wart *** this therapy,whether it is necessary to augment the immunosuppression to prevent rejection is unclear as that may come with a risk of infectious ***,prospective studies in pediatric KT recipients are needed to explore these important issues.

关键词： Warts Kidney transplantation Candida Immunotherapy Pediatric Case report

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Hereditary hemorrhagic telangiectasia presenting as a recurrent epistaxis in an adolescent:A case report

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World Journal of Clinical Pediatrics 2021年第1期10卷 1-6页

作者： ratna acharya Katherin Portwood Kiran Upadhyay Department of Pediatrics University of FloridaGainesvilleFL 32610United States

BACKGROUND Epistaxis can be an isolated finding or a manifestation of a systemic *** of the potential etiologies are usage of anticoagulants,bleeding disorders,vascular aneurysms,nasal neoplasm,hypertension and nasal *** hemorrhagic telangiectasia(HHT)as a cause of recurrent epistaxis is *** SUMMARY In this report,we describe an 18-year-old adolescent with recurrent epistaxis,mucocutaneous telangiectasia and family history of HHT,consistent with *** Timely diagnosis is needed not only to treat the epistaxis but also to be vigilant for other serious manifestations of this condition.

关键词： Epistaxis Telangiectasia Hemorrhagic Hereditary Pediatrics Case report

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