Purpose To describe the temporal association of specific acute neurological symptoms in pediatric patients with confirmed SARS-CoV-2 infection between May and August 2020. Methods We performed a recollection of all the clinical and laboratory data of patients having acute neurological symptoms temporally associated with SARS-CoV-2 infection at a third-level referral hospital in Mexico City (Instituto Nacional de Pediatría). Patients in an age group of 0–17 years with acute neurological signs (including ascending weakness with areflexia, diminished visual acuity, encephalopathy, ataxia, stroke, or weakness with plasma creatinine kinase (CK) elevation) were evaluated. Results Out of 23 patients with neurological manifestations, 10 (43%) had a confirmed SARS-CoV-2 infection. Among the infected patients, 5 (50%) were males aged 2–16 years old (median age 11.8 years old). Four (40%) patients confirmed a close contact with a relative positive for SARS-CoV-2, while 6 (60%) cases had a history of SARS-CoV-2–related symptoms over the previous 2 weeks. The following diagnoses were established: 3 cases of GBS, 2 of ON, 2 of AIS, one of myositis with rhabdomyolysis, one ACA, and one of anti-NMDA-R encephalitis. Conclusions Neurological manifestations temporally associated with SARS-CoV-2 infection were noticed in the pediatric population even without respiratory symptoms. In this study, 2 of 6 symptomatic patients had mild respiratory symptoms and 4 had unspecific symptoms. During this pandemic, SARS-CoV-2 infection should be considered as etiology in patients with acute neurological symptoms, with or without previous respiratory manifestations, particularly in teenagers.
Diabetes Mellitus (DM) is a chronic disease characterized by hyperglycemia, as a result of abnormal insulin production, insulin function, or both. DM is associated with systemic complications, such as infections, neuropathy and angiopathy, which involve the genitourinary tract. The three most significant urologic complications include: bladder cystopathy, sexual dysfunction and urinary tract infections.Almost half of the patients with DM have bladder dysfunction or cystopathy, which can be manifested in women as hypersensitivity (in 39–61% of the diabetic women) or neurogenic bladder. In males it can be experienced as lower urinary tract symptoms (in 25% of diabetic males with a nearly twofold increased risk when seen by age groups). Additionally, an increased prostate volume affects their micturition as well as their urinary tract.Involving sexual dysfunction in women, it includes reduced libido, decreased arousal, clitoral erectile dysfunction and painful or non-sensitive intercourse; and in diabetic males it varies from low libido, ejaculatory abnormalities and erectile dysfunction. Globally, sexual disorders have a prevalence of 18–42%. Erectile dysfunction is ranked as the third most important complication of DM. Urinary tract infections are observed frequently in diabetic patients, and vary from emphysematous infections, Fournier gangrene, staghorn infected lithiasis to repetitive bacterial cystitis. The most frequent finding in diabetic women has been lower urinary tract infections. Because of the high incidence of obesity worldwide and its association with diabetes, it is very important to keep in mind the urologic complication associated with DM in patients, in order to better diagnose and treat this population.
These tumors represent a rare condition in children. However, they can occur at any age, therefore it is important to acknowledge the clinical manifestations, diagnostic approach and therapeutic options. In this case the patient presented unusual symptoms which makes it more interesting.
ANTECEDENTES: La atrofia muscular espinal es la principal causa de muerte por enfermedad genética en lactantes. Es un trastorno degenerativo de las neuronas del asta anterior de la médula espinal. Según la edad de presentación se clasifica en 5 tipos. Las manifestaciones clínicas son: debilidad, hipotonía, atrofia muscular y retraso psicomotor. OBJETIVO: Conocer las características clínicas de pacientes mexicanos con atrofia muscular espinal (AME) que permitan el reconocimiento oportuno de la patología y el inicio de medidas terapéuticas. PACIENTES Y MÉTODOS: Estudio retrospectivo, retrolectivo, observacional y descriptivo al que se incluyeron pacientes con diagnóstico clínico y/o molecular de atrofia muscular espinal.RESULTADOS: Se estudiaron 31 pacientes, 15 de ellos con atrofia muscular espinal I, 13 con AME II y 3 con AME III. Todos los pacientes iniciaron con debilidad muscular, hipotonía y retraso del desarrollo psicomotor. El diagnóstico se estableció a una edad promedio de 30.81 meses, mediana de 23, mínima 2 y máxima 108 meses. Se estableció el diagnóstico genético en 23 de los 31 pacientes. Los de la clasificación AME I fallecieron.CONCLUSIONES: La AME I es el tipo más frecuente. La debilidad severa y las infecciones de las vías respiratorias son los motivos de consulta más comunes. Las manifestaciones clínicas de la AME III son de inicio más tardío y son ortopédicas que generan discapacidad. Existe retraso en el diagnóstico de esta enfermedad y limitaciones importantes en México para el tratamiento y aplicación de la terapia modificadora, lo que limita la calidad de vida y pronóstico de los pacientes.
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