Giacomo is a 10 month old gypsy boy, who came to our attention because of two epi-sodes characterized by prolonged expira-tory apnea, unconsciousness, cyanosis and hypotonia lasting about 20 seconds and followed by spontaneous resolution. Gia-como’s pregnancy was complicated by oligohydramnios and perinatal distress; the cesarean delivery was at 35 weeks of gestation. To clinical observation, Giacomo showed normal skin color for his gypsy ethnicity and 2/6 systolic heart murmure to centrum cordis due to small left>right jet at the level of oval fossa attributable to patent foramen ovale; at neurological examination the child presented slight asymmetry of active motility, less fluid movement in left upper extremity, capacity for grabbing but not of transferring ob-jects, sitting position not fully captured. Blood examination was performed. A se-vere iron deficiency anemia is diagnosed (Hb 6,7 mg/dl; MCV 53,9fl; RDW 19%; ferritin 2ng/ml). EEG showed prevalence of right-sided slowest waves. Giacomo started iron therapy; he will have brain MRI and echocardiography checks. 8% of ALTE (Apparent Life-Threatening Events) epi-sodes are due to BHS (Breath Holding Spells) the diagnosis of which is mainly of clinical type and is sometimes associated with that of iron deficiency anemia. Martial status study is therefore recommended in the evaluation of these patients, also in apparent absence of other signs of iron deficiency
About Breath Holding Spells…
SAGGESE, GIUSEPPE
2013-01-01
Abstract
Giacomo is a 10 month old gypsy boy, who came to our attention because of two epi-sodes characterized by prolonged expira-tory apnea, unconsciousness, cyanosis and hypotonia lasting about 20 seconds and followed by spontaneous resolution. Gia-como’s pregnancy was complicated by oligohydramnios and perinatal distress; the cesarean delivery was at 35 weeks of gestation. To clinical observation, Giacomo showed normal skin color for his gypsy ethnicity and 2/6 systolic heart murmure to centrum cordis due to small left>right jet at the level of oval fossa attributable to patent foramen ovale; at neurological examination the child presented slight asymmetry of active motility, less fluid movement in left upper extremity, capacity for grabbing but not of transferring ob-jects, sitting position not fully captured. Blood examination was performed. A se-vere iron deficiency anemia is diagnosed (Hb 6,7 mg/dl; MCV 53,9fl; RDW 19%; ferritin 2ng/ml). EEG showed prevalence of right-sided slowest waves. Giacomo started iron therapy; he will have brain MRI and echocardiography checks. 8% of ALTE (Apparent Life-Threatening Events) epi-sodes are due to BHS (Breath Holding Spells) the diagnosis of which is mainly of clinical type and is sometimes associated with that of iron deficiency anemia. Martial status study is therefore recommended in the evaluation of these patients, also in apparent absence of other signs of iron deficiencyI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
