Presentation
Gastric and colonic polyposis are both present in 100% of patients with this diagnosis. Small bowel involvement is seen in 50% of patients. [radiopaedia.org]
This patient did not present with the cardinal manifestations of CCS which resulted in a delayed diagnosis. [spandidos-publications.com]
Neonatal respiratory distress syndrome Prevalence: 1-5 / 10 000 Inheritance: Not applicable Age of onset: Infancy, Neonatal ICD-10: P22.0 OMIM: 267450 UMLS: C0020192 C0035220 C0852283 MeSH: - GARD: - MedDRA: - The documents contained in this web site are presented [orpha.net]
Entire Body System
- Sepsis
World Sepsis Day A series of articles and thought leader interviews for World Sepsis Day on the 10th September 2018, aiming to raise awareness and improve understanding. [news-medical.net]
Various pre- and postnatal factors, such as exposure to chorioamnionitis, pneumonia, sepsis and asphyxia, induce an injurious inflammatory response in the lungs of preterm infants, which may subsequently affect surfactant function, synthesis and alveolar [ncbi.nlm.nih.gov]
Additional findings depend on the underlying cause (e.g., abnormal white blood count in sepsis ) or associated complications (e.g., increased creatinine levels in acute tubular necrosis ). [amboss.com]
The source of sepsis was similar in both groups (pulmonary, 39 percent; nonpulmonary, 61 percent), and pneumonia was the most common condition precipitating sepsis (in 18 percent in the placebo group and 19 percent in the surfactant group). [nejm.org]
Steinberg The effects of ibuprofen on the physiology and survival of patients with sepsis. The Ibuprofen in Sepsis Study Group [32.] R. Ullrich, C. Lorber, G. Roder, G. Urak, B. Faryniak, R.N. [analesdepediatria.org]
- Inflammation
Secretory phospholipase A2 plays an important role in inflammation and possible dysfunction of surfactants in ARDS. [ncbi.nlm.nih.gov]
This is usually triggered by an event that leads to major systemic inflammation, which can be indirectly damage the capillary membrane or directly damage the capillary membrane. [youtube.com]
ARDS is a lung condition where the patient suffers from sudden breathlessness, low blood oxygen levels and lung inflammation that could progress to respiratory failure. [medindia.net]
[…] of the pancreas can spread throughout the body Lung inflammation may occur following an infection that has spread through the blood to affect the whole body. [hse.ie]
Inflammation of the lung parenchyma leads to impaired gas exchange with systemic release of inflammatory mediators, causing inflammation, hypoxemia and frequently multiple organ failure. This condition has a 90% death rate in untreated patients. [symcat.com]
- Pain
Chest pain is the most commonly reported symptom among both women and men. [healthline.com]
Symptoms of pediatric acute respiratory distress syndrome (ARDS) include: Abdominal pain (in pancreatitis) Cough (often with white or pink frothy sputum) Fatigue Fever Shortness of breath What are the causes of Pediatric Acute Respiratory Distress Syndrome [childrens.com]
Pain management may also be required. Regular colonoscopy to remove polyps and identify colon cancer should be undertaken. [dermnetnz.org]
[…] for active chest pain, given sublingually or by spray Telemetry and prehospital ECG, if available Emergency department and inpatient care Initial stabilization of patients with suspected MI and ongoing acute chest pain should include administration of [emedicine.medscape.com]
- Anemia
The two cases we present had acute severe foetal anemia with foetal sinusoidal rhythm and decreased foetal movement. There was no chorioamnionitis. Severe anemia as a cause of ARDS was not described in the adult and pediatric literature. [omicsonline.org]
Complications - Patients may suffer from complications like trauma during ventilation, infections, muscle weakness, kidney failure, stomach ulcers, anemia and even death. [medindia.net]
Laboratory parameters reveal normocytic, normochromic anemia, vitamin deficiency, hypoproteinemia and hypoalbuminemia. [orpha.net]
They can also look for signs of infection or anemia, a lack of red blood cells. Heart tests. These can rule out conditions such as heart failure (when your heart doesn’t pump blood through your body the way it should). [webmd.com]
[…] macrolide antibiotics. 61 Resch B...Urlesberger B 26518581 2016 44 Outcome of Twin Deliveries at a Tertiary Care Centre of Eastern Nepal. 61 Chaudhary S...Shah L 27885296 2016 45 LARS2 Variants Associated with Hydrops, Lactic Acidosis, Sideroblastic Anemia [malacards.org]
- Asymptomatic
The possibilities of asymptomatic offspring or afflicted patients have not been excluded. [emedicine.medscape.com]
About two-thirds of patients with serpiginous choroiditis have scars in one or both eyes at initial presentation, and most patients are asymptomatic until the macula is involved (11). [studyres.com]
at-risk infants, who did not receive adequate antibiotic prophylaxis, require a limited evaluation and observation for 48 hours, but antibiotic initiation is not necessary unless clinical suspicion arises. (4)(31)(32) Asymptomatic, at-risk infants who [ncbi.nlm.nih.gov]
Long-term survivors may show mild abnormalities in pulmonary function and are often asymptomatic unless they progress to the fibrotic phase. Incorrect diagnosis ARDS is a diagnosis of exclusion. [cancertherapyadvisor.com]
Respiratoric
- Respiratory Distress
Respiratory Distress Syndrome, Infant Synonyms of Respiratory Distress Syndrome, Infant Hyaline Membrane Disease Infantile Respiratory Distress Syndrome IRDS Subdivisions of Respiratory Distress Syndrome, Infant surfactant protein-B deficiency General [rarediseases.org]
CONCLUSIONS: Exogenous pulmonary surfactant is an efficient medication for infants suffering acute respiratory distress syndrome after cardiac surgery. [ncbi.nlm.nih.gov]
Infant respiratory distress syndrome is also known as neonatal respiratory distress syndrome or hyaline membrane disease. It is caused by developmental insufficiency of surfactant production and structural immaturity in the lungs of the infants. [imedpub.com]
Homepage Rare diseases Search Search for a rare disease Infant acute respiratory distress syndrome Disease definition Infant acute respiratory distress syndrome is a lung disorder that affects premature infants caused by developmental insufficiency of [orpha.net]
[…] and respiratory distress syndrome in premature twins. 56 Marttila R...Hallman M 12483294 2003 4 Surfactant proteins A and B as interactive genetic determinants of neonatal respiratory distress syndrome. 56 Haataja R...Hallman M 11063734 2000 5 Association [malacards.org]
- Pneumonia
Surfactant inactivation--and dysfunction--is also a hallmark in newborns with meconium aspiration syndrome (MAS), pneumonia and other disorders affecting the pulmonary function. [ncbi.nlm.nih.gov]
Predisposing Cause The largest subgroup was comprised of 13 children with pneumonia (including 1 child with aspiration). Three of the above had staphylococcal pneumonia. [indianpediatrics.net]
Bacterial pneumonia Diffuse collagenous fibrosis Hyaline membranes Onset of respiratory failure 1 week after cardiac surgery Organizing pneumonia Board review answer #1 C. Hyaline membranes Back to top [pathologyoutlines.com]
See Also 8 Pneumonia Nursing Care Plans 5 Pneumonia Nursing Care Plans Last Updated On: February 26, 2019 [nurseslabs.com]
- Aspiration
Meconium aspiration syndrome The pathophysiology of meconium aspiration syndrome (MAS) is characterized by a mechanical obstruction of the airways leading to an uneven ventilation and respiratory failure. [nature.com]
Surfactant inactivation--and dysfunction--is also a hallmark in newborns with meconium aspiration syndrome (MAS), pneumonia and other disorders affecting the pulmonary function. [ncbi.nlm.nih.gov]
Direct Breathing harmful fumes or smoke Chest trauma Inhaling vomit (aspiration) Near drowning Pneumonia Indirect Blood transfusions Injury that causes low blood pressure Pancreatitis (inflammation of the pancreas) Severe and widespread bacterial infection [childrens.com]
- Tachypnea
The symptoms usually appear shortly after birth and may include tachypnea, tachycardia, chest wall retractions (recession), expiratory grunting, nasal flaring and cyanosis during breathing efforts. [orpha.net]
Hypoxemia further increases tachypnea. (16)(18) Therefore, affected newborns present with marked tachypnea. Because tachypnea is a nonspecific symptom, additional clinical findings aid in narrowing the cause to a respiratory disorder. [ncbi.nlm.nih.gov]
Direct Links to chapters: 1:59-Chapter 2: Transient Tachypnea of the Newborn 3:32-Chapter 3: Neonatal Pneumonia 5:11-Chapter 4: Respiratory Distress Syndrome 6:41-Chapter 5: Meconium Aspiration Syndrome 8:19-Chapter 6: Case Study Please visit: www.openpediatrics.org [youtube.com]
- Dyspnea
Definition (NCI_FDA) A condition of the newborn marked by dyspnea with cyanosis, most frequently occurring in premature infants, children of diabetic mothers and infants delivered by cesarean section, and sometimes with no predisposing cause. [fpnotebook.com]
Patients initially present with acute onset cyanosis, dyspnea, and tachypnea. [amboss.com]
Presentation Symptoms dyspnea, tachypnea during first hours of life nasal flaring expiratory grunting, intercostal, subxiphoid retractions Physical exam severe hypoxemia not responsive to 100% O 2 atelectasis results in intrapulmonary (right-to-left) [medbullets.com]
Other names: Acute Respiratory Distress Syndrome; ARDS Medication List About Respiratory Distress Syndrome: A condition of the newborn marked by dyspnea with cyanosis, heralded by such prodromal signs as dilatation of the alae nasi, expiratory grunt, [drugs.com]
[…] on exertion followed by dyspnea at rest Hypoxia; PaO 2 /FIO 2 ≤ 300 mm Hg Often sepsis and MODS ( JAMA 2016;315:788 ) Respiratory dysfunction and physical disability may persist for months after remission of ARDS, with gradual improvement ( N Engl J [pathologyoutlines.com]
Gastrointestinal
- Diarrhea
AB - Cronkhite-Canada syndrome (CCS) is a noninherited condition, associated with high morbidity, and characterized by gastrointestinal inflammatory polyposis, alopecia, onychodystrophy, hyperpigmentation, and diarrhea. [mayoclinic.pure.elsevier.com]
In summary, CCS is a rare, non-hereditary disease characterized by gastrointestinal polyposis associated with diarrhea and epidermal manifestations. [alliedacademies.org]
Patients typically present with watery diarrhea and a protein-losing enteropathy with associated nail atrophy, brownish skin pigmentation, and alopecia 3. [radiopaedia.org]
For patients with CCS, diarrhea is the most common initial symptom, which may develop to substantially watery diarrhea, followed with symptoms of malabsorption, including weakness, anemia, weight loss, edema and dysgeusia ( 17 ). [spandidos-publications.com]
Presenting symptoms include watery diarrhea with stool volumes of 4-6 L (steatorrhea and melena may also occur), dysgeusia, dry mouth, partial or total lack of appetite, weight loss (often >10 kg), constant or episodic abdominal pain, and weakness. [orpha.net]
Cardiovascular
- Hypertension
Right-to-left shunting may be severe and occurs through collapsed lung (intrapulmonary) or, if pulmonary hypertension is severe, across the ductus arteriosus and the foramen ovale (extrapulmonary). [patient.info]
It is a rare cause of persistent pulmonary hypertension in infants and may also be a rare cause of pulmonary hypoplasia. [blueprintgenetics.com]
Both infants were profoundly anemic at birth, and developed severe hypoxia with pulmonary hypertension, and responded poorly to repeated doses of surfactant. [omicsonline.org]
Some of which are: Transient tachypnea of the newborn Pneumonia Sepsis Pneumothorax Persistent pulmonary hypertension Congenital lung malformations Aspiration syndromes Treatment Urgent delivery of care to infants with hyaline membrane disease is very [pedclerk.bsd.uchicago.edu]
- Cyanosis
The symptoms usually appear shortly after birth and may include tachypnea, tachycardia, chest wall retractions (recession), expiratory grunting, nasal flaring and cyanosis during breathing efforts. [orpha.net]
Deficiency of surfactant is seen in pre-mature babies and it will lead to infant respiratory distress syndrome which is seen shortly after birth with apnea, tachycardia, respiratory grunting, flaring of nostril, cyanosis, chest wall retraction, atelectasis [youtube.com]
Definition (NCI_FDA) A condition of the newborn marked by dyspnea with cyanosis, most frequently occurring in premature infants, children of diabetic mothers and infants delivered by cesarean section, and sometimes with no predisposing cause. [fpnotebook.com]
- Tachycardia
The symptoms usually appear shortly after birth and may include tachypnea, tachycardia, chest wall retractions (recession), expiratory grunting, nasal flaring and cyanosis during breathing efforts. [orpha.net]
Deficiency of surfactant is seen in pre-mature babies and it will lead to infant respiratory distress syndrome which is seen shortly after birth with apnea, tachycardia, respiratory grunting, flaring of nostril, cyanosis, chest wall retraction, atelectasis [youtube.com]
- Thrombosis
The 5-year mortality rate of CCS can be as high as 50 % (mainly due to GI malignancy or portal vein thrombosis, infection and membranous glomerulonephritis), even with treatment. [orpha.net]
This is usually due to colon cancer or portal vein thrombosis. See smartphone apps to check your skin. [Sponsored content] References National Organization for Rare Diseases (NORD). Cronkhite-Canada syndrome. Updated 2005. [dermnetnz.org]
Complications Acute complications These include the following: Complications related to procedures - eg, trauma to vocal cords from tracheal intubation; infection, embolism or thrombosis from venous or arterial catheterisation. [patient.info]
In addition, CCS was reported to be associated with various rare complications including recurrent severe acute pancreatitis ( 20 ), GI tract cancer, portal thrombosis, a high titer of antinuclear antibodies and membranous glomerulonephritis ( 21 ). [spandidos-publications.com]
Cronkhite-Canada syndrome with colon cancer, portal thrombosis, high titer of antinuclear antibodies, and membranous glomerulonephritis. J Gastroenterol. 2003. 38 (8):791-5. [Medline]. Gys B, Mertens J, Ruppert M, Hubens G. [emedicine.medscape.com]
Skin
- Blister
[…] malnutrition; these include: Patchy and diffuse, mild to severe hair loss on the scalp, face, and genitals Hyperpigmentation, especially on the limbs, neck, torso and body folds Hypopigmented macules or leukoderma on the palms, soles, upper limbs, chest Blisters [dermnetnz.org]
Neurologic
- Headache
Headache 2. Dizziness 3. Labored breathing 4. All of the above 29. While working in a closed space, a Sailor has lost consciousness. [cram.com]
Urogenital
- Renal Insufficiency
Use of diuretics or hemofiltration, in patients with renal insufficiency, is frequent. Currently there is no proof that transfusing hemoglobin levels to super normal levels benefits ARDS patients. [cancertherapyadvisor.com]
Workup
The workup is based on history and physicial examination followed by imaging and endoscopy, while histologic examination is used to confirm the diagnosis of GI polyposis. Endoscopic morphologic findings are not specific. [dermatologyadvisor.com]
See Workup for more detail. [emedicine.medscape.com]
X-Ray
- Atelectasis
Deficiency of surfactant is seen in pre-mature babies and it will lead to infant respiratory distress syndrome which is seen shortly after birth with apnea, tachycardia, respiratory grunting, flaring of nostril, cyanosis, chest wall retraction, atelectasis [youtube.com]
Data indicate that adoption of an open-lung ventilation strategy, characterized by sufficient positive end-expiratory pressure to avoid atelectasis, a tidal volume that is limited to less than 5-7 cc/kg per breath and a plateau pressure of 30 cm of water [ncbi.nlm.nih.gov]
Impairment in the synthesis and/or secretion of surfactant leads to an increase in dead space due to atelectasis and a decrease in lung compliance. [pedclerk.bsd.uchicago.edu]
Data indicate that adoption of a lung protective ventilation with low tidal volumes and of an open-lung ventilation strategy, characterized by sufficient positive end-expiratory pressure (PEEP) to avoid atelectasis, provides the greatest likelihood of [jpnim.com]
As atelectasis and respiratory failure progress, symptoms worsen, with cyanosis, lethargy, irregular breathing, and apnea. [msdmanuals.com]
Serum
- Hyponatremia
[…] dystrophy, neonatal myasthenia gravis, spinal muscular atrophy, congenital myopathies, and spinal cord injury Other Sepsis,a hypoglycemia,a metabolic acidosis,a hypothermia or hyperthermia, hydrops fetalis, inborn error of metabolism, hypermagnesemia, hyponatremia [ncbi.nlm.nih.gov]
Colonoscopy
- Polyps
[…] and histologic features of CCS polyps and polyps in other polyposis syndromes makes CCS a clinicopathologic diagnosis that cannot be made solely based on polyp histology. [ncbi.nlm.nih.gov]
These polyps are harmatomas similar to the juvenile (retention) polyps, but unlike juvenile polyposis, the mucosa between the polyps is histologically abnormal, with edema, congestion, and inflammation. [alliedacademies.org]
[…] syndrome polyps is normal 4. [radiopaedia.org]
[…] with cystically dilated glands and crypts associated with an edematous lamina propria containing mononuclear cells and eosinophils, microscopically indistinguishable from juvenile polyps ( Am J Surg Pathol 1989;13:940 ) Intervening nonpolypoid mucosa [pathologyoutlines.com]
Treatment
Clinical experience seems to justify surfactant treatment in neonates with ARDS. [ncbi.nlm.nih.gov]
Standard Therapies Treatment of infant respiratory distress syndrome consists of mechanical or physical breathing assistance such as positive end expiratory pressure (PEEP). Other treatment is symptomatic and supportive. [rarediseases.org]
Statistically there is a highly significant difference between Surfactant treatment group and not given surfactant treatment group (p < 0.01). [jemds.com]
Evidence suggests early treatment within 2 hours of delivery is more beneficial than if treatment is delayed. They'll also be given fluids and nutrition through a tube connected to a vein. [nhs.uk]
[…] a complication of the treatment is Figure C 5 The chest x-ray would reveal ground glass opacities and the fundoscopic image depicting a complication of the treatment is Figure B M1 Select Answer to see Preferred Response PREFERRED RESPONSE 5 (M1.PL.75 [medbullets.com]
Prognosis
Definition / general Rare, nonhereditary polyposis syndrome of unknown etiology Disorder of middle adulthood, with mean age of diagnosis of 59 years Poor prognosis due to associated nutritional complications Up to 50% have remissions Rarely has a fulminant [pathologyoutlines.com]
The prognosis is much better for babies weighing over 1500 g. Prevention Antenatal corticosteroids (dexamethasone) accelerate fetal surfactant production and lung maturation. [patient.info]
Indirect (source isn’t the lungs): capillary membrane is INDIRECTLY damaged due to a systemic inflammatory response system (SIRS) by the immune system: *Sepsis (most common and very poor prognosis for patients who have gram-negative bacteria) Burns Blood [youtube.com]
This case argues against the poor prognosis previously ascribed to patients with this syndrome. gastrointestinal system endoscopy View Full Text Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use [casereports.bmj.com]
Etiology
In this chapter, we provide a succinct overview of the history, etiology, risk factors, clinical manifestations, diagnosis, and management of CCS. [mayoclinic.pure.elsevier.com]
Mental stress and physical fatigue may also contribute to the etiology. [dermatologyadvisor.com]
Etiology The causes of ARDS can result from direct lung injury, termed pulmonary ARDS, or extrapulmonary where the triggering insult is outside of the lungs. These two etiological subtypes respond in different ways to mechanical ventilation. [radiopaedia.org]
For patients in the observed group infectious etiology was Introduction White dot syndrome comprises a heterogeneous group of autoimmune diseases of a noninfectious etiology that affect the choriocapillaris, pigment epithelium and the exterior layers [yumpu.com]
Published on May 25, 2018 In this video, the viewer will learn the differential diagnosis for newborn respiratory distress, and the epidemiology, pathophysiology, presentation, diagnosis, and management of its most common etiologies. [youtube.com]
Epidemiology
This reinforces the importance of using PALICC criteria moving forward for future epidemiologic studies of PARDS. [atm.amegroups.com]
[…] the result of a scientific and technical-logistical effort that lasted over two years”, explained Giorgio Conti, “which included repeated meetings and which, at the same time, extended the project to a second phase aimed at describing clinical course, epidemiology [researchitaly.it]
Published on May 25, 2018 In this video, the viewer will learn the differential diagnosis for newborn respiratory distress, and the epidemiology, pathophysiology, presentation, diagnosis, and management of its most common etiologies. [youtube.com]
Epidemiological history was positive for upper respiratory tract infection. Personal history revealed that she had been prenatally diagnosed with omphalocele. [signavitae.com]
Epidemiology of death in the PICU at five U.S. teaching hospitals. Crit Care Med 2014; 42:2101–2108 [PMC free article] [PubMed] [Google Scholar] 11. Quasney MW, Lopez-Fernandez YM, Santschi M, et al. [ncbi.nlm.nih.gov]
Pathophysiology
The pathophysiology of respiratory failure in preterm infants is characterized by a combination of primary surfactant deficiency and surfactant inactivation as a result of plasma proteins leaking into the airways from areas of epithelial disruption and [ncbi.nlm.nih.gov]
This paper reviews the pathophysiology of ARDS and the management of paediatric patients with acute lung injury. [jpnim.com]
Prevention
The best way of preventing HMD is by preventing a preterm birth. [childrenshospital.org]
Abstract The reversal of lung collapse is one of the challenges of lung injury prevention in pediatric acute respiratory distress syndrome. [ncbi.nlm.nih.gov]
Taking steps to prevent premature birth can help prevent neonatal RDS. Good prenatal care and regular checkups beginning as soon as a woman discovers she is pregnant can help avoid premature birth. [medlineplus.gov]
Prevention The vast majority of babies who develop RDS do so because they are premature. Attempts to prevent early delivery are therefore a major consideration. A number of strategies can be used. [nursingtimes.net]