L'esperienza che insegna
Ostruzioni nasali e russamento: da tre casi insoliti una lezione per il pediatra
Nasal obstruction and snoring: three unusual cases as a lesson for the paediatrician
Riccardo Masetti, Davide Leardini, Laura Ronchini, Serena Riolo, Fiorentina Guida, Francesco Baccelli, Sara Cerasi, Teresa Papaleo, Luca Bertelli, Andrea Pession
UO di Pediatria, Policlinico Sant’Orsola-Malpighi, AOU di Bologna, Università di Bologna
Novembre 2020 - pagg. 585 -589 | DOI: 10.53126/MEB39585
Abstract
Nasal obstruction with or without snoring is a frequent condition and, as such, it is easily disregarded by paediatricians and by parents as well. The paper describes three “unforgettable” clinical cases that must be a warning to investigate and not to underestimate those atypical and/or characteristic aspects, such as the nasal obstruction that rapidly becomes severe. Such aspects must induce to deepen investigations to exclude much more rare pathologies that if not promptly diagnosed would have serious prognostic repercussions on the child. Surely, the first alarm signal is time (recent onset and/or snoring that rapidly becomes severe), with worsening of symptoms. Surely, lymphadenopathy is another alarm signal, especially when bilateral and large. Furthermore, the onset of epistasis associated with oral cavity bleeding must not be underestimated.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Contenuto riservato
Per leggere l'articolo completo è necessario effettuare il login.
Non sei ancora registrato? Registrati
Bibliografia
1. Shern JF, Yohe ME, Khan J. Pediatric rhabdomyosarcoma. Crit Rev Oncog 2015;20 (3-4):227-43.
2. Pizzo PA, Poplack DG. Principles and Practice of Pediatric Oncology 7th Edition. 2016.
3. Shern JF, Chen L, Chmielecki J, et al. Comprehensive genomic analysis of rhabdomyosarcoma reveals a landscape of alterations affecting a common genetic axis in fusion-positive and fusion-negative tumors. Cancer Discov 2014;4(2):216-31.
4. Yohe ME, Heske CM, Stewart E, et al. Insights into pediatric rhabdomyosarcoma research: challenges and goals. Pediatr Blood Cancer 2019;66(10):1-10.
5. Jawad N, McHugh K. The clinical and radiologic features of paediatric rhabdomyosarcoma. Pediatr Radiol 2019;49(11):1516-23.
6. Bisogno G, Jenney M, Bergeron C, et al. Addition of dose-intensified doxorubicin to standard chemotherapy for rhabdomyosarcoma (EpSSG RMS 2005): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet Oncol 2018;19(8):1061-71.
7. Molyneux EM, Rochford R, Griffin B, et al. Burkitt’s lymphoma. Lancet 2012;379:1234-44.
8. Mussolin L, Lovisa F, Gallingani I, et al. Minimal residual disease analysis in childhood mature B-cell leukaemia/lymphoma treated with AIEOP LNH-97 protocol with/ without anti-CD20 administration. Br J Haematol 2020;12:1-4.
9. Pillon M, Mussolin L, Carraro E, et al. Detection of prognostic factors in children and adolescents with Burkitt and diffuse large B-cell lymphoma treated with the AIEOP LNH-97 protocol. Br J Haematol 2016;175(3):467-75.
10. AIRTUM. I numeri del cancro. Assoc Ital Regist Tumori. 2019.
11. Hunger SP, Mullighan CG. Acute lymphoblastic leukemia in children. N Engl J Med 2015;373(16):1541-52.
12. Attarbaschi A, Mann G, Zimmermann M, et al. Randomized post-induction and delayed intensification therapy in high-risk pediatric acute lymphoblastic leukemia: long-term results of the international AIEOP-BFM ALL 2000 trial. Leukemia 2020;34:1694-700.
13. Conter V, Valsecchi MG, Buldini B, et al. Early T-cell precursor acute lymphoblastic leukaemia in children treated in AIEOP centres with AIEOP-BFM protocols: a retrospective analysis. Lancet Haematol 2016;3(2):e80-e86.
14. Grasso AG, Radice C, Corrias F, Verzegnassi F, Marchetti F. La leucemia ridotta all’osso: fatti e misfatti. Medico e Bambino 2017;36(7):428-34.
Corrispondenza: riccardo.masetti@gmail.com